July 27th, 2005


One after another...

Walked out of my call room to find another ooky strip. OB was in the room when I slid in - I'm getting good at the knockandenter that is required for staying involved - explaining the rationale for going to section. And the rationale was thus: hours and hours of labor, no cervical change - stuck at 5 cm dilation - and baby was starting to look a little worrisome. Good variability but lots of deep variable decelerations and some lates; a baby whose environment was becoming less welcoming. We went to section, and then I went from that section to a second section with the perinatologist on call.
If you sound interested, I have learned, some doctors will go out of their way to talk. She is one. She talked a lot, discussed the case as we were extracting a 30-something week infant via classical C-section incision from a uterus filled with blood of all ages. Old clots, pale and fibrous. Newer clots, red, black. Fresh blood. The placenta was tattered-looking and the amniotic fluid was a stunningly deep purple; grossly bloody. Baby came out a little purple, but he perked up quickly and NICU this morning sounded optimistic. A good ending.

NICU this morning also sounded cautiously optimistic regarding yesterday afternoon's crash section baby. He hasn't started seizing yet; his hematocrit is up to 40, they're going to turn off the vent this morning. There are no overt signs of neurological damage. We won't know for a while - years, perhaps - what the final outcome is, but thus far he is a blessed child and a lucky one.

It is 0930. I am cautiously optimistic regarding my prospects for the day. I have called the operator and the ER and I have no pregnant patients yet that I know of, and I am signed out for the National Conference of Family Medicine Residents and Medical Students in Kansas City, of which I will spend the greater portion attending meetings of the Society of Teachers of Family Medicine. I also promised I would hang out at the recruiting booth, so as to count the trip as a recruiting effort, so as to avoid having to take any vacation or CME time off. I am also going to sleep.

Total documented for this month: nineteen vaginal deliveries and twelve C-section assists. Not bad for the first month. Next up is ER, and a whole week of vacation in mid-August. I'm looking forward to it.
  • Current Mood
    sleepy sleepy