August 17, 2011

Where are all the grown-ups?

Today I had two surgeries (by "I had" I mean I generally watched and held things): one was a dramatic robotic surgery that was more difficult than they thought it would be so they converted to an open surgery. The second surgery was a suction evacuation of a woman who had had a failed termination of a 9 week pregnancy 3 weeks before and subsequently developed an infection along with not actually terminating the pregnancy. It was one of the most interesting cases I've had yet, not because of the procedure but because of all the ethics and emotion tied up in the case. For starters, it was hard to find staff for the case. It ended up being one attending who did not want it known that she performed terminations and two residents (A first year and a second year) along with a first year anesthesia attending and a circulating nurse who was about my age.

I definitely had a thought before we started like, "but where are all the grown-ups that are usually in the OR with us?" but everything went really well and obviously the OB attending was there, mostly teaching me and confirming what the residents were doing/finding.

After the procedure, we have to confirm that the "products of conception" have been removed from the uterus. This involves piecing through the specimen to find evidence of a gestational sac and organs/structures. It felt very strange but oddly similar to my undergraduate research lab to be searching through bloody mush to find specific parts.

I ended up sitting with the patient a long time afterward because she was so emotional and so scared. It was the one moment this rotation that I've been glad to be a medical student - because I didn't have to run off anywhere to do all sorts of other things and could just answer all her questions whenever she had them. (because otherwise, it's been infuriating to be a medical student and mostly observing...)

Ob-gyn is still going well - I'm done with q2 (every other day) 24 hour shifts on OB and have moved on to the "gyn" section which is a lot of surgery and outpatient clinics, but still requires me to be at the hospital before 5am. A few days ago I had a complete scraping-the-bottom-of-my-barrel-of-energy day where everything felt overwhelming and I felt incompetent. Then I remembered that the last time I got more than 5 hours of sleep at one time was about 3 weeks ago and that I still don't know what meal my body feels like it should be eating. After a run, a good dinner, a glass of wine, and an early bed time (6hours last night, hooray!)


"self preservation is a full time occupation"
-ani defranco

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