On Tuesday, Nicole and I drove to North Shore Hospital, where we'll be rotating with one of the obstetricians, to pick up ID badges. We arrived and waited while other students filtered in, passing the time reading through Blueprints OB, the required text and an astoundingly better book than the one we used for our family practice rotation (incidentally, we received our scores for the shelf, and I scored well above average. Nice). Anyway, eventually one of the hospital liaisons came to see us, and we were told that we'd have to wait until orientation to get our badges, and that there wouldn't be an orientation until next Friday, because the program director hadn't contacted him. Unfortunately, without those badges, none of the students are allowed in the hospital proper, though we are permitted in the doctor's private office. Unpleasant, but oh well - I figured that this would be an easy two weeks, during which time I could really sink my teeth into this novel and confusing culture of obstetrics and gynecology....but we all know how my plans turn out, especially those involving Ross. We called and spoke with the doctor, explained the predicament, and agreed to meet up with him when he was out of surgery. In the mean time, we took a quick trip to Costco - because Target stores everywhere were sold out of my protein powder - and Nicole got into it with one of cashiers over a change to some membership policy. Around the same time, I called and spoke with someone in the central office - the program director was unavailable - and tried to get something sorted out with the badges. They told me they were working on something. We sat and read at Starbucks until the appointed time.
Then we went to the doctor's office, which was absolutely packed, and waited some more, continuing the reading. He showed up an hour or two after he thought he would, which is understandable given the capricious nature of surgery. We finally met him and his cute Ecuadorian P.A. student, and figured out the particulars of the schedule. Fortunately, this is a young, energetic doc who loves to teach. The only serious drawback is that he performs abortions - we won't have to participate or even be present, but this is perhaps the sole issue that indelibly colors my view of this sub-speciality. There isn't anything else in medicine so polarizing. Regardless of the issue, we agreed to meet up with the doc on Thursday - he'd be in surgery all day. Importantly, he told us not to ever wear anything to OB that we'd have a hard time throwing away at the end of the day, so on the way home, Nicole and I detoured to uniform city and picked up a few sets of scrubs. As much as I love my ties, this was certainly the way to go.
Wednesday was nice and relaxing - I had time to read about the complications of delivery, work out, and go on a light jog with Nicole. Midway through the day, the program director sent out an e-mail, alerting us to the fact that (1) there would be an orientation Thursday morning so that we could get our badges (2) there would be a lecture on Thursday, despite her earlier comment, and (3) regardless of how the docs told us to dress, we were to present to the clinic where we'd receive our lectures in business casual attire. See what I mean about the plans? There goes the two weeks of study. A particularly frustrating point of contention was the "no-scrubs-in-the-clinic" rule - it's completely asinine to put on scrubs for the hospital, change into a shirt and tie for the lecture, and change back to return to the hospital. Asinine.
We showed up bright and early Thursday morning - I'd planned to have a heart-to-heart with our program director. This seemed like a good idea - our family practice rotation didn't allow carpooling or other schedule-change requests (because some idiot students had, upon deciding they didn't like a clinic, simply stopped going). I called and spoke with that program director, and very politely wove the conversation in such a way as to talk her into allowing Nicole and I to carpool. I also talked this current program director into the carpooling thing, and so I figured that it couldn't hurt to bring the scrubs issue to her attention. She never showed up. The orientation was supposed to begin at 8am - we also had to go to an orientation at Jackson North at 12 noon - but 8:45 came and went, and no one had arrived. Finally, someone showed up, and my frustration with her tardiness quickly dissipated once she'd told us that the person who'd called her to come do the orientation had never confirmed with her, and this dear sweet woman had come in on one of her vacation days. Bless her heart. So we drove back over to North Shore, picked up our badges, and made out way over to Jackson North.
Fortunately we showed up early, because there was not only paperwork to hand in, but the woman to whom we handed the paperwork screwed it up, and we had to run back and forth between physician services and human resources. Finally, we got things squared away and had ID badges for Jackson North and North Shore Hospitals, allowing us access to all the surgical suites. By that point, it was perhaps 2:00, and though we were supposed to meet up with the doc, we decided that it'd be better to cross town for the 4:30 lecture. I spoke with the P.A. student, and learned that she wasn't supposed to meet up with the doc before 3:30, so it was a done deal.
We returned to the clinic and sat down for our weekly lecture on uterine leiomyomata - the common fibroid. Perhaps they began with this topic because it's so overwhelmingly common - in fact it's the most common tumor in women. That being the case, though, it's something I've been reading about here and there since beginning medical school - so the lecture didn't really provide too much new information. Once that was over, I texted the PA student to see what was going on - and there was a C-section in 15 minutes! Nicole and I hastily put on our scrubs and burned rubber over to North Shore. Unfortunately, we were a few minutes too late - the surgery had started by the time we got there. So, Nicole and I sat out in the lobby.....waiting.....and waiting..... Finally they shut off most of the lights and announced that visiting offers were over....and then came the text. Nicole and I made our way up to labor and delivery (L&D) and met up with the doc and the P.A. student. We followed him around while he rounded on some patients, and around 10:00 that night, agreed that we'd met up on Friday. The doc told us that there were a few ladies who were getting close to delivery, but that it probably wouldn't be before 2 or 3pm; in fact, he told us not to call him before noon. That sounds like my ideal schedule!
So - my uneventful, slightly frustrating 14 hour day ended in a big bowl of lentil soup. Since we were supposed to have the next morning off, I planned out my reading - reviewing the complications and physiological changes of labor, exams of pregnant patients - and planned to take a morning jog, figuring I could relax a bit . What was that I said about my plans?
The call came at 5:45 in the morning - one of the patients was ready to deliver. I should have known that this was an inauspicious omen that would color the course of the rest of the day. I drove like a bat out of hell through the pre-dawn darkness of I-95, realizing that this was the very first experience of being ripped from a comfortable sleep by my chosen career - the first step on a long, long path. Once again, we arrived just too late, though the doc was impressed that we'd made such good time. And so Nicole and I hung around the L&D nurse's station, waiting for something to happen. An older anesthesiologist came by, looking for supplies. He didn't seem that old, but he looked very tired; he was trembling and told us it was because of the flu. So our doc made him promise to go home as soon as possible. He had to sit down to enter a security code to one of the supply closets, and finally one of the nurses had to go open the door for him. Then he placed an epidural, and went on his way.
There wasn't any time to get coffee or a meal, and so I felt as if I was swimming through cotton when the doc started giving us a lesson on fetal heart monitoring. Fortunately, I'd covered a lot of it in my reading. He was telling us about accelerations and decelerations when, out of the corner of my eye, I saw Nicole's head moving strangely. I wondered what she was looking at, and before I knew what was happening, she'd gone limp and was on her way down. I caught her and guided her to the floor, and we were immediately swarmed by nurses with orange juice and smelling salts. She stared at the ceiling with glass eyes while I patted her cheek, until she came around a few seconds later, terribly embarrassed. She said that she'd just gotten really hot all of a sudden, thinking that she should sit down - and then we were all around her. After one of the nurses made her some coffee and got her a donut, she was as good as new.
We stood around waiting for something else to happen after that, and finally they called the doc back because one of the patients was ready to deliver. It was my first time seeing anyone give birth, and after watching Nicole faint, I was wondering how I'd handle it. One the one hand, I was nervous that I'd be grossed out, but on the other hand, I'd been told how amazing it is, and that it makes one think of the miracle of life. The reality was somewhere in beteween - this particular mother was very calm and at-ease - she'd actually walked passed us in the lobby last night while we were waiting for the doc. She took a few deep breaths, gave a few good pushes, and her little boy popped out with a full head of hair. As I watched his entrance in the world, I couldn't help but recall all of the changes that happen when a baby takes their first breath of air, and their physiology switches over from womb to world. He was a perfect little guy - all of his fingers and toes, pink and healthy, and screaming like there was nothing else to do.
The second birth I watched today was far different - this mother had had 2 epidurals and was still in serious pain. She was dilated to 8cm hours before, but after checking on some patients in the mother and baby section, we got the call that she was ready to go. There was a lot more screaming to this one; it was more how I imagined it to be. The mother was in a lot of pain and was exhausted from her labor. Finally, she squeezed out her perfect little girl, also pink and hollerin'. The P.A. student had shown up by then - apparently, she only watched 3 deliveries before the doc really let her participate. For this birth, she jumped right in like an old pro - helping position the mother for the birth, and then delivering the placenta. I don't feel like I know anything about obstetrics yet, but I guess I've seen enough to be useful.
After checking on and discharging some other mothers, the doc told us that it was unlikely for anything else to happen before 3 or 4 this afternoon, so we were done for a while. We were headed down the stairwell to the parking lot when he turned around to us and said "Hey - you guys remember that anesthesiologist from this morning?"
"Yeah, "I said - "He told us he was shaking because of the flu".
"No," said the doc "He had a stroke."
"What? When?"
"This morning."
Wow. Luckily, there was no place better to have a stroke than in a hospital. Wow.
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