Tuesday, November 25, 2008

11/25/2008

Family & Friends,

In anticipation of Thanksgiving on Thursday, I send my love and wishes that I could make it home to see people…but alas, I am scheduled to be on call Thursday (more on this in a minute) and will be in Wisconsin until Christmas time. Hopefully I can see a lot of you during the week I have in Utah between Christmas and New Years.
It seems to me that there are a few topics that I write about that get a lot of response from people. One of those topics is Chopper the mutant man-eating Godzilla dog who lives upstairs. The other is anything regarding me and OB/GYN – I guess the image of awkward ridiculous single me trying to deal with female-issues gives people a big kick (frankly it is funny in retrospect, though usually mortifying at the time!) Having said this, I guess I’ll be batting 50% in this letter. I really don’t have much to say about Chopper – he’s as big and dumb as ever – but I am 2 weeks into my OB/GYN rotation and I’m collecting embarrassing moments at an alarming rate!
Let me attempt to set the scene a little bit and describe what rotating through OB/GYN is like. First let me state that I respect most OB/GYN doctors I’ve met. Most are nice and reasonable people. They do good things and help with issues that need to be handled. I even find that I quite enjoy most of the work that they do (delivering babies is neat, surgery is neat, the medical chart notes they are required to write are short – a BIG plus in my mind) however, they have the WORST lifestyle! Seriously, you will never meet a bigger group of work-a-holic insomniacs in your life (outside of neurosurgery, that is). Every few days they have to be “on call” which means they work a ~30 hour shift (from 5:30am to about noon the next day) and of course as students we have to pull similar hours. I’m actually post-call today, which means I haven’t slept since 5am yesterday (it is currently about 4:30pm today). I will sleep tonight, work a 12ish hour shift tomorrow, sleep again and then begin another 48 hours of wakefulness. I’m only on this rotation for 6 weeks…I can’t imagine how people do this year in and year out! They are stronger than me I guess!
Anyway, most of the time I’m on the Labor and Delivery floor working with women who are actively in labor. What I do is meet the women when they first get there. I ask a whole bunch of questions, do a brief physical exam and then leave for several hours to write up all the information I gathered from the interview and exam. Several hours later I pop my head back in and make sure everything is going okay. This continues until the woman’s cervix is dilated to somewhere around 8cm. Once this happens the doctor and I rush in, throw on sterile gown/gloves/mask and join the nurse in helping the lady have her baby. I find it funny (maybe that is not a good word-choice) that really it is the nurse who spends all the time with the woman. The doctor and I just sort of show up for the exciting part and then leave again…strange, but oh well!
I have observed that there are several types of laboring women. There are those who have been down this road before. In fact in some cases the babies practically tap-dance their way out because mom’s pelvis just doesn’t offer much resistance any more. These women have sage-like knowledge and do not get ruffled when a stuttering medical student is catching their baby because they simply know that things usually go just fine. In many ways working with these ladies is nice.
On the other hand, there are ladies who would like to kill anything with a Y chromosome – or at very least hit us in a body part of their choice with a ball-pein hammer every time they have a contraction. Not that I can really blame them…I’m not quite sure how much I’d love some stranger sitting down observing me from, shall we say, an unflattering angle while my feet are in stirrups all the while I’m trying to defy the laws of physics by squeezing a cantaloupe through a drinking straw. Frankly, I might get a little grumpy myself!
My first day of work was something of a “baptism by fire” experience. Not only was I clueless about what I was supposed to be doing, I was on call, exhausted, and not yet emotionally calibrated to the birthing process (a feeling that comes surprisingly quickly once you have delivered 7 or 8 babies at 3am). That first night we had 8 or 9 births, 2 of which were emergency C-sections. I decided after that night that there are some fundamental laws of the obstetrical universe:
1) No babies will be born during normal daytime hours
2) All babies will be born between the hours of 11pm and 5am
3) All emergency C-sections will need to happen at exactly the same time even though there is only one team to perform the operations

That first birth really was quite the experience for me. In some ways it was one of the most disconcerting things I’d ever seen. A part of me felt like I was in a real life “Aliens” movie. The other part of me was in awe of the miracle of birth. I will say that despite all the blood and gore of birth, once that wriggling little baby was out and letting the world know he was UNHAPPY my heart sort of melted and it was easy to forget that I had just seen every law of physics shatter.
Well, I’m exhausted and need to cook dinner, so I’ll finish up. Love you all!
-Eric