Saturday, October 31, 2009

Kevin learns some important facts about childbirth

Ah, 3rd year. The promised land every 2nd year is dreaming of and the 9th level of hell that every 4th year wishes they could forget. So far David has given you a glimpse into the life of a 3rd year surgery rotation student. Now that I’m done with my OB/GYN rotation, I feel obliged to share some intriguing insights into the entire miracle of childbirth that people might not know.

1. It takes a long time
I know what you’ve seen in the movies: Katherine Heigl is out eating some dinner, talking about nothing, when suddenly her water breaks. She goes to the hospital and 15 minutes you have a baby. Not so much in real life. Life on the labor and delivery floor for a medical student is long and tedious. Your duties include watching the mom groan for a really long time, checking the fetal heart rate and then going back to watching the mom groan. Luckily most women are reasonable enough to ask for an epidural (or they’re so beaten down by the constant sensation of having a human being pass through their vagina that they’re willing to compromise on their previous beliefs) so that it’s mostly just waiting without having to hear the groaning. But really, the entire process from onset of labor to actual delivery can take hours, hours where you’re not allowed to sneak away and go watch ESPN in the doctor’s lounge. Or so I’ve been told…

Sigh... if only

2. It smells really really bad
Despite all the lectures about fetal positioning, physiology of pregnancy and the birthing process, no one bothered to tell me child birth is by far the smelliest processes a human being can experience. I mean seriously, it’s awful. First of all, everybody poops, especially in childbirth. When the pushing process takes an hour or two, it’s just a constant dribble of little poop balls. Luckily the nurses are really good about whisking them away but unfortunately the smell is always just hanging in the air. Then once the baby is delivered, there is a huge gush of amniotic fluid, blood, vernix and sometimes meconium. In case you don’t know what vernix is, here’s what up:
“Vernix has a highly variable makeup but is primarily composed of sebum, cells that have sloughed off the fetus's skin and shed lanugo hair.”

So in other words, if you were able to collect BO from 100 fat hairy dudes and somehow condense it into a paste, you’d have some vernix on your hands. I’m absolutely sure vernix was invented just to be the bane of my existence. Well… at least 80% sure.

This reminds me of one delivery I was on where I caught a vernix covered baby onto my chest, right between the numbers. Even though we clamped and cut the cord in a reasonable amount of time, it was too late. I was pasted in baby goo. No matter where I turned, the waft of vernix followed me. Unfortunately I still had to deliver the placenta (another thing people never tell you) and check vaginal lacerations. But, after being hit with the fetus grenade all I could focus on was not vomiting. Every time I moved, it would stir the air and I’d get a little more of that cheesy goodness. By the end I think I was taking about 1 breath a minute. If I was on a pulse ox someone probably would have called a codeAfter that delivery I had to excuse myself to dry heave in the bathroom.

3. You have to be happy for the parents
Maybe this is just a personal struggle of mine but I have a lot of trouble mustering up the happy feelings at 3am in the morning to congratulate the mom and dad on their new baby. Clearly the birth of a child, especially the first, is one of the greatest moments a person can experience… unless it’s not your baby, and especially if you’ve already seen 5 that day. At the end of the day, I really have trouble feigning the fake joy necessary to congratulate some new parents on their new baby, who happens to look exactly like the baby I saw 15 minutes ago. I can say he looks cute but really, that’s not true at all. New babies look like pink little aliens that cry a lot. That’s about all they do. It takes awhile before they develop the chubby cheeks necessary to look hilarious in lobster costumes, which you can then spread across the internet and hopefully haunt them in their adulthood. Until then, they really bring nothing to the table.

This is payback for being so smelly

Monday, October 26, 2009

David Takes Call

As you may have noticed, many moons have passed since our last post. Due to a mind-boggling lapse in (Kevin’s) judgment, our previous intertube oasis at has been seized by web squatters. Still, in an effort to better the world (and stop Amanda from crying), we will soldier on at this address until Kevin can undo his folly.

Meanwhile, Kevin and I have narrowly avoided board failure and transitioned to the world of white coats, SOAP notes, and Jesse’s iatrogenesis. For Kevin, this has meant a fantastic voyage of babies and bad smells, while on Surgery, I’ve realized I was never truly tired at any point in my life until now. To illustrate, here’s a quick running diary of a recent call night.

0400: Mmmm, a fresh new day! Only 30-plus hours until next we meet, bed. I’ll think of you fondly while I’m gone.

0505: Pre-rounds and dressing changes. Note to self: Try not to do heroin.

1015: OR, first case. I don’t even know what you’re asking, but I’m going to go with “atelectasis.” Please don’t take my suture scissors away; they’re all I have…

1400: Second case. Pros: I’m actually touching a beating heart. Cons: I can’t feel my legs.

1600: Back on the floor. Are those my bowel sounds or the patient’s? Will he see if I eat some of his pudding?

1830: ED: Hmm, so that’s the most common orifice to hide drugs and drug-related paraphernalia...

1945: I didn’t realize so many people are allergic to "everything but 'Dah-lowd-ee.'” Must be an epidemic.

2100: If I crawled into the scanner and acted somnolent, would the nap be worth the repercussions while they imaged my head? Tough call.

This is the dream…

0020: If only I had some No Doze

0200: Boo-yah, there’s my second wind. This isn’t so bad. That stapler wasn’t an awful pillow and that guy waiting in the hall stopped giving me the stink-eye.

0600: Rounds II: Son of Rounds. I don’t even remember life on the outside. This must’ve been what Brooks felt like in Shawshank Redemption. I hope the sun is as bright as it is in my dreams. I hope…

It’s OK, Brooks. I understand.

0945: Clinic. Can you turn your head and cough, please?

1215: Off. If I don’t make it home alive, at least I touched a heart.