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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