Monday, April 27, 2009

"Surgery" Rotation

I am on my very last rotation of medical school. (Whoa!)

This last month fulfills a requirement for a 4th year surgery experience. Not being a very big fan of surgery (or some surgeons, or surgeons' hours), and wanting to do something that would be of some use in a family practice career, I scheduled a rotation in Maternal-Fetal Medicine (also called perinatology, or high-risk obstetrics). Since this is an OB sub-specialty, and OB-GYN is a surgical specialty, it fulfills the requirement.

The MFM doctors do three main things: they read a lot of ultrasounds, they see high-risk pregnant patients in clinic (such as women with diabetes or other chronic diseases, or women with a history of obstetrical problems), and they help supervise the Labor & Delivery ward.

My main goal with the rotation is to get more comfortable reading ultrasounds, and I am well on my way with that.

But today, I spent the day in Labor & Delivery. It turned out to be a very, very busy morning. The second of the scheduled C-sections got postponed due to an emergency when the poor woman was already anesthetized and waiting on the OR table! The OB residents were tied up in the other operating rooms, so the consultant I was working with decided that he would just go ahead and do the C-section. He insisted to the nurses that he did not need them to call a backup doctor, that he was perfectly comfortable doing the surgery with me as his assistant.

And so, we did. It was actually really fun, since I got to be more involved with a much better view than ever before (during my OB rotation last year, I was often the second-assist, and held the bladder retractor). The most exciting part was that I actually helped to deliver the baby—once the doctor made the uterine incision, the baby's head started to come out (still in the bag of waters! I could see him turning his head around just underneath the membrane!) and my job was to push down from the top of the woman's belly as the doctor guided the head out. Worked like a charm, the baby slid out, the doctor cut the cord, I handed the baby to the pediatrician waiting in the wings, and voila!

According to the nurses who were helping out in the room, this was the fastest C-section they had ever seen. Good to know, if your baby is in distress and needs to be out right away. And certainly not sloppy in any way, just very efficient. So, now I have been first-assist on a C-section (this will probably happen more in residency, but seems like a pretty big deal to me right now). And I don't have to feel guilty about having a surgery elective with no surgery!

In honor of hanging out with newborns, here is a reminder of how Brynna looked just shy of 9 months ago:

Quite a difference now:

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