Back to work

Ok, didn't post over the weekend. But it was back to work today, so back to blogging. For better or worse, not a lot to write about today. The woman I was following looked like she was on the verge of delivering all day...and finally started pushing just as I left for PBL. And there weren't enough C sections to go around. So I ended up doing a lot of reading today...hopefully that'll help me not embarrass myself tomorrow when I start doing clinic work with Dr. Jaja. We'll see how that goes, but having met and worked with him briefly last week, I think this might turn out ok. I'll be as detailed as possible in my description of how the days run to give anyone who might be interested in signing up for this alternative a feel for what happens on any given day.

I guess the one thing that did happen today was a PBL that spent a great deal of time discussing contraception and sterilization. It really sort of made me think...the way the facilitator approached the topic (and the way that medicine and, indeed, society in general approach the topic) was from a mindset of contraception being a fundamental right. The underlying corollary to this, of course, is that sex is also a fundamental right. Furthermore, there is an even deeper and more insidious understanding that we as human beings should be able to do whatever we want without consequences or responsibility. And by these flawed understandings, we have taken an act that stood at the pinnacle of human relationship as a total, reciprocal self-giving and turned it into a cheap tool of quick pleasure, a Saturday night "hook-up." It has been said by many theologians that sexual intercourse, the act of conjugal love, is the nearest we can come in this life to approximating the love of the Trinity. But by removing the consequences and the need for commitment, by removing the responsibility and gravity that once attended sex, the act itself has become meaningless and emotionless, having no particular value over and above any other means of showing affection or obtaining pleasure. The message today is that sex is fun, babies are inconvenient, and that the individual's enjoyment is the most important thing. Hakuna matata, right?

...but didn't Simba eventually realize he was wrong for leaving his responsibilities behind? Maybe, someday, we will too. Anyway, that's my sermonizing for the day. Back tomorrow with new and exciting stuff! Till then, peace and God bless!

Lots of cutting

Just a brief post today. It was a day for C-sections (kind of like yesterday), and I scrubbed in on two; I think we only had one or two women deliver vaginally during the entire day today. The only other clinical event of any significance was a pregnant patient who had a condition called for her when it appeared she was having a seizure. From what little I could gather, neuro thought that this was another (likely deliberate) pseudo-seizure, as she has been found to have similar events many times over the last few days. This was particularly sad because she had been told by one of my residents earlier in the day that seizure meds (Ativan) were bad for her baby but if she appeared to seize he'd have no choice but to give her that medicine because seizures would be even worse. I hope there's another explanation, but it'll have to wait until Tuesday.

The "I'm kicking myself" special of the day: I wasn't paying close enough attention right after I came out from my first C-section of the day, so I completely missed an opportunity to scrub on a delivery of twins. That may end up being the biggest regret I have from this rotation.

Anyway, that's all for now...if I have a little discipline, I'll post on other topics over the weekend. Till next time, peace and God bless!

A Tale of Two Days

It was the best of times, it was the worst of times. We'll start with the bad so that we can finish with the good. The day finished with a lecture on abortion delivered by a prolific abortionist(who, ironically, is associated with the "Family Planning Center"). The lecture, billed by the course director as being focused on the medical aspects of abortion, sadly failed to live up to that description. Instead, it was an hour long cheerleading session about the benefits of abortion and how low the risks are compared to delivering a baby with occasional tidbits of actual knowledge thrown in. The words "studies have shown" were thrown around a lot, but with no actual citations to back them up. Having reviewed the literature myself in the past, I think his claims were greatly exaggerated; when I have a little time, I'll go back through and find some of the articles I've read in the past. He also dismissed the pro-life movement as being "anti-choice" and our ethics, arguments, and evidence as "just rhetoric." Just for kicks, he also threw in an incredibly inappropriate description of the abortion process that is not suitable for print; if for some reason you really want to know, ask me by some other means.

Anyway, after the lecture ended, I introduced myself to him as one of the pro-life students he had spoken about. I said that I respected his opinion though I disagreed with him, and I asked him to please have a little respect for my beliefs and those of like-minded people. His response? "Sure, I respect your beliefs, but that doesn't change the fact that you're anti-choice." I told him that I respectfully disagreed, and that I didn't think that name-calling by either side was conducive to a productive dialogue. He replied "I won't argue with you. You can't call me anti-life, I'm very pro-life. I believe that people should be able to live however they want. You're anti-choice. You don't think a woman should be able to choose how she wants to live." I again told him that I respectfully disagreed and that I could produce evidence to support my beliefs ("It's just rhetoric," he snorted), but that I wasn't looking for an argument, merely for a little respect. "Psh," he said, "fine. I respect your opinion." And he walked out of the room. So yeah, first serious challenge of the rotation there. Dunno how this will play out long term, but if I never have to work with this individual again, it'll be too soon.

Anyway, the good...today I actually got to deliver a baby. Not to watch one delivered, not to have the intern's hands doing all the work over top of mine, but to really, truly be the one to work the baby out of the womb and into the world. Before too long, everything in the preceding paragraphs will be forgotten. This I will NEVER forget. It was a C-section delivery, and the PA had just incised the uterus so that we could bring the baby out when the attending said to me "Hey Seth, do you want to deliver this baby?" I don't remember what words found their way out of my mouth at that point, but the upshot (clearly) was "heck yes!" "Ok, here's what you need to do..." I had learned all the techniques, but many of them deserted me in the face of this actual delivery...and the fact that it's a lot less scary to push really hard on a mannequin than to exert serious pressure on a baby. And I do mean SERIOUS pressure. It takes a lot to get the shoulders out. I didn't do it perfectly, but I got the little guy out in one piece and in perfect health, and that's what counts, right? Hopefully I'll have a chance to do that once or twice more before this part of the rotation ends, but regardless, I think (and hope!) that this delivery will forever remain etched in my memory.

Anyway, that was the day. I'm sorry to have to spoil the delivery of such a beautiful, awesome creature with a story of a sad, confused, insecure individual, but I promised I'd chronicle the challenges associated with the rotation, and unfortunately, that's going to be one of them. Still, though, disheartening though that encounter was, it'll drift away with the morning breeze and leave the memory of a beautiful newborn baby boy screaming his lungs out while resting in my hands. Still can't get over the sheer awesomeness of that. Anyway, until next time, all...peace and God bless!

Long day = short post

Mostly a good day today. On post-partum rounds this morning got caught briefly in the awkward situation of being in the room while the intern was counseling a patient about contraceptive use. For better or worse, it was short enough that I didn't have time to leave the room. Otherwise, the day was highlighted by two vaginal deliveries (aptly described by one of my classmates as "so gross but SO AWESOME!") and an uncomplicated C-section resulting in three healthy children and three ecstatic families. The residents were also in full teaching mode today for some reason that I'm not going to question, so it was a productive day both in terms of skills and knowledge. No other real issues, blessedly. That will, unfortunately, likely change tomorrow when an attending with whom I've unfortunately crossed paths before delivers a lecture on abortion. Suffice it to say that if it's at all similar to the one he delivered 6 or 7 months ago, I'll have plenty to say about it in this space tomorrow.

Anyhow, I guess so far this hasn't been bad. I hope and pray that lasts, and that the good news delivered by another classmate (maybe we'll get a pro-life Ob-Gyn option after all!) comes to full fruition before next year. That's all from me for tonight; hope everyone's doing well. Peace and God bless!

Pure wonder

Early start this morning...got onto the floor a little before 5:30 to meet the intern. I got to hang out in the nursery while we were waiting, so no complaints there. Shortly thereafter we began helping out with postpartum rounds. Once more the issue of contraception came up, as one of the expected questions for the new mother is "what kind of birth control do you want to use?" It's kind of sad, really...you're talking to this woman, often holding her child, and you're supposed to ask how she wants to make sure that she won't be holding another one anytime soon. Anyway, once again the intern (different intern this time) rather surprised me with the pleasantness of her reaction to my statement that I could not and would not counsel about contraception. Of course, the patient I saw had had a tubal ligation after her delivery, rendering the question rather pointless...

The next thing for the day was grand rounds, which was a pretty decent account of the history of obstetric anesthesia. The presenter's occasional references to religion caused a bit of eyebrow raising on my part (I may have been reading too much into it, but it seemed like she set up a sharp contrast between the logical, humanistic view and the "religious" view which was exactly the opposite), but it wasn't a focus of the presentation. From there it was back to the clinical floors.

At one point when all three of the MS-3s were together in the central team area, one of my classmates asked me about what I had said on rounds about contraception, wondering if I could clarify a little about my moral stance and the reasons for it. In the end, it turned into a pretty decent discussion among the three of us; I'd like to think I did something to clarify my understanding of (and the Church's teaching about) abortion, contraception and sterilization. As a quick aside, if anyone has questions about any of those things, I'll be more than happy to speak with you about them.

After that came the true highlight of the day. I had signed up to participate in a 10:30 C section, but when I got to the OR at 10:17, I was just in time to see a real live miracle. One moment there was nothing but a hole in a woman's abdomen; not ten seconds later the surgeon was holding a baby girl. She was pretty blue (which I'm told is fairly common), but otherwise looked great. I couldn't see mom, but the look on dad's face told a story more eloquent than any ever written. It took a couple of minutes for the pediatrician to assess the infant (she was a breech baby, relatively cyanotic as previously mentioned, and needed a bit of a workup, which I was blessed to be able to help with), but when he was finally able to bring the child to her father...it'll have to suffice to say that no words exist that could do justice to the beauty of the moment. Everyone should have the opportunity to witness that at least once...it was an instant of truly pure wonder.

The rest of the day was pretty smooth, although nothing nearly so exciting as the delivery happened. I met a few more expectant mothers and nervous families, went to a lecture, and did the standard clinical-ish things. So far, two days in, things have been ok; I'll be hoping and praying that that continues.

That's all I've got for now...back with more updates tomorrow. Till then, peace and God bless!

...Well, I guess that wasn't so bad...

Actually, today could have been a lot worse. The day started off with an orientation by the course director and course coordinator, which was fairly routine. During one of the breaks, the course director asked me to hang around and chat for a minute. He told me that my beliefs would be respected completely during the rotation, but warned that there might be a few "hiccups" along the way. These, he told me, he wants to know about so that he can take appropriate action to prevent recurrences in the future. That was promising, if slightly ominous. After lunch, we began the clinical part of the rotation. I'm starting with labor and delivery (L&D), so two classmates and I reported to the central control area in the L&D suite. There we met our residents, who began to orient us to our surroundings. They seemed genuinely interested in teaching and began doing so immediately. One of the things that came up was post-partum rounds in the morning. The PGY-2 we're working with had compiled a one-page summary of key questions to ask, facts to include and abbreviations to know for progress notes. One of the questions specified that the patient was to be asked what kind of birth control she would be interested in going forward. A few moments later, I had an opportunity to go see a patient with the intern. On the way over, I took a deep breath and explained that I wouldn't be able to recommend or counsel patients about birth control. I frankly expected her to be annoyed, but she just nodded and basically said "Ok, just remind me that you haven't discussed that with the patients." She kept teaching, too, and didn't seem to treat me any differently. She even let me use the ultrasound (highlight of the day, definitely!). She and the PGY-2 also taught us how to read the fetal monitors, which promises to be a useful skill for the rest of the week. All in all, I was pretty happy with the residents and had a fairly good clinical experience today. The day finished with a lecture on peripartum care and the delivery process which was OK but pretty scattershot; the lecturer often went off on tangents before completing full thoughts. Oh well, given that the rest of the day mercifully went pretty well, I can deal with a disorganized lecture.

Anyway, that was day #1 on Ob-Gyn. All in all, I have to say it was a pretty decent day. If all my residents and attendings are like the ones I met today, maybe this won't be such a nightmare after all. We'll see how it goes...day #2 starts at 5:30 tomorrow morning. Back with more tomorrow evening; till then, peace and God bless!

A true "defining moment"

Actually, it's a "defining month," but that's just semantics. So here's what's going to happen...each day for the next month (while I'm on Ob-Gyn), I will be chronicling my adventures (and my misadventures) in this space. I will attempt to be as fair and objective as possible, but I will warn you now: I WILL make editorial comments on both the good and the bad. Also, in case you haven't gathered from the title of the blog (and from my bio), I am a practicing Roman Catholic and I have strong objections to abortion, contraception, and sterilization. Part of the objective in my taking time to do this each day is to give a firsthand account of how these issues arise in daily practice at Magee and to what degree a pro-life student will be affected by them.

All I can say now is that I'm terrified. I don't quite know what to expect...I've heard so many different stories from so many different people, and I have no idea what my experience will be like. I guess I'm hoping for the best, expecting the worst, and praying for the strength to stand strong and not falter. Orientation starts at 8 tomorrow...prayers would be tremendously appreciated, both then and throughout the rotation.

One last thing: I've decided I'm going to make a conscious effort to be as positive as I can, so as a theme song of sorts I've decided on one of my favorite hymns (sorry, this was the best version I could find on YouTube). Peace and God bless!



"And whether our tomorrows / Be filled with good or ill, / We'll triumph through our sorrows / And rise to bless Thee still!"