OB/Gyn done!

Well it's been an interesting two weeks. The first week (two weeks ago) was gynecological surgery. It was a fairly easy week, not at all the 6am to 6pm days we were told to expect. It was usually 7:30am to 3 or 4pm with even lighter days on Th and Fr when we only had one long morning surgery each day.

I lucked out in that I was able to scrub for some unusual surgeries. For example, a laparoscopic sacral colpopexy was pretty cool to see. I usually just stood next to the First Assist cutting suture and suctioning blood. Occasionally I got to suture or staple when closing up the patient. But it was still very interesting and I learned a ton.

Last week was days on Labor & Delivery (L&D). The first two days were awful. Nothing happened at all. I got a lot of reading in, but could have done that without the hour plus commute to Desert Banner. Wednesday picked up a lot and was attended by my favorite teacher during the rotation, Dr. Mourad. I had three deliveries and I caught the baby on each one. On the third I was pretty self-sufficient and just needed a little help repairing a couple small tears. It was amazing to see how much better moms push without epidurals. While it is more painful, the moms sure get through the whole process much more quickly. I also got in one C-section with Dr. Mourad where he even let me cauterize some with the bovey. The most amazing thing was that we delivered a healthy (Apgars 7 @ 1m and 8 @5m) 24 week old! The mom had been bleeding, had ruptured membranes and was on steroids for fetal lung development. It's hard to know how well the baby will do over the next few years, but the birth couldn't have gone better.

Fate then decided to play a role in my week. I realized that I lost my last car key in one of the goop bags for the three vaginal deliveries I handled. The nurses were great and helped me look everywhere else. If I had to feel through one garbage bag of used garments and bloody rags I might have considered it. But not three with no guarantee it was in any of them. So I did my Friday 24 hour shift on Wednesday. The bonus was that Dr. Mourad was the attending, it was a relatively easy night and this would allow me to see my boys first piano recital Friday night.

We had one more C-section that night, then I slept in one of the physician sleep rooms until Becky called me at 8am! I actually slept better and more hours than I had been getting at home. When the locksmith was late I called a local Honda dealership. Glad I did because even in 2000, Honda had electric chips in the keys at the locksmith would have had to replace every lock in the car. By 1:30pm I had two new keys and was $270 dollars lighter. I took the rest of the day off.

Friday was pretty uneventful. I make it in time to see observe one delivery which definitely wasn't as much fun after catching half a dozen babies myself. Then I scrubbed in on one C-section that was very messy. At one point we had at least five locking forceps closing squirting arteries. All three of us (surgeon, first assist and myself) were splattered in blood. My two hands were put to good use holding retractors, suction, bovey, etc. I felt fairly useful for a change.

I had a chance to scrub in a twins C-section, but decided to head home early to get ready for the recital. My attending actually encouraged me to go. I turned in my badges, said goodbye to the staff and got home well before traffic started.

I never did get over the dichotomy of old guys with tons of serious conditions and diseases last month at the VA and generally healthy young women having healthy babies this month. If it wasn't for the horrible hours, insane legal atmosphere, stratospheric malpractice insurance ($150k per year) and endless office hours staring at vaginal discharges OB/Gyn would be incredibly cool!

It was a rotation filled some incredible highs with a few great attendings. But it also some of the most mind numbing hours I had with awful attendings, who while good physicians, had no place dealings with students in any capacity. Now it's time to study for the shelf exam on Tuesday and get ready for the Holidays and my long two months in Toledo, OH.