The OB-GYN preceptors are very nice. They are very busy. They do not let me do anything but listen to babies in the office, and I feel like a third-year or worse. But such things happen. And so, despite my adoration for clinical medicine, chronic care, and all the other things they find repulsive, I am in the OR every day. And I am happy as a clam.
There is no pimping in the operating room here; I am not being graded on whether or not I remember the seven layers of the abdominal wall. I am a pair of hands to hold and pull and extract placentas and adjust lights and cut sutures and I got to use the Bovie cautery for the very first time yesterday, I got to Bovie the forceps to burn a bleeding vessel. I have helped on three C-sections, two hysterectomies (the first one was rough, the first time in the OR in a while. I stood my ground through cold sweats and dizzy spells, and I've been fine ever since), a Bartholin's cyst excision, a vaginal sling, and a Novasure endometrial ablation. All that since Thursday. I am pleased. I don't have a lot of time, but I have some more patient stories brewing in the back of my mind. Most of them fall under the category of "What Your Doctor Tells You Is Very Important." Especially when the doctor tells you not to have any more babies. There is, I assure you, a reason. For example: If you have pregnancy-induced hypertension (preeclampsia) at 20 weeks gestational age, are on enough medicines to make a mammoth hypotensive, deliver under imminent threat of liver failure, seizures, and your baby suffering a stroke and being disabled for life and your doctor tells you that there is a better than 50% chance that every future pregnancy will take the same or worse course, so don't get pregnant again, Don't Get Pregnant Again. There are a lot of children out there who need people to love them. Please don't play Russian roulette with the future of an unborn child.
"See how thin that uterus is?" he asks me, holding it between two fingers, measuring out a half-centimetre or less of muscle. "That's after one prior section. And this -" he indicates the tissue once more, looking up at me over a blue surgical mask as if to emphasize his point, "- this is where it would have ruptured. I don't do VBACs any more. I don't want any more dead babies on my conscience." A beat. "Okay, follow my stitches." And we return to closing the uterus.
This weekend, $residency is having a Second Look Weekend. My Angel and I are going. And then I will submit my Rank Order list, which is so radically different from what I thought I had planned to submit that I am certain it must be the right thing. I will tell you how it goes, after the Match.