Obs/gyn
And the last two months were NOT easier. In case anyone was following.
It was split into two parts: one month gyne onc, and one month obstetrics. There is no happier place in the hospital than obstetrics. And with the possible exception of pediatric oncology, gyne onc is the most tragic. It was certainly the rotation where i've seen the most extremes.
I tried to get through the gyne part as quickly as possible. Medical or surgical, i'm not crazy about wards. There were some very nice surgeries, and surgeons who did beautiful dissections (can i say that?). and some really nice patients. But it was a string of horrible stories from fairly young women who've had their lives ripped away quite suddenly by ovarian cancer.
There was the occasional normal gynecology case as well. . . A few pregnant women who kept tossing their cookies and needed rehydration and a rest, the occasional ectopic pregnancy. It felt weird to visit them each day as if they were the happy cases. Excessive puking is hardly cheery (especially when you can't take care of your kids or hang onto your job) and i saw some tragic ectopics ending in infertility.
I have found that anything in large quantities becomes absurd. -- Like peanut butter by the drum, hundreds of gay choirs, big statues built by small prairie towns. And I end up with two separate perspectives -- as in both enjoying a spoonful of PB on my toast, as well as knowing that there is a high ratio of detergent to peanut butter required to clean it up when you spill a gallon or so on the floor.
Similarly with heart-wrenching stories in large quantity. Not that i can no longer listen to individuals, but that there is now a new dimension to tragedy that wasn't there before.
I feel lucky that MamaM also works in a "quantity suffering" field (she does rape crisis counselling), and that we can talk about it in those terms sometimes. At the end of a day of hearing horrible-ness one horribil-ity after another, i need some distance. Scale can give distance. And i'm getting through by living with someone who doesn't have to bring it down to an individual level all the time in order to relate to me. We can talk about traumatized vulva as a category (for example) without having to visualise our selves in that situation or remember the trauma of a loved one. . . We can do that too, but all the emotional bits get so intense, sometimes it's good to just sit with the absurdity of hundreds of foosty vaginas for a while before going back to face another day.
Obs was fantastic. But not too much sleeping. Babies don't have a lot of respect for sleep schedules. I wish it'd been earlier in the year, when i had a bit more energy, because obs call was the first time where i really got ZERO sleep overnight. I learned tons and saw tons. I caught a baby with only verbal support, I did most of a few 2nd degree perineal repairs. And i caught countless placentas and examined them. I'm reasonably accurate in examining how dilated a cervix is, and i got to try a hand-over-hand D&C.
I learned that:
* crocs without holes save you from wearing socks with bloody polka-dots
* no form of birth control is 100%
* TAB's - although safer than childbirth- are not benign, and don't erase a pregnancy (duh. obvious in retrospect)
And lots of other things i can't post on the internets.
Someday (like after the match is over) I'll write something about taking my progressive/radical politics to medskool, and obs/gyn will feature strongly in it. For now, two things:
1. In 2nd year, normal gyne exams were initially taught to us by a community-based feminist collective of volunteer patients/instructors.
2. Before medskool, I'd heard the stories about women going for surgeries who, when unconscious, became unwitting sites of gyne exam practice for lots of students.
That never happened.
It is still a teaching hospital obviously, but i only examined surgical patients when i was going to be involved in the whole case, and the staff were blessedly strict about only participating in deliveries after having met the patient.
Near the end of the rotation one of the other students asked me if i would want a family doc or an obstetrician to deliver my own babies. (neither wasn't an option). I got a shocked look for preferring a family doc. "But they're not experts, and things can go wrong!"
It looks like obstetrics is a surgical specialty that aims to keep patients alive, and preserve health and fertility. For me, sometimes, living is more important than not dying. And i have to believe that taking that risk is worth it for myself if i can ever hope to be credible in offering it to people i'm working for.
Next will be ER psych, and wow i need to sit down for a bit.
It was split into two parts: one month gyne onc, and one month obstetrics. There is no happier place in the hospital than obstetrics. And with the possible exception of pediatric oncology, gyne onc is the most tragic. It was certainly the rotation where i've seen the most extremes.
I tried to get through the gyne part as quickly as possible. Medical or surgical, i'm not crazy about wards. There were some very nice surgeries, and surgeons who did beautiful dissections (can i say that?). and some really nice patients. But it was a string of horrible stories from fairly young women who've had their lives ripped away quite suddenly by ovarian cancer.
There was the occasional normal gynecology case as well. . . A few pregnant women who kept tossing their cookies and needed rehydration and a rest, the occasional ectopic pregnancy. It felt weird to visit them each day as if they were the happy cases. Excessive puking is hardly cheery (especially when you can't take care of your kids or hang onto your job) and i saw some tragic ectopics ending in infertility.
I have found that anything in large quantities becomes absurd. -- Like peanut butter by the drum, hundreds of gay choirs, big statues built by small prairie towns. And I end up with two separate perspectives -- as in both enjoying a spoonful of PB on my toast, as well as knowing that there is a high ratio of detergent to peanut butter required to clean it up when you spill a gallon or so on the floor.
Similarly with heart-wrenching stories in large quantity. Not that i can no longer listen to individuals, but that there is now a new dimension to tragedy that wasn't there before.
I feel lucky that MamaM also works in a "quantity suffering" field (she does rape crisis counselling), and that we can talk about it in those terms sometimes. At the end of a day of hearing horrible-ness one horribil-ity after another, i need some distance. Scale can give distance. And i'm getting through by living with someone who doesn't have to bring it down to an individual level all the time in order to relate to me. We can talk about traumatized vulva as a category (for example) without having to visualise our selves in that situation or remember the trauma of a loved one. . . We can do that too, but all the emotional bits get so intense, sometimes it's good to just sit with the absurdity of hundreds of foosty vaginas for a while before going back to face another day.
Obs was fantastic. But not too much sleeping. Babies don't have a lot of respect for sleep schedules. I wish it'd been earlier in the year, when i had a bit more energy, because obs call was the first time where i really got ZERO sleep overnight. I learned tons and saw tons. I caught a baby with only verbal support, I did most of a few 2nd degree perineal repairs. And i caught countless placentas and examined them. I'm reasonably accurate in examining how dilated a cervix is, and i got to try a hand-over-hand D&C.
I learned that:
* crocs without holes save you from wearing socks with bloody polka-dots
* no form of birth control is 100%
* TAB's - although safer than childbirth- are not benign, and don't erase a pregnancy (duh. obvious in retrospect)
And lots of other things i can't post on the internets.
Someday (like after the match is over) I'll write something about taking my progressive/radical politics to medskool, and obs/gyn will feature strongly in it. For now, two things:
1. In 2nd year, normal gyne exams were initially taught to us by a community-based feminist collective of volunteer patients/instructors.
2. Before medskool, I'd heard the stories about women going for surgeries who, when unconscious, became unwitting sites of gyne exam practice for lots of students.
That never happened.
It is still a teaching hospital obviously, but i only examined surgical patients when i was going to be involved in the whole case, and the staff were blessedly strict about only participating in deliveries after having met the patient.
Near the end of the rotation one of the other students asked me if i would want a family doc or an obstetrician to deliver my own babies. (neither wasn't an option). I got a shocked look for preferring a family doc. "But they're not experts, and things can go wrong!"
It looks like obstetrics is a surgical specialty that aims to keep patients alive, and preserve health and fertility. For me, sometimes, living is more important than not dying. And i have to believe that taking that risk is worth it for myself if i can ever hope to be credible in offering it to people i'm working for.
Next will be ER psych, and wow i need to sit down for a bit.
Labels: medskool
posted by lothyn at 6.7.07
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