Saturday, August 11, 2007

Block 2: Obstetrics

Have I told you I love my job? I was getting really depressed during my Radiology rotation. I think the reason was that I wasn't actively doing anything; there was no patient contact, my mind wasn't stimulated and I didn't feel any gratification for my efforts. This month, however, has been a breath of fresh air.

As my third week in OB winds down, I've started to reflect on how much I've learned. I was absolutely terrified my first week. I was a bit rusty on my OB and didn't really have any confidence. As the weeks passed, I started managing different cases, doing more deliveries and it all started to click. OB is definitely gratifying AND I love the patient care. It's all very exciting. Another added bonus is that USUALLY the moms are healthy and all you have to worry about is getting that baby out. Even when there are problems, there are only a finite number of things that could go wrong, so it's alot easier to manage theoretically.

Then I started to think, "Am I enjoying myself because it's OB or because it's Family Medicine?" Today I found my answer. I was on call last night, which involves admitting patients to the Medicine team from the Emergency Department. We had three admissions, and I only got 3 hours of sleep, but I was satisfied mentally, emotionally and psychologically. I enjoy talking to patients, thinking through and diagnosing their problems, and finally managing their medical issues. And aside from all of that I actually CARE about these patients. I care about what happens to them and their best interests. I tell you, it's an amazing feeling and I really couldn't imagine myself doing anything else.

Story of the Rotation:
My third day on my OB rotation, I was hanging out in L&D(Labor and Delivery) looking for patients who might potentially deliver soon. I notice one patient is 9 centimeters dilated. I call my OB senior to come down and help me. We find out that her membranes were not ruptured, so we called her primary OB to ask if he wanted us to rupture her. We did so and waited. Five minutes later, the nurse comes out of the room and says she's bleeding alot. We go in and assess her, page her doctor and wait for the call back. We inform him of her bleeding and he says he'll meet us soon. Right as we hang up the phone, the patient's sister comes running out of the room yelling, "The baby's head is coming out!!" We run into the room and indeed the baby's head had come out(HOLY CRAP!) My senior grabs some non-sterile gloves and supports the head. In OB "sterile" is a loosely used term; the priority is getting the baby delivered safe. So I unsterily open the delivery cart and pull out the bulb to suction the baby, in addition to whatever tools we needed to finish the delivery. Both mom and baby were ok, but that was a crazy situation!!

Lesson for the rotation: GOWN UP! Don't get showered with amniotic fluid gownless!!! It's not pretty.