OBGYN: First Cuts

I’m two days into Labor and Delivery and haven’t had time to really process any of it. The thing about OBGYN is that it’s a surgical speciality. This is less than stellar for a couple of reasons. 

  • Early mornings: We round on our (more than 20) patients no later than 5:30, of course this means that I need to be there significantly earlier than 5:30 to spend more than 3 minutes with my patients, and not look like an idiot on rounds.
  • Late nights: We get out pretty late, and after I go home I still need to study.
  • I haven’t really had a ton of time to think, so my thoughts here aren’t particularly deep.
  • Unlike Orac I am not a surgeon. Anyone who has seen me in an operating room would never ever mistake me for a surgeon.
  • I’m very tall. Most OBGYN’s at my institution (35 of 40 residents) are female. Most of them are short. That means that I’m spending 3-8 hours a day killing my poor back, holding the bladder blade.
  • Did I mention holding the bladder blade? The bladder blade is the implement used to keep the bladder, and part of the body wall, out of the operating field. This allows the surgeon to perform the C-section. I’m told this makes me an important member of the surgical team…

On the other hand. This is the only service I’ve been on where people are so happy! I love that about this rotation. Sure the women are angry and screaming when they’re in labor, but that is to be expected. These are the only patients I’ve seen happy to be woken up at 5 in the morning and asked if they’ve passed gas yet. Don’t look at me funny! Flatus is very important to surgeons – you can’t go home til we know your gut works.

Heck, today I asked a patient that and they said “Nope, but look at the baby isn’t she cute?!”

You just don’t get that on surgical oncology, no one says “Nope but look at that tumor!”

On a completely different note, I still have not achieved my goal for the rotation. What’s my goal? Well I’m going into emergency medicine. I won’t do C-sections as an EM doctor. But I will occasionally have to deliver a baby. I really want to be ready to do that when the time comes. So my goal this rotation? Catch a baby. More officially, “deliver” a baby. I hope that you’ll all wish me luck in my quest to help bring a bundle of joy into the world.

Moving on to general meta-blogging.

I’m having a tough time focusing on specific blog posts right now so I’ve been simultaneously half working on far too many posts right now, including:

  • Last post on Swine Flu: One more research article on the subject, it’s really more on flu in general, to clear up alot of myths I’ve been hearing repeated.
  • Post on Jadedness in physicians: wherein I discuss apparent jadedness as a coping mechanism, among other things. It’s also kind of  a segue into a series of posts (in the very very long run) about the bad parts of medical training.
  • Parts 4 and 5 of HC:Vaccines and Autism. I can guarantee these won’t come before the weekend. The HC posts are really satisfying for me to write, but the research takes time, and I work hard to get the science right.
  • My first actual, thought out reactions on OBGYN, with some answers for the readers who took the time to comment on OBGYN dreamin’.
  • Two completely random posts that are more for me than all of you, but posts that hopefully some people will enjoy anyway.

Feel free to vote for which of those posts you want to come out first in the comments. No guarantees, but I’ll try to take into account what my readers actually want to read rather than my own randomness alone.

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10 Comments on “OBGYN: First Cuts”

  1. leigh Says:

    those sound like long days! good luck getting involved with a delivery.

    i’m curious about your thoughts on jadedness in the medical profession…

  2. nonplus Says:

    Would you mind sharing your thoughts on midwifery – and how it’s viewed in your OBGYN docs?

    Actually, I’d love to read a post about other non-MD health-care workers (nurse practitioners, etc.) and the relationship (and turf wars?, e.g. prescription privileges) they have with MDs.


    • Ya know, I wish I had a valid opinion on this. I’ve heard good and bad things about midwifery. Unfortunately, we don’t see alot of it at my institution. I’m at a tertiary care center, almost all of our patients are high risk. This is a population that midwifery is less likely to handle.

      However, a post about non-MD healthcare works and the relationship/turf wars is now officially on the list of posts to write.

      I’ll tellya the short version right now though. It’s all about defined roles and responsibilities.
      At my institution we have an increasing number of nurse practitioners. It’s not a bad thing. They have a well defined role, and they work in concert with the doctors.

      I suspect that there is more tension in the outpatient setting, where nurse practioners may compete with some primary care doctors. However I will thoroughly investigate before I weigh in!

  3. JLK Says:

    I vote for jadedness.


  4. Well 2 votes seals it. Jadedness post it is – It’s actually expanding into it’s own series of posts as we speak. Apparently I just can’t shut up about things.


  5. I hated two things about medical school. Human Anatomy. OBGYN clinical.

  6. ddw11 Says:

    Never let it be said doctors are in it purely for the money. There is nothing like driving yourself deeply into debt in order to pay someone for the privilege to be at the hospital well before the sun rises for prerounds.


  7. Plastic surgeons in Beverly Hills (who aren’t on call to an ER department somewhere) probably work 8-5. Maybe 3 days a week. Of course with the economy, maybe they took that attending position at USC-LA County.

  8. Dawn Says:

    @Whitecoattales: CNM here. Only a minor quibble. You don’t “deliver” the baby. You CATCH it. Especially in the ER. If the baby is coming that fast that they can’t get the mom up to L&D (and believe me, they will try!!!) all you can do is catch it. The mother does all the work and delivers the baby. (Yeah, I had that beaten into my head during my midwifery days…)

    You are generally right. OB/GYN can be a fun rotation. Tertiary hospitals can see a lot of weird stuff, so learn it and keep it in mind. Believe it or not, you WILL see weirdness even in a little, level I hospital and go, Oh, yeah, I remember that from med school. Even in the ER of that little hospital. Good luck.

    And don’t worry about not being surgically talented. Suturing was not my best skill either, but, as Orac will tell you, it IS a skill that comes with practice.


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