Friday, April 23, 2010
My classmate's first circumcision :)
Tuesday, April 20, 2010
Heading into home stretch ...
Well. What a time it's been. So many patients, so many situations. Lots of conditions, lots of labs, a few tears.
Grand rounds this morning, on vulva abscess. Very interesting and educational ... especially that antibiotics are not always necessary, sometimes just incision and drainage is all that's needed.
We saw a woman today, her baby died this morning in her womb. 18 weeks old, it just wasn't meant to be. My Doc sat on her bed while I stood at the foot, and he asked her if she would like to hold the baby after it was delivered. She said no, and he told her that many who make that decision regret it afterwards. She thanked him for his compassion. I was of course starting to tear up, as tears had been rolling down her face since before we had walked in the room. He gave her the news that it would most likely not happen to her again, should she decide to have any more children. He was stellar with her, I was very proud of him.
The rest of the day we spent rounding in the hospital. We saw a patient who had delivered while she was pre-eclamptic, and was then being monitored for 48 hours after delivery. We went to lunch and then got a call that a patient was delivering so we dropped our meals and ran. After the baby was out and resting on her mother's breast, the mother wouldn't let the nurses take her new daughter from her. The Doctor had to plead with her, "okay Mommy, we need to take her so that we can clean her, okay?" She shook her head and said "noo!" "Okay?" he asked again. She finally acquiesced. Can you imagine her face? Shining like the sun, so in love, crying and looking down at her little girl. Good times, good times.
Lots of study to come over the next week, a lot.
Grand rounds this morning, on vulva abscess. Very interesting and educational ... especially that antibiotics are not always necessary, sometimes just incision and drainage is all that's needed.
We saw a woman today, her baby died this morning in her womb. 18 weeks old, it just wasn't meant to be. My Doc sat on her bed while I stood at the foot, and he asked her if she would like to hold the baby after it was delivered. She said no, and he told her that many who make that decision regret it afterwards. She thanked him for his compassion. I was of course starting to tear up, as tears had been rolling down her face since before we had walked in the room. He gave her the news that it would most likely not happen to her again, should she decide to have any more children. He was stellar with her, I was very proud of him.
The rest of the day we spent rounding in the hospital. We saw a patient who had delivered while she was pre-eclamptic, and was then being monitored for 48 hours after delivery. We went to lunch and then got a call that a patient was delivering so we dropped our meals and ran. After the baby was out and resting on her mother's breast, the mother wouldn't let the nurses take her new daughter from her. The Doctor had to plead with her, "okay Mommy, we need to take her so that we can clean her, okay?" She shook her head and said "noo!" "Okay?" he asked again. She finally acquiesced. Can you imagine her face? Shining like the sun, so in love, crying and looking down at her little girl. Good times, good times.
Lots of study to come over the next week, a lot.
Thursday, April 8, 2010
Surreal day
Helped deliver this morning. My Doc told me he wanted me to watch his technique ... he dropped the baby. Thank The All for the afterbirth bin! I was sort of in shock when it happened ... the father just said, "what..." All day, I would remember and burst out laughing. It happened at really inopportune times, of course, where I would have to mask my guffaw with a 'terrible cough' ... righteous. Yes, the baby was just fine! Poor thing, with her head in all that muck, just laying there, like, 'look man, this wasn't how I intended to enter the world ...'
Anyhow, then a little later on I noticed the chaplains in a room. I stood outside a few feet away, just listening and trying to figure out what was going on. I heard someone say that the baby was dying, so I went and asked one of the chaplains how old it was. He said, "three weeks", which didn't make any sense, so I went in myself (the mother, a young mentally retarded woman, was in a different room). The baby was 21 weeks. The cutoff for assistance at this hospital is 24 weeks, so they were just letting her pass away. She was so tiny ... frail. Her eyes were fused shut, but other than that she just looked so small and fragile ... almost even normal .. almost. She was lying naked in the bin, and every so often she would let out an agonal gasp. Her lungs weren't hardly developed, so there was no chest rise, but she tried. Her little heart was beating away, ignorantly unaware. There were nurses and nursing students just standing around, not doing anything for this little life who was doomed. So I just stepped in front of all of them and grabbed a blanket and covered her nakedness, and to help keep her warm. Then I took the top of the blanket that was under her, and pulled it up over her head, in a little head covering. My fingers brushed against her skull and it was barely there, it felt so paper-thin that it was probably more what was there of her brains more than anything. Anyhow, they ended up dressing her and waiting for her heart to stop before they took her to the mother, and I said, you know, it would be nicer if you let her die in the arms of her mother, so they listened to me and took her in to her.
I left and moved down the hall to another room, where a delivery was about to take place. I started to tear up, so I stopped and pretended to look at some pictures while I mustered up my strength. I went in just as an observer on this one, but started tearing up again and had to leave the room. I took a few seconds in the bathroom, shook myself off, and went back in. This time the baby was delivering, and the sight of it made me start crying, silently of course. When they put the baby in the heated bin, the father saw that I was crying and he must have thought I was crying out of joy because then he started crying as he walked over to where I was standing next to the baby. Bless his face, what innocence ... he will make a wonderful father, no doubt.
Hours later, I heard a calloused nurse say, "isn't that baby dead yet??" I wanted to slap her, but instead I went back into the room where the dying baby was. There was a wonderful nurse in the room, she was putting everything together in preparation for presentation to the family ... the blanket, the footprints, a few pictures they had taken. I asked if she was still living, and she said she didn't know and would I listen for a heartbeat? I did, and there wasn't one. There was just the body, of this little soul who visited momentarily. I don't know if anyone else loved her while she was here, but I did. Maybe I'll see her around in the next dimension, who knows ... maybe one day she'll do the same for me.
Anyhow, then a little later on I noticed the chaplains in a room. I stood outside a few feet away, just listening and trying to figure out what was going on. I heard someone say that the baby was dying, so I went and asked one of the chaplains how old it was. He said, "three weeks", which didn't make any sense, so I went in myself (the mother, a young mentally retarded woman, was in a different room). The baby was 21 weeks. The cutoff for assistance at this hospital is 24 weeks, so they were just letting her pass away. She was so tiny ... frail. Her eyes were fused shut, but other than that she just looked so small and fragile ... almost even normal .. almost. She was lying naked in the bin, and every so often she would let out an agonal gasp. Her lungs weren't hardly developed, so there was no chest rise, but she tried. Her little heart was beating away, ignorantly unaware. There were nurses and nursing students just standing around, not doing anything for this little life who was doomed. So I just stepped in front of all of them and grabbed a blanket and covered her nakedness, and to help keep her warm. Then I took the top of the blanket that was under her, and pulled it up over her head, in a little head covering. My fingers brushed against her skull and it was barely there, it felt so paper-thin that it was probably more what was there of her brains more than anything. Anyhow, they ended up dressing her and waiting for her heart to stop before they took her to the mother, and I said, you know, it would be nicer if you let her die in the arms of her mother, so they listened to me and took her in to her.
I left and moved down the hall to another room, where a delivery was about to take place. I started to tear up, so I stopped and pretended to look at some pictures while I mustered up my strength. I went in just as an observer on this one, but started tearing up again and had to leave the room. I took a few seconds in the bathroom, shook myself off, and went back in. This time the baby was delivering, and the sight of it made me start crying, silently of course. When they put the baby in the heated bin, the father saw that I was crying and he must have thought I was crying out of joy because then he started crying as he walked over to where I was standing next to the baby. Bless his face, what innocence ... he will make a wonderful father, no doubt.
Hours later, I heard a calloused nurse say, "isn't that baby dead yet??" I wanted to slap her, but instead I went back into the room where the dying baby was. There was a wonderful nurse in the room, she was putting everything together in preparation for presentation to the family ... the blanket, the footprints, a few pictures they had taken. I asked if she was still living, and she said she didn't know and would I listen for a heartbeat? I did, and there wasn't one. There was just the body, of this little soul who visited momentarily. I don't know if anyone else loved her while she was here, but I did. Maybe I'll see her around in the next dimension, who knows ... maybe one day she'll do the same for me.
Friday, April 2, 2010
1st week
A lot of what you can probably imagine ... pap smears, taking cultures, breast exams, prevention counseling. I like viewing cultures under the microscope, I had thought that my days of microbiology lab were over. Nothing else too exciting ... one patient was having unprotected sex with her boyfriend who shoots heroin. She and I had a serious talk, which ended with me saying, "come on, surely you've had this talk with a medical professional before." She said, "I've never had this talk with ANYone before." That made me feel good, but my main concern is that she wisen up and take better care of her health and her life.
Anyhow, as I was leaving my preceptor said, "strong first week, I like it". So that was good. Now a weekend of heavy study on dysmenorrhea and every other subject under the sun, and then back to the clinic on Monday. Tuesday ... hospital scrub in at L&D.
Anyhow, as I was leaving my preceptor said, "strong first week, I like it". So that was good. Now a weekend of heavy study on dysmenorrhea and every other subject under the sun, and then back to the clinic on Monday. Tuesday ... hospital scrub in at L&D.
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