OB/GYN happened a few months back, but I haven’t blogged about it yet. Area medical student discovers blogging difficult to schedule during third year. Story on page 12. Ahem. Anyway, here are some more lessons learned:
- The human body is freakin’ amazing, and female bodies are amazing in specific ways. I mean, the human ovary, man. This is an organ that ruptures and heals itself once a month for like thirty years. The first time I saw an ovarian cyst removed, I was confused about why we were closing up when the de-cysted ovary still looked like a frittata, but the attending told me, “In a month or two it will have completely remodeled and repaired itself, like you never know we were here.” That’s pretty wild.
- I am not a future surgeon. Yeah I could have told you that before, but I am so strongly interested in reproductive health (this is the one rotation during which I actually looked forward to studying for the stupid SHELF exam) that part of me thought maybe, just maybe. I liked my residents, I loved the patient population, I was interested in the diseases, but I just don’t love the OR. I really like to talk to my patients, which is less fulfilling when they’re unconscious. And I can’t get used to the practice of avoiding contamination by resting my hands on an anesthetized patient as though they were a table.
- Here is a list of surgery-adjacent activities that are acutely physically painful: Standing for hours, sitting for hours, holding retractors in the same position for hours, keeping ones hands sterile for hours by folding them over ones thorax as though preparing to break into a chorus of How do you Solve a Problem Like Maria?, being the first person awake in your whole neighborhood (mediated by emotional pain). Have I mentioned I’m about to start my surgery rotation?
- Ovarian cancer really sucks. I’ve made a pest of my self on every rotation since OB/GYN trying to get my superiors to test for ovarian cancer in patients who are in the hospital for, say, psychiatric disorders. As you probably know, the biggest challenge is getting a diagnosis early, because the symptoms are not very specific and are often ignored. If you haven’t yet, tell your gal pals, your girlfriends, your wives, your sisters, and your moms over 40(ish), not to ignore digestive, urinary, or abdominal symptoms. Meanwhile I’ll try to work on their doctors (not the OB/GYNs, though, they’re on it).
- Spanish skills are in short supply around here (see the photo below, taken in the surgeon’s lounge, of the cup of soup that had been reserved for a chief resident). Because of cost, interpreters were sometimes only requested on the L&D floor when there were at least three Spanish-speaking patients. The thought of going through labor surrounded by people who can’t understand you gives me chills. As far as my education went, having enough Spanish to hang got me a lot of opportunities to work with patients. But I also found out the hard way while rounding on a patient the morning after her c-section that I didn’t know how to say “pass gas”–I racked my brains unsuccessfully for a Spanish translation of “fart,” and finally wound up acting it out. I figure there’s about a 30% chance the patient in question just wanted to see what I would do.
- Among OB/GYNs, gender was a weaker predictor of awesomeness than I expected. The only clinician I observed exhibiting true indifference to patients’ comfort was female. There were certainly some male OB/GYNs who truly believed themselves to be the victims of discrimination, and that was, ahem, frustrating. As one of my female colleagues put it–and in order to honor her original wording while preserving this blog’s PG rating I will be making use of the French word for seal–“Oh, they’re at a disadvantage in one field? Boo -ing hoo.” On the other hand, one of my awesomest male colleagues really clicked with this rotation, and I’m psyched about it, because of things like this: When one of the attendings found out he was considering OB, she encouraged him to talk to some of the male doctors about their experience. “Why would I need to do that?” he answered. “I already talked to the female doctors.” Basically a doctor with humility trumps a doctor whose genitals and/or gender identity matches your own.