Two weeks ago I shadowed an OB/GYN who specialized in Reproductive Endocrinology and Infertility (REI). I observed half a dozen discussions about IVF, donor eggs, and donor embryos. And I had a personal tour of the IVF lab. It was surreal and confusing and heartbreaking.
Conception and Death
Last week I was rounding on the gynecology service, and was scheduled to scrub in on a ruptured ectopic pregnancy. The same day, I saw a patient with disseminated ovarian cancer who was being "withdrawn" from aggressive ICU care (heroic measures were stopped and she was allowed to die naturally only a few minutes after I listened to her heart and lungs). The beginning and the end of life, in one day.
I have now been to 3 vaginal births and 5 C-sections (one of which was for twins). There was one C-section for prolonged rupture of membranes and severe intrauterine infection. The amniotic fluid gushed a thick purple, like blueberry syrup at IHOP, instead of a healthy clear. The inside of the uterus was mushy and white, instead of the typical mossy red. The baby was a preemie in frank breech, and the NICU team took him and (again, not as usual) didn't bring him back to the Mom before the procedure ended. I hope they do well.
I ended up not scrubbing on that ectopic pregnancy case, but it created a small stir for me. When I was told I was scheduled to do it, I thought, "oh great! I am especially interested in ectopic pregnancy and tubal surgery!" This is I want to save early lives and give couples with tubal factor infertility an option besides IVF! Then I realized, "oh dear. What if the surgery planned is a salpingostomy, or salpingotomy?" Quickly, I looked at the patients records and saw that she was planned for salpingectomy. I breathed a sigh of relief.
For the tubal ligation, which involves cutting of four sutures, I folded my hands and stood at the table, simply observing and listening. I pretended to be forgetful of asking for the scissors. Once that procedure was done, though, I resumed cutting, retracting, and sponging for the rest of the C-section.
I had my first night call last week. I worked a typical day on gynecology (I got to work at 4:50am for rounds at 6:00), and then had a dinner break from 5:00pm to 5:45pm, at which point I worked until about 7:30 the next morning, with a 45-minute nap somewhere in between. That was exhausting. I am not sure I've stayed up for 24 hours before that. Ever. And I've got to do that again tomorrow. Merp.
Overall, OB/GYN is good.
I like the clinic, I like the surgery, and I love deliveries. I don't like all the people I'm working with, and I don't like knowing so little about what I want to do. It's a little stressful, but overall I'm enjoying it. One thing I'm struggling with is how prayer fits in to a 60-hour work week. During the past week, I've been paging the hospital chaplain and receiving communion from him on days I can (and that means I missed two days!), and I've missed parts of the Liturgy of the Hours several times. Even so, I think I am doing God's will, and I have fewer occasions of sin, and my thoughts stray to Jesus more easily.