Rose was an old nurse. She had been working on L&D literally longer than I had been alive. You learned early on (if you were a smart intern) to do what she told you to do. It was just easier that way for all involved.
I'm back in the call room, relaxing. Easy call night so far, no major issues going on. I was even watching TV. Then my phone rang.
Rose knew where I was and that calling would be faster than paging. "I can't get heart tones on a 23 weeker who came in with abdominal pain."
That sentence ended that calm night. I walk the 30 yards to triage to find her, the patient and the patient's father there. I wheeled the ultrasound machine into the tiny space and plugged it in. Actually there was a heartbeat...but I couldn't quite get all of the fetus in view abdominally. The heart was basically on top of her pubic bone.
Mentally groaning, I go to check her cervix. Gloves are on and my left hand separates the labia to find...butt cheeks.
Fuck. Fuck. Fuckety-fuck-fuck. My resident and the in-house attending are going to love this. Did I mention the word FUCK went through my mind? Because it did.
Wheel her back to the delivery room and page my senior resident, the attending, and NICU for delivery. Wheel her out - 23 weeks even...not even an extra day. Aint nuthin good going to come out of this.
Quick history to NICU doctor: 23 weeks, butt on perineum. And we deliver the butt, the body.......................but no head is coming.
Eventually, we end up cutting the cervix to allow the head to finally deliver. A live (sorta) baby. Fortunately, she died the next day.
Even if there is nothing we can do, it still sucks.