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ticktockman

Syracuse, NY

Member Since 2006

Followers 50 Following 66

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Sunday Nov 15, 2009

Nov 15, 2009
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This week's much loathed OB clinical was great, and for all the wrong reasons.

First, my poor patient, about 22 hours postpartum, had a seizure. She has a history of them, sporadically, but hadn't had one since January. Transport had just shown up to take her for a tubal ligation she'd been waiting all day for (without eating), and Grand Mal she goes. I felt awful for her, but it was still really cool and will serve as the topic for an assignment.

Second, I was hoping to see the tubal ligation done. Surgery = fun, and at least it gets me off the floor for awhile, but the instructor had told me she didn't have students see them. Tubals are done in the regular OR instead of the maternity OR, and she didn't have the connections. But a doctor overheard her talking about all this and was cool with another student and I watching. Even better, when we got to the OR she let me place the catheter (which I hadn't done save on a mannequin) and let us scrub in and assist in the procedure, holding retractors and so on. Entirely against the rules, and the doctor knew it. With a wink we made a pact of silence on the matter.

Third, I had to watch a delivery, and while C-sections are fine I am no fan of vaginal birth. Revolting! Yet there I was, holding my patient's leg as she screamed out her latest (mind you, I liked the patient and her husband, but birth...ew). I then had to write a couple paragraphs of my "thoughts and emotions as I watched the birthing experience." I think I captured my impressions well (reprinted below the Spoiler), albeit dressed up and dramatized. I like to give these more free form assignments my own particular voice. This led to a 45 minute one-on-one chat with my instructor, who simply could not figure out how to deal with me.

"I have to write your mid-term eval, and I don't even know where to start." "This [the paper] makes me afraid to have you with patients." And so on. Hilarious!

And over that 45 minutes I think we came to some sort of understanding. She'd clearly misinterpreted a few things I'd said, and while I'm actually quite good with patients, she hasn't been around me enough to notice the interactions (and tends to take over when she is). So it all went very well, though the clinical itself still blows.

For your amusement, vaginal birth impressions:

SPOILERS! (Click to view)

It was horror, Lovecraftian in quality and magnitude, the sort of experience
that scrapes across the eyes like a chisel and turns a screw deep within ones
belly. Compelled to take part in this ghastly ritual, I found I could not draw
my gaze entirely free of the unfolding events. The woman screamed out her pain
and effort as though from a turn of the rack as her husband and I held back her
legs, the better to expel her bodys loathsome tenant from the chthonic recesses
of her womb. The heads emergence elicited further shrieking, her nerves
insufficiently shielded from pain by the analgesic pumping between her
vertebrae. Pushing and twisting in a manner that I thought should produce the
snapping of bone and cartilage, the physician forced the offsprings shoulder
free of its mooring and pulled the quivering body fully forth from the mire, but
for the lightly pulsating cord that yet drew some life from the wailing mother.

Its body was ashen gray and coated in a miasma of vernix and grisly ooze. Its
eyes sealed shut against the world, and its bladder vented forth the childs
opinion of being released from its place of rest. The final, visceral link to
its mother rent by the doctors intercession, attendants spirited the newborn
away to be inked, injected, measured, and scoured free of its foul coating.
Moments later, amidst a horrific gush of sanguine effluvium, the placenta issued
forth like a grotesquely vascularized pancake from the griddle of nightmares.
Shortly, the childs skin assumed a more human-like pigmentation, and its weak
cries filled the space vacated by its exhausted mothers silence. Banded on
wrist and ankle and bundled within sheets of cloth, the offspring quieted as its
grandmother delivered the prize to its eager mother. The family reveled in the
peaceable conclusion of their nine month journey and so, being one who delights
in felicitous outcomes for his patients, I felt some small measure of
contentment amidst the unnatural confounding of my senses.

Truly, this was a unique experience. I can only hope it remains so.



Not much else happening outside of school. The ladyfriend's ex just went on a mini-rampage and had to be arrested. She'll get a restraining order but is really stressed and understandably not much in the mood for socializing. It's 70 out. Time for a run. Cheers,

-TTm

VIEW 12 of 12 COMMENTS
paprika:
So happy to make you happy biggrin
Now tell me my friend... when are we going to see a new blog?
It's time for an update already! We want to know what's new in your life...
Tell me are how are you doing?
Dec 21, 2009
naruka:
thank you so much biggrin
Dec 21, 2009

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