Let's give this a try

Just for the record, I find the whole idea of blogging a little bit silly, and I'm a little bit embarrassed that I resorted to starting one. However, when I was way too tired this morning at some ungodly hour after being awake for far too long, I thought it would be a good idea. Fortunately for everyone involved, I didn't start it then. I don't think it would have been all that coherent.

Okay, now that that's out of the way... for those of you who don't know what I'm up to these days (which is most people... my level of communication has really declined recently), I am two weeks away from the end of my third year of medical school at The Ohio State University College of Medicine, and four days away from the end of my OB/GYN rotation, and I am thrilled with the idea of being done with OB. I don't think words could adequately express how much I dislike this rotation--some of that comes from the fact that I'm post-call and my brain isn't very good at coming up with words right now, and some of that is that I just find it that horrible. I have about a million reasons for why that is, but I'll sum it up by saying the hours are really long and the residents are really stressed most of the time, and for good reason. There's a lot that can go wrong in the whole pregnancy/labor and delivery thing, and it's their job to keep those bad things to a minimum. That, and they work even longer hours than I do. The difference is, they're doing what they want to be doing for the rest of their lives. I am not.

Call last night was, as far as call nights go (at least my call nights) not too bad. I was working in the low-risk OB clinic during the day, and there is no Friday afternoon clinic, which meant I had a few hours off before beginning my overnight stretch on the labor and delivery floor. A few hours off means a pre-call nap, which is just about essential for surviving the night. I did get scolded by a roommate for coming home to take a nap instead of staying at the hospital, but I wasn't too worried about that. She seemed to be the only one who thought I shouldn't have done that.

So I returned to the hospital at 5:20, which, as it turns out, was 20 minutes late--I didn't realize the night team started at 5 on Fridays (they start at 5:30 Sunday-Thursday). So I was late for a c-section and didn't scrub in for that, but to me, most c-sections are the same, so I don't feel that I missed anything. There were two others last night, run in staggered ORs, so I only helped with one, a woman who was 27 weeks and six days pregnant (for non-medical people, pregnancy is 40 weeks. 37-42 weeks is considered full-term, 42+ is past-term, 24-37 is pre-term, and 24 and less is not viable). So even just from the dates standpoint, this was not going to be a happy baby, but to add to it (and the reason why we were doing the cesarean), the baby had fetal hydrops, which is severe anemia of the fetus. This baby was so anemic that when he was delivered, he was white. Not white like Caucasian (which he was), but white like a piece of paper. The maternal-fetal medicine specialist estimated his hemoglobin at 3 (normal for a newborn is 14-20). As it turned out, it was 1.5, the lowest the neonatologist has ever seen. When I left L&D this morning, he was still alive and in the NICU at OSU. If he makes it the next couple of days, they might transfer him to the NICU at Nationwide Children's. Sad situation, but the parents are hopeful.

The rest of the night was fairly mundane. While in that c-section, I missed a delivery of a woman I had been following for the first few hours of the night, so there really wasn't much to do other than writing notes on the patients receiving magnesium for pre-eclampsia every two hours. Then a woman came into the ER "in labor" (as I'm being to discover, many pregnant women think they are in labor up to weeks before they actually deliver. The OB residents are pretty good at figuring out which are really about to deliver and which are not). Anyway, we get a call from the ER saying that she is crowning and they're bringing her up. So we're confused about why they're bringing her up, because they should know how to deliver babies in the ER (ER docs do a couple of months on L&D during residency), and crowning isn't exactly a controlled situation that you would risk an elevator ride with. Well, she gets to the floor, and there is no crowning going on--she's about 4 cm dilated (have to be 10 to deliver), and it was her first pregnancy. Things usually present a little slower for the first one. That gave us a good laugh for the rest of the night, though. She did end up delivering before I went home in the morning, but the resident I was with seemed to think that I couldn't handle it (despite having delivered three babies already), so I didn't really do anything. And then it was back to the magnesium checks until the Saturday team arrived at 8, at which point I stumbled back home and slept until noon, then got some studying done. I have to go back tomorrow for the Sunday day shift (fortunately, it's short--only ten hours as opposed to the 12.5 during the week or 26 when on call). So I have to live through Sunday, Monday, Tuesday, and the exam on Wednesday, and I'll be able to put OB behind me forever.

Anyway, that's my life right now. Hopefully I'll be in a better mood and writing about something happier in the future.