Poster on the diner wall

In a bacon and egg breakfast, the chicken is involved but the pig is committed.



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Hurry hard!!

One of my tasks in L&D is to coach the woman in labour. This involves me looking her in the eye, saying "are you ready?" then "OK go go go go go go push push push push push!". Repeat. A lot. I also encourage good pushes that make baby move further down the canal. It sounds pretty goofy while I'm doing it. Even more goofy to anyone not directly involved in the pushing.

One dad who looked like he was stuck in an surreal movie scene started laughing. He said he felt like we were at the Briar and that he expected me to start saying "hurry hard!".

I was laughing too hard to help with the next push.

You can laugh the baby out right?

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I'm loving my Obs Gyne rotation

After having such a terrible experience in clerkship it's great to finally get what all the fuss is about. The nurses in town are amazing. They are teaching me tons and helping make this rotation a lot of fun. Now I know that I want to include some obstetrics in my future practice. That was something I hadn't considered until this rotation. This is what residency should be about.




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Lessons from the don't file

I'm thinking of album names for a friend. Something catchy, memorable, and that will make their album stand out.




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Just call me butt face

There are always what appear to be strings of similar cases in medicine. They work out to be a great way to learn, then solidify the learning by practicing it over and over again.

Recently, it was the skill of artificially rupturing membranes. This involves inserting a plastic hook through the internal cervical os and tugging at the amniotic sac enough to make a small hole. We always check to make sure that there is a hard head well applied. If not, we could end up with a cord prolapse. A very scary obstetrical emergency.

There was one particularly difficult ARM that I did. The internal os was a fingertip open and very posterior. I really wanted to do a touchdown dance when I got the gush of fluid. But that would have been wrong.

Heaven forbid I be allowed to enjoy being so clever and doing so well with my new skill.

During one of our busiest days, I ruptured membranes for an adorable woman quite easily. Later that night, her clever nurse noticed that labour had slowed down and had a strange contraction pattern. Her doc went in to double check the cervical dilation. According to the patient, he was up to his elbow and making a funny face. She was, to be fair, hopped up on nitrous gas. You can't deny though that her baby was breech. I ruptured the membrane over a bum. The patient was kind to me. She said she was sure baby had flipped since I ruptured the membranes. Sweet white lies.

The new skill I'm working on is applying to gel to cervixes to make them appropriate for induction of labour. But I've learned. All these moms are getting Leopold maneuvers and an ultra sound to make sure junior is head down.


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Dear OR nurses,

While I generally have nothing but respect for nurses, I was very disappointed in your behaviour the other night. Usually nurses remind physicians that we need to be respectful of our patients. Hopefully you will understand why I was so upset with you, the small group of nurses in our OR on shift while I was on call.

To begin with, acknowledge that emergency surgeries are just that. When we put these on the board, we aren't trying to ruin your night. I know you prefer to sleep through the last part of your shift instead of having to work it. I also enjoy sleep. Patients don't want to have emergency surgery in the middle of the night. Please remember that sometimes our work is about the patient, not us.

Also, your stage whispers can be heard by everyone who is conscious in the OR including the patient undergoing awake surgery. I'm ok with you talking about me in the disparaging way you enjoy so much. I'm not ok with you talking about the patient while they can hear you, especially about how awful things look while we are desperately trying to calm them down.

I can't express how disappointed I was in your behaviour, or how grateful I am that your attitude is so rare among your colleagues.



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Things that made me smile this morning

1. A huge Irish setter that out of the corner of my eye, and with the sunrise just so, looked like Clifford the Big Red Dog.
2. Hearing Stereo Hearts by Gym Class Heroes on the radio (It's ok if you judge.)
3. Finished my presentation in time for rounds.
4. A chipmunk running around the parking lot of the hospital.
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Words that always give me chills

Please don't let me die.

I hope I never become so callous that these words don't give me goosebumps. What an awesome amount of trust my patients put in me and my colleagues.


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I'd rather be delivering babies

None seem to want to join us in the L&D. Instead, I quilt.


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Have you ever noticed

...when L&D staff get chatting and gesturing wildly, they keep their index and middle fingers together?

Risk of the job I suppose.


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I may have a new crush

There was a baby stuck in mom's pelvis this morning. It was pretty tense. Baby was OP, so instead of looking left or right she was facing the ceiling. After a failed attempt to reposition baby's head, one of the older docs came in. He brought his forceps.

It was like magic.

The tension in the room dropped. Baby was out in a very short time. It was one of the most amazing things I've ever seen.

I think I have a little crush on forceps. They're shiny an everyone was in awe of what they can do.

Amazing.


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Dealing with disappointment

Seeing so many of my colleagues get their first choice in the match this year made me excited for them. It also made me regret my decisions that let to me not getting my first choice of resident.

It was devastating last year when I didn't get my first choice, I tried to pretend I was happy with my placement but I truly wasn't. It took over a month to convince myself that residency, in a town I didn't want to be in, wouldn't suck.

I made my partner and I a home so we would be comfortable where we were going to live for (at least) the next 2 years. It's a comfy house that has a great patio in a nice neighbourhood. We're close to all amenities and less than 5 minutes from the hospital, perfect.

When I met my fellow residents, I was happy. This was as great group to be with.

My home base, a family health team, was welcoming and lovely. I felt like I was a part of the team.

But it still wasn't where I wanted to be.

This is why I did site visits in my first year of residency. No one that I know of was doing visits this year. I needed to remind myself of the happiness that was to come. It really helped keep me centered.

It also encouraged me to change the site I was at to one that would better suit my lifestyle and learning needs.

I start in a new town in July.




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My new definition of gross

Parents who kiss their freshly born baby after they've marinated in meconium full amniotic fluid.
Yes we wipe the kids off first, but still....Ew.




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OMG it's match day!!!

I woke up this morning in a cold sweat before realizing its not my match day.

As is said about another well known, life changing lottery, may the odds be ever in your favour.


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Making friends

It's well known that the best way to get cozy with obstetrical nurses is to feed them.
When one of my nurses was a bit grumpy, I bought some candies and left them at her desk. Minutes later they were put on the doctors desk.
I found out later that this nurse was on a strict diet.
Because the best thing I can do to make friends is poke the bear with a pointy stick.
Oops.
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Not a busy night on call

I've seen only 3 women on my 24 hours of obs call. In between number 2 and 3 I went home, had roast beef dinner and a very long nap.

Going back in to see number 3, I was a bit groggy having just fallen into a good sleep.

When I went to introduce myself, I slurred my words "hi, I'm Dr. Impostrrrrrraaaaa..." and let it trail off. Quickly rebounded with, "so, what's going on with you?"

After much reassurance baby was ok, I get to go back bed.

Next time I'll practice speaking out loud after a good nap before chatting with a terrified patient.

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Guess which room the jaundiced baby is in

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I delivered a baby!!!!

First one ever. Little tyke grabbed my hand on her way out.

Squeee!


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How do they do it?

I forgot how painful a surgical rotation is. I'm expected to be at the hospital and up on all current cases before 7. AM!!!!

My partner was a huge help this morning in making the transition from a 9:00 start. He brought me coffee in bed, changed the temperature in the room to make it more appealing to leave the covers, and bugged me q5 minutes to get my lazy bones out of bed.

I have no idea how residents without partners survive. Though truth be told I'm too spoiled to even be able to think about any other way o life.


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First day of obs

I finally found the cervix!!! Today was my third attempt ever in life. My first two tries to determine a pregnant woman's dilation failed. I had no idea what I was doing.

Today however ... 1 cm! 50% effaced! Mid way! And I was right.

I had been coached by a friend the night before and one of the nurses just before going in. They made it so easy for me!

I'd almost forgotten how joyful medicine can be.




This was a good day.


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