Lessons in humility

I started on my labor and delivery (L&D) rotation last Thursday--and it has been challenging, to say the least. The most difficult part of L&D also happens to be the part on which everything else hinges: the cervical check. Deciding whether to admit a patient? Do a cervical check! Wondering if it's time to call the anesthesiologist for an epidural? Check the cervix! Questioning the progress of labor? Cervix!

Why is this such a problem? Imagine introducing yourself for the first time to a woman who (at worst) is screaming and writhing in pain and (at best) is extremely uncomfortable, then saying, "I'll need to check your cervix." Translation: We just met, and you have a human being trying to escape from your body...but can you please get in a frog-leg position so that I can stick my hand in your vagina? Not only is it painful for the soon-to-be mom, but given my lack of experience with palpating squishy objects that are hidden from my vision in narrow spaces, the resulting pronouncement is essentially meaningless: "Umm...so I think that the cervix is about 3-4 cm dilated, 80% effaced, and baby's head is at -1 station." Recheck by chief resident: "So...she's actually 9 cm, 100%, and +1 station."

Fortunately, all of the attendings and upper level residents are unbelievably supportive and patient. After the scenario I just described, I apologized to the attending for my faux pas, and she said, "Don't apologize! This is for your learning. You got to have the experience of doing an exam that was a 9 but felt like a 3!"Is there such a thing as a 9 that feels like a 3? Probably not...but I appreciated her kindness.

The past few days on L&D have been busy/crazy/challenging, especially the daily (hourly!) lessons in humility that come from being an M.D. but having no idea what to do. On the bright side: I'm getting paid for it! (And I have back-up, so moms and babies are still getting good care.) Hopefully the embarrassment will pay off and I'll become an expert at sterognosis!

In other news: we had our first visitors last week, and it was great! Here are some pictures.

Comments

For my dad

{Dad, third from right, breaking ground at the site of his clinic, ~1987.} On June 24, I graduated from family medicine residency and became the fourth family physician/general practitioner in three generations of Dorwarts. A week later, on July 1, our family gathered in Sidney, Nebraska, to celebrate my dad's retirement after 35 years as a family physician there. I couldn't be prouder of the work my dad has done throughout his career, his dedication to our hometown, his persistence through difficult times, and his unwavering insistence on doing the right thing even when it's not the easy thing. Even though I considered forays into surgery and gynecologic oncology (among other things), I am happy to have found my way to family medicine and to my father's footsteps. Although my dad worked long hours throughout my childhood, I never felt like I was missing out because I appreciated the importance of what he was doing. My perception was that he was spending his d...

5 years later

Somehow five years have passed since I finished residency and since my dad's retirement party (though he had the party, he has yet to fully retire). The passage of time is a funny thing...often when I'm running behind in my clinic schedule or when a patient arrives at 10:30 for their 8:15 appointment, I'll say something about time being a social construct or, "What even is time?" One of my coworkers and I often misquote Friedrich Nietzsche by saying, "Time is a square circle," which is our way of saying that time is meaningless or nonsensical. (I have just emerged from a deep dive into the Friedrich Nietzsche Wikipedia page where I learned or was reminded that the actual quote is "time is a flat circle" meaning essentially that history repeats itself.) Philosophies about the nature of time notwithstanding, for some reason I've decided to write a post. (Incidentally, I now have a 3-year-old daughter who occasionally uses the phrase "...

From Valentine's Day to International Women's Day

On Valentine’s Day, as I was walking back toward the hospital after buying a Coke from the Red Cross canteen (a little shop adjacent to the hospital “car park” where they sell snacks, soft drinks, and sadza ), a man about my age walked briskly toward me, saying, “Hi doc, I’m sorry to interrupt you but can I ask a personal question?” My mind jumped to: where’s the rash? Instead, he continued, “It’s about my wife. She was admitted to the labour ward for an induction today, but now they’re sending her back to the antepartum ward because she isn’t having contractions.” (The labour ward has a strict no visitors policy, which also means no husbands.Throughout the rest of the hospital, visitors are only allowed for two hour-long periods each day.) He went on to tell me about the recent course of his wife’s pregnancy, and I was becoming curious about what the “personal question” would be. After a few minutes, he asked simply, “Do you think she’ll be okay? Do you think the baby will be ...

Go together well

Search This Blog