3.21.2009

OB/GYN

I really thought I was going to despise OB/GYN. We're talking angsty, pit-of-the-stomach dread...not just the "oh man this is going to suck alot". I basically thought I was plunging back into the surgery-type dread of not wanting to get out of bed.

It turns out that it's really a lot of fun. It may have been a product of the wonderful people that I worked with in the lovely private facility with the largely private patient population, but it was a nice mixture of everything (Surgery, primary care and babies). Things that I will be taking with me for my future EM career:

1) Pelvic Exams- they're not fun for anyone, but they're not too bad once you've done a bunch of them...except with discharge, those are always bad.
2) SVD's are horrifying- Anyone who thinks that the act of birth is beautiful watches WAAAAY too much TLC or has never seen a birth. Then there's the smell...ohhh that smell of rending flesh, blood, poo and amniotic fluid...ugh.
3) Epidurals are good- You have not heard a blood curdling scream until you've heard a "natural birth." Oh good lord, every time one of those niave primips would walk through the door I would just roll my eyes and try to avoid that delivery room. I definitely learned how to sell the epidural though...something about 20+ hours of labor (aka the worst pain imaginable) without pain control made the case itself.
4) Some women just don't know when they're pregnant- it may be unfathomable to you, oh virgin teenager in the ED with your parents, but your 4 month amenorrhea and weight-gain in the uterus area kind of tipped me off.
5) Drugs and babies don't mix- Just because your first two kids were fine despite your eight-ball a day coke habit doesn't mean that this one will be. Or yes, your baby will be ok, he's just going through withdrawl from your vicodin habit...you can visit him in the NICU. And my favorite: You do realize that you'll probably want an epidural because your nasty pot-habit has caused your child to tip the scales at around 10 pounds...
6) Juno was the worst movie ever in terms of creating mis-conceptions about pregnancy
7) DIC (or disseminated intravascular coagulopathy) is scary shit...
8) intrapartum hypertension+proteinuria=magnesium
9) Don't rupture the cyst- or to quote my favorite attending "If you rupture this f---ing cyst I will literally kill you." For the record, I felt it when before she went to ultrasound.
10) Acute pelvic pain= rule out ectopic pregnancy, ovarian torsion, hemorrhagic cyst rupture, physiologic cyst rupture and PID.

I would have considered OB/Gyn as a career, but if I had to be surrounded by hormonal/pregnant/OCD women for the rest of my career I'd lose it. Never mind the patients...;)

I'm a bad blogger

So it turns out that I've been a very bad blogger over the past several months. I guess what it comes down to is spotty internet access at one clinical site and just straight up boredom on my psych rotation...and now that it's coming to a close I figure that I should probably write at least something down to show that I'm still alive.

I've just been feeling like there isn't much to write about on a day to day basis. I'm much less distressed in the clinical world and as my third year comes to a close over the next several weeks, I'll be looking back at what I've done, reflecting on how it's going to impact my near future and untimately my career/personal life.

But boy do I have stories when I get around to writing them down...these people are crazy.

Stay tuned