Saturday, May 15, 2010

Fourth Year Rocks!

I have to start out by saying sorry, sorry, sorry to everyone who has been trying to get ahold of me, or expecting a call or email that just isn't getting to them. I am exhaused. Currently I'm taking my sub-internship, which is a fourth year medical school elective that focuses on students learning to act as an intern and be more autonomous with their patients in their chosen field. It also kind of acts as an audition at the residency program where you are doing the rotation. I am doing mine in Maternal Fetal Medicine (high risk obstetrics) at a major referral center. I have never been this busy at work in my life. And I love it!

The hours are crazy. I get in at about 5am and leave after 7 most days. This isn't the most I've ever worked since I don't have every fourth day (or q4 in medspeak) call on this rotation, but being over 6 months preggo and on my feet for every one of those hours gets exhausting to say the least. I originally specifically chose this rotation because weekends are free. I need this time to recover right now. And it's a luxury I won't have as an intern. I was worried when I registered that I would have nothing but bad outcomes for my patients and that I would feel sad and overwhelmed for the whole month. This has, thankfully, not been the case.

My patients are almost exclusively women who are pregnant but not yet at term (defined as 37 weeks pregnant), so their babies are premies. They usually have either an obstetric or medical condition that causes them to have a difficult pregnancy or to have the expectation of a difficult labor (or no labor at all). This week I scrubbed on a c-section for a 28 week baby(due dates are at 40 weeks of pregnancy). I have never seen a kiddo that tiny. At this center we have an amazing NICU (neonatal intensive care unit) and this little one has been very well taken care of and is doing quite well. I know they won't all go well over the next weeks, but I love that I can really get to know these women and give them some sort of comfort when they are so uncomfortable most of the time.

And I'm learning SOOO much! It's been a year since I got to spend any time on labor and delivery. It is a place I really like to be. I think the medical issues are challenging and there's surgical issues too. It's definitely the field for me, and even though I'm tired and my feet hurt, I am happy.

I also really love this residency program. I love the residents, and yes, they are exhausted. But I've never really seen residents who aren't tired. Residency is hard. Every one of them. But I think these residents are so well trained. They really know what they're doing and they come out exceptionally well trained. My favorite part is the awesome OB training they get. I think other programs get great surgical experience, maybe better than here, but OB is such a big part of practice and the OBs from here really know what they're doing. I would feel confident after finishing a residency here that I would not panic regardless of what walks through the door. It makes me excited!

I'm not gonna lie, though. Sitting here in my chair with my feet up on a Saturday morning feels pretty great, and after June 4th, when I can do this all the time, I will be a happy camper!!!

Patient story of the week:

A woman was being induced (unsuccessfully) for labor. Her cervix was not dilating much and we were inserting what's called a Foley bulb. It's when you take a Foley catheter (the kind that goes in your bladder), thread it into the cervix, and blow up the baloon. This acts like the baby's head and makes the cervix start to dilate. We were explaining the procedure to the patient and her mother. Her mother had this horrified look on her face and said "they're gonna pop you like a champagne bottle!"