"no more babies. We cut. Snip snip. No mas bebes"
-resident to mom in clinic

OB GYN Rotation Quotes

“happy birthday!!” - dr L as he pulls out the baby in a c/s

"andale" -Dr L whenever he wants you to speed it, or just whenever he feels like saying it

"whats the best way to clean this thing "-me referring to my stethoscope "throw it in the toilet and flush"- dr L's response on overhearing our conversation

"did you ask about how she feels about the casey anthony case verdict?" dr.L asks me in the middle of presenting a patient in the clinic

“do you see a sign outside saying burger king? no. because this is not burger king, you cannot ‘have it your way?’ -dr v to pt's who request c sections [contrary to popular belief, c sections are only done when medically indicated]

“this is a test for down’s syndrome, we want to make sure your baby wont come out looking like this [points to Masato]” -dr. v to pregnant pt

“when does the brain develop?" -Dr T. “um, 4 months after fertilization, um, i mean 4 weeks, wait, um, sometime really early..[everyone dies laughing]” -lance on rounds

During surgery: “cut cut cut”- Dr. L tells me about cutting a suture, after i miss the string i say “well now your just making me nervous” he replies "good"

“this is bullshit” turns to me, "i mean....this is a very complicated case" - dr. w during surgery

“lets look around and find something cool for dorothy to look at” - dr w before closing up our abdominal hysterectomy

“i just saved her from appendicitis and she didnt even know it” -dr h

“i found my first cervix, sounds weird i know” -Kavitha

"im leaving, ive had enough of you guys" Dr.L [one of the few men that work in the OB department. We were in the break room and starting talking about cute boys...he got bored i guess]

"How to tell the difference between a 3rd year and 4th year medical student: Attending Physician dismisses you for the day. 3rd year: lingers, waiting for friends to walk out with, says bye and thank you to the staff. 4th year: cloud of dust and in his car within seconds." -Tan

MORE SCORES!!!

Well, i got my COMLEX score today and though i didnt do as good as i wanted, i still did well enough.

 Karthik knew i was really into OB and i had told him what i got on the boards so while we were all with Dr. W [the chair of the department] he asked for me, "So, what kind of board scores are you guys looking for." We ended up talking with her for at least an hour about residency and what she looks for in her applicants. After a long discussion, she basically wanted us to walk away with this:

LOW MAINTENANCE. residency directors are looking for self sufficient students who will be low maintenance.

i guess i can do that! plus, my scores are def good enough to get into an OB residency of my choice so im pretty excited. that is, if i really end up doing it. i really hope i find something else i like better.

im really trying to find this whole 'loving' OB GYN thing because shit, its a hell of a long 4 year residency and damn is it stressful!!!!

Thursday was a day shift in L&D. I started the day doing a C section with Dr. H and Dr.L. The patient was under a complete local anesthetic because the spinal tap didnt work. It was crazy because we had her on the table ready to cut and like always, we tested to see if the patient could feel anything before hand. We use these little grabbers that look like tweezers but with big teeth that would def hurt if you didnt have any anesthesia. You clamp a piece of abdominal skin and ask the patient if they can feel it and if so, what side. Each time we did it the patient complained it hurt and could tell us exactly where we were pinching. Obviously we couldnt start the section this way so we had to put her under and do the delivery that way.

Joe, the first year, was with me on this shift also. He seemed to be pretty bored during it because there werent a lot of deliveries but we did have a lot of admits and r/o labors. During the afternoon, one of Dr. G’s patients went into labor. Dr.G does not work for the hospital but he has ‘privileges’ there. He has his own OB practice and when one of his patients goes into labor, he meets them at riverside county and he delivers them there. we are not allowed to do anything with them unless of course he is running late or something. i had to leave the room because there was another admit and i thought i wouldnt be able to do anything with this delivery anyway. after i left, i went back to the front desk about 45 minutes later and saw Joe standing there just beaming with joy. I asked him if he saw his first delivery [assuming thats why he was so happy]. “Not only did i see it, I just DID it!” i was speechless. apparently when dr G got there he had joe scrub in and let him deliver the damn baby. i was so freakin bitter because i still hadnt delivered a baby yet. 

A little bit later in the afternoon i was with Dr. H and Dr. L. I casually mentioned to them that Joe delivered Dr. G’s patient and then followed with, “not that im bitter or anything. i mean, im totally happy for the FIRST year who delivered a baby on his first day even though i havent delivered one yet.” they both laughed at me and at that moment i think we all realized i was a potential budding OB/GYN.

SCORES SCORES SCORES

Wednesday i got my USMLE score. i am super happy with my results. i checked during clinic and felt pretty good for the rest of the day. i cant believe that much work and sacrifice is done and over and i have finally found out the result of my efforts!

[It’s actually Nov 9 and i am going back to finish up writing about my last 3 weeks of OB/ GYN. its not that i didnt like the rotation and didnt want to write about it, it was the exact opposite. I loved it so much and was working so hard that i really had no time to write, and when i did have time, i was sleeping or enjoying the minimal outside hospital life i had. i hope i can incorporate all the details and feelings i had during this time but really, i dont think i will be able to because i really loved this rotation and am having a hard time trying to convince myself to NOT go into OB/GYN because as amazing as it is, the lifestyle is just so poor.]

Monday morning of this week started with a grunt as i pulled myself out of bed. I had just done my 24 hour  shift and got home Sunday morning and then now i had to go back to work to another 5 day week. no bueno. It was just a clinic day and we ended really late, i didnt leave until 6:30pm.

Getting home around 7:30pm on Monday night, i ate dinner, showered, and went to sleep. I had to be at the hospital for rounds that started at 6:30am so i left the house around 5:30am. In the middle of rounds i left with Dr. S [a resident] to go into the OR to start an entire day of surgery. I was pretty excited given the fact that the last laparoscopic surgery i was in was rad!

The first surgery thing i did that morning was an exploratory laparoscopy on a female who they thought had endometriosis [it was the same procedure i was in last week.] the lady ended up not having any major endometriosis in her abdomen so we closed up. my biggest accomplishment was scrubbing in correctly and not looking like an idiot :)

The next 2 procedures were D&C’s [dilation and curettage]. Both were to make sure there were no products of conception left in the uterus after both women had missed abortions [aka a miscarriage, aka a NON therapeutic abortion.]

Then the big one came up. We were doing a total abdominal hysterectomy. Thus, we were taking out a woman’s uterus by cutting open her abdomen. reason for her surgery was that her uterus had become a very large fibroid and was causing a lot of post- menopausal bleeding and some major abdominal pain. The attending [Dr.W] and the resident [Dr.H] stood on either side of the body and i stood between the legs as they were spread apart in stirrups [i know this sounds gross but everything but the operating field are covered in blue sterile drapes so really it wasnt that bad.] We started the surgery around 2pm and i had no idea what i had gotten myself into. actually, the resident and attending felt the same way. we started dissecting down to the uterus and every time we cut or cauterized, the patient would bleed more. the fibroid had been there for so long and was so large that it had creating a million different new blood vessels to sustain itself. this thing was huge, it measured 19cm on ultrasound [to put this into perspective, your uterus should grow 1cm each week during pregnancy. thus, this ladies uterus was acting like she was 19 weeks pregnant]. 

The procedure took us hours. we had to be so careful every step of the way to make sure she didnt hemorrhage and all of us were exhausted. most of all, the attending. she actually got a really bad cramp in her arm and had to stop for about 15 minutes. this procedure takes a lot of muscle. im talking ripping open stuff, using muscles to get to the right location, etc. Dr. W was sweating like a pig [and of course we are under hot hot lights.] She must have gotten so dehydrated that her arms started cramping up and needed a hydration boost. we all joked about hooking her up to an IV and rehydrating her with some saline. 

when we finally got the uterus out it was the most disgusting thing i have ever seen. it was huge. it also was extremely funny looking because it had an aborting uterine fibroid. she had let this thing grow without getting any medical care for so long that the middle of her uterus began to fibrous and it got so large and heavy that it began to DILATE her cervix and fall out. DISGUSTING.  

Of course, we finally finished the procedure [even though i thought it would never end] and before we closed up the abdomen, Dr. W looked over at the resident and said, “let’s look around and find something cool for Dorothy to look at.” I was ecstatic. Mostly because she knew my name,this attending was a hardass and as cool as she was, she never really learned anyones name. But hey, she learned mine. point me! 

I left the hospital at 7pm that day and didnt mind a bit. i was so freaking tired but it was a really great day. sadly, i had to be back at 5am on Wednesday to see my post-surgical patient’s before rounds. damnit.

I woke up late on Wednesday and got to the hospital around 5:45am. oops. i was talking  to my patient who we did a TAH on and in comes the resident, we ended up talking to her together and doing a quick physical exam, then left the room. i got some major attitude from Dr. H. she pretty much scolded me for not being there earlier enough. “you are supposed to be there waaay earlier than me.” she kinda rolled her eyes and left and i felt like crap the rest of the morning. we had a pretty good relationship i thought so it was surprised. but hey, we all have our moments and i have to admit, i was really late that day so i guess i deserved it. 

After rounds and lecture i went to clinic. there was a first year from UCR there that was shadowing [why he was spending his last remaining summer shadowing at a hospital i will never figure out...] He came in with me to watch a pap smear and pelvic exam and when we got out of the room he went, “wow, your really good at that.” i didnt know whether to be flattered or not. is that really something to be proud of? i guess...

This was the first day i had an inmate as a patient. she was a young girl named Mikeala and at first i was really hesitant to go in the room. she ended up being really cool and i kinda felt bad for her. she was pregnant and in jail, that cant be fun. even worse, we arent allowed to tell inmates any plans or dates of things [because of the potential of setting up a way to escape] so i couldnt even tell her her due date. bummer.

[rest of OB GYN weeks 4-6 to be continued shortly...