One Down, Five to Go

Well week one of the OB/GYN rotation is in the books and it has gone much like I thought it would. Since I have been in the Women's Health Clinic this week, it has pretty much been taking histories, doing vaginal exams, pap smears, and other assorted things. Nothing too exciting or challenging. The high point of my time at the clinic so far was finding the fetal heart beat with a doppler (think small microphone that you put against the abdomen which is attached to a speaker) and wathcing the woman's face light up as she heard her baby's heartbeat for the fist time. This kind of thing never gets old I imagine. It was a real Hallmark Moment. Another couple weeks bobbing up and down in this sea of estrogen and I might possibly have shed a tear. ;-)

NAH!

Thursday night I was On-Call.

For the uninitiated, On-Call is what the hospitals now impose on its residents in the aftermath of other, more colorful, draconian methods of torture having fallen out of favor or having been campaigned against by Amensty International. There is no good reason that medical students need to be On-Call, by the way. I suppose it is just a combination of initiation/hazing to, you know, get us acclimated to the suffering; and a brief respite for the beleaguered residents to have eager students around to help them complete the endless list of doctor-ry things they are required to do every night the On-Call demons have them chained to the grindstone. Misery, that promiscuous whore, loves company I suppose.

Thursday was my first of many On-Call nights and it was pretty interesting at least. I got to scrub-in on 2 surgeries. The first was was a D&C on a woman who had a miscarriage a few days before and was still bleeding. The next case was a bit more interesting. A woman who had a C-section a week ago came back with a rip-roaring infection around the incision. (a word of advice: those antibiotics the cute little doctor gave you, don't actually help in the paper prescription form- you actually need to trade that in at the pharmacy for some pills. Some folks need practical advice!)

Her infection was so advanced that she needed to be taken to surgery for Radical Wound Debridement- which is doctor-speak for "We're gonna cut all that infected shit out." (actual quote used by a surgery resident). The procedure involved re-opening the incision and removing large hunks of infected tissue, cleaning out the area with the surgical equivalent of a Super-Soaker with built in suction abilities. (think: handheld upolstery steam cleaner- only with warm water) and packing the wound cavity (now the size of a football) with gauze and leaving the abdomen "open". She will be taken back to the OR in a couple days to rinse and repeat just like it says on the shampoo bottle. It was unsettling to watch the surgeon weild his tools with all of the genlteness of a lumberjack that failed out of his Anger Management classes; but as he explained to me (he must have seen the bewildered look in my eyes across the table) "You can't be ginger with these infections, my good man" and proceded to hack and pummle away at the considerable panniculus (BMI= 52!)

I even got to do a little retracting and suctioning; and the whole event would have been far more enjoyabe were it not for the considerable assault my olfactory bulb was under during the whole procedure. The smell from the infection was so bad that, given the choice, I would have to seriously consider being locked in a phone booth with a goat herder. In August. Who had eaten chili the previous night- to be less offensive to my sense of smell then the fragrances wafting out of this poor woman's wound!



Ain't medicine fun!