Thus spake Mom.
I’m currently in my final week of the inpatient portion of my first rotation, obstetrics and gynecology. The whole block is eight weeks, but the first month is subdivided into two weeks on “L&D” – labor and delivery – and two weeks on surgical gynecology.
A post about gyn surgery will come later. For now, let me first say that the experience of catching babies, as we call it, is a tremendous life experience. Leaving aside the fact that humans have been giving birth on their own since we looked more like lemurs than people, helping bring a kinda-gross looking eight-pound Alien through a mother’s birth canal is a pretty intense “welcome to real med school” moment.
I have two insider secrets for you: first, a newborn – not the cleaned-up cute little sleeping midgetperson you see swaddled in a blankey and a hat version, I mean the literally bloodstained product of an internal body cavity version – is not cute. It is not at all cute until it has been wiped down like a Mr. Miyagi training session and draped in gender-neutral clothing and a small hat.
Second, the actual process of assisting in a birth closely approximates Will Smith in the original Men in Black (see video). Stuff goes everywhere. There are bodily fluids on the floor. People throw up sometimes. It’s beautiful and kind of scary and you definitely don’t want Chipotle for a little while. Like, for maybe a whole hour.
Anyway. I really enjoyed my time on L&D, because it’s one of the few places in the hospital where the patients usually want to be there. Nobody with a third-degree burn or a COPD exacerbation wants to be in a hospital bed and annoyed by an endless parade of people with needles. Almost-mothers are a little more tolerant of the “Hi, I’m the med student!” talk and don’t complain when you wake them up at 4:30 in the morning (yes, really) to push on their abdomen, pretending to know what you’re pushing for.
On my last day on L&D, I caught a baby by myself. As the med student, you help coach a laboring mother through contractions, especially if it is their first baby. When delivery is “imminent” – a determination made by the senior nurse in the room, not the student thank god – they call for the delivery team. The whole team piles into the room and puts on E.T.-style gowns and gloves. It’s scary as hell. The intern usually does the actual delivery, and if they’re nice they’ll let you put your hands on top of theirs as they guide the baby out.
Okay. So before I go on, remember, women have been delivering with zero help whatsoever for way longer than when we figured out what shoulder dystocia was. In an uncomplicated pregnancy (like the one I’m about to describe) we are practically unnecessary, intern or not.
Anyway. After what seemed like forever, the baby’s head started making moves. As the med student, I’d been there yelling “EMPUJE! MAS FUERTE!” to no avail for three hours already, so I got into a gown and fumbled through putting on gloves. Normally at this point the room has twelve people in it and I get shoved aside, but there was silence. Except for the screaming woman.
The nurse called for delivery. I found out later this was approximately five minutes later than the call is usually made, making me an unexpected Deliverer of Babies. (This was welcome, because my night was supposed to have ended about four hours earlier. I had elected to stay “a little longer” because I mistakenly thought the end was in sight.)
The intern ran into the room, took stock of the crowning baby and the med student crouched down in her spot, and said – and I quote – “Um.”
Um? I’m good to go, boss. I got this. I put my hands into the appropriate position, if the appropriate position is exactly 180 degrees opposite from what I am actually supposed to be doing, and stand at the ready. You want me on this wall, you need me on this wall, etc etc.
“DON’T PUSH!” yells the intern, as she frantically pulled on her gown.
There are a certain set of things you can say to another human being that will be completely ignored. Telling a three-year-old, “No, Bobby, don’t put that Lego into your mouth.” “Play nice, boys.” “I know you’re graduating college in two weeks, but maybe you should study for your sociology exam.”
Telling an almost-mother who has been pushing for three hours and is about thirty seconds away from passing the equivalent of a bowling ball through an orifice normally the size of a Bic highlighter to not push is one of these things.
Especially if she doesn’t speak English.
I would have laughed, if I wasn’t so scared I thought I might throw up on my shoes. Intern doctor, you are awesome and a great teacher and I loved having you on my rotation, but I have been here for THREE FREAKING HOURS yelling “push!” in grammatically incorrect Spanish and I am going to be standing in this spot when this poor woman pushes in about five seconds.
And! I was an (admittedly terrible) wide receiver in high school and I promise you I will catch this baby.
I didn’t actually say that out loud. But it was 5 AM and the thought crossed my mind.
Sure enough, the next contraction came a couple of seconds later. The baby rotated sideways, just like the textbooks said, and I flipped my hands around to the correct angle. A push down, a nudge up, and a gush of fluid later OH HOLY SHIT THIS THING IS SLIPPERY AND IT IS MOVING AND maybe I should just put this down on the mom now.
Boom. Baby out. The intern appeared next to me, “stimulating” the baby to get it to cry. Stimulating is essentially rubbing the hell out of the baby with a towel to a) make it cute and b) prove its lungs work by irritating it enough to induce crying. Which they did.
Everyone went home happy. I left the hospital at about 6 AM and zombie-walked my way to my apartment. I passed out for four hours, which happens to be the exact amount of time until Chipotle opened, and rewarded myself with a burrito bowl before the clock hit noon. With guac. Yes, thank you, I know it is extra, but I brought a human being into the world today. I deserved some freaking guacamole.
Final note: riding an ego high, I came home refreshed from my delicious lunch to conquer some practice questions. On a fifty-question test, I got fourteen correct.
Welcome to rotations!