Monday, September 26, 2011

First One

They say you always remember your first one. And for vaginal deliveries, this is mine:

Intern year. I was on a gyn service for the July month. Gyn interns were also on the L&D call schedule. My first call was July 4th. Dr. Smith was the in-house attending for the day. Obviously no inductions were scheduled for that day but some came in in labor.

I obviously was COMPLETELY clueless. Not only did I have no fricken' idea about this doctoring bit, I had no clue about anything on this floor. Thank God we had good nurses that day (who REALLY hated July). I'm also really happy that it was Dr. Smith on for my first. I don't think anything could phase that man.

So, the patient had managed to deliver her child. And we're awaiting the placenta. Dr. Smith tells me to pull a little on the cord. So I did. Just a little. Nothing happened because, well, I was so terrified that my "pull" was about as strong as a gnat's would be. Smith smiled and said "Pull like you mean it." So I did.

And evulsed the damned cord.

Smith just looks at me then with a smirk on his face said "Well now you did it. Go after it!"


"Stick you hand into her uterus and manually remove the placenta." Which I did, after giving him the WTF look.

And that was my first delivery.


Grumpy, M.D. said...

"And now I have that retrieved placenta proudly hanging above my desk."

rlbates said...


ER's Mom said...

No Grumpy, but I have a lot of Dr. Smith stories. ;)

Anonymous said...

Is it better for patients to just completely emotionally disconnect from the experience until they get home? Because I don't want to be thinking about the awe of having a baby (which it's probably not awe inspiring if someone does it for their job) if I'm the only one in the room doing that any everyone else is just thinking about yanking on a placenta.

Eileen said...

Anonymous - I don't know about anyone else but my daughter is a midwife (not in the US) and every baby she delivers is an amazing event for her. I hope she never loses that sense of wonder.

ER's Mom said...

Births are amazing. Period, the end. But just because something awesome has happened doesn't mean that I can disengage the rational part of my brain. If I just bask in the wonder, I may miss something important...and that is not in anyone's best interest.

Hopefully, that helps explain the mindset. If you go back to earlier posts, I hug everyone after the delivery (even those who have shower upon admission orders). I call myself "an overpriced cheerleader". Support folks can be all about the miracle happening. I as the doctor have to see beyond that.

DJ said...

And this is why I'd never give birth in a teaching hospital, or recommend that anyone do so.

ER's Mom said...

@DJ - too bad. I had both kids at teaching hospitals. I allowed residents in on my son's surgery (although that time, I admit, I hand-chose the resident!). I have gone to a FP resident clinic as a patient. I walk the walk.

How can you expect training to occur without the hands-on part? Actors and manniquins can only help so much. And yes, there WILL be a first time for all clinicians. Because if someone doesn't privilege us with the first, there will never be a second. And a third. And a "I'm OK to do this without supervision".

Unspoken social contract and all.

DJ said...

Because I can't "hand-choose" the resident. It's not exactly "walking the walk" unless you're willing to see any intern or resident, including the weakest one, who might be asked to leave the program at the end of the year.