Birth

"I think I need to step away from the table..."

I had been waiting all week for the opportunity. My first rotation in OB/GYN, the field I may want to pursue, has a plethora of surgeries to participate in. Hysterectomies, tubal ligations, c-sections, myomectomies, oophorectomies, and ectopic pregnancies are some of the procedures that OB/GYN physicians are licensed to perform. However, for the first week of my rotation, I was assigned to inpatient maternal-fetal medicine and not surgical obstetrics, so I only did patient histories and physicals. If inpatient wasn't very busy, then I was able to steal away to the surgery floor and hang around, just in case...

Finally, my chance! The chief resident and her supervising attending offered me the assist spot. I gleefully ran to get the necessary gear: hair cover, surgical mask with face shield, and boots. Then, I scrubbed in and entered the OR. I was gowned by the surgery tech and, as I took my place beside the attending physician, the spinal was being given by the anesthesiology resident and the soon-to-be new mommy was made comfortable.

The physicians quickly went to work. They explained what they were doing, they answered questions, they laughed and talked while they efficiently probed deeper through seven layers of tissue.

I was in medical student heaven.

At last, a little head full of hair peaked out of the incision and soon the baby was out, followed by a shower of amniotic fluid. The baby coughed, took a deep breath, and belted out the unforgettable cry of a newborn. As intense as it was, I got teary eyed for the new life that just took its first breath. The baby was whisked off to be cleaned up and introduced to its mommy.

After the drama of delivering the baby, the urgency lessened a bit. The physicians began the long and careful process of stitching up each layer of tissue. As they took out the uterus and laid it on the mommy's tummy for incision repair, I realized how surreal it was to be looking into the body of another human being. It hit me like a ton of bricks. I suddenly noticed the blood on my hands, on my scrubs, all over the table, the fluids that flowed into the bags hanging off the table, the needle going into and out of the uterus. I felt it coming on, like a cloak of darkness, and I knew there was no way to stop it. I was going to have to accept that the defining moment of my first assist on a c-section was not my skill at suctioning or holding retraction. It was allowing a little thing like blood, amniotic fluid, and open gaping surgical incisions to ruin an otherwise awesome experience.

Now, I had seen a couple c-sections already the couple days prior, but only as an observer in the corner. During every surgery, I steeled my eyes on all the blood just to make sure I could handle it. I willed myself to stay focused and not get queasy and really, I was fine all week.

As my hands dropped below the sterile field and and I backed away from the table, I knew I was done. The nurse and attending anesthesiologist rushed to my side and helped me to the chair conveniently placed just outside the door.

"Are you pregnant? Did you eat today?" The anesthesiologist was taking my pulse and the nurse was ripping off my gown and mask to cool me off. I dutifully answered with my head between my knees. "Don't worry... it happens all the time," the nurse said as she patted my shoulder. Someone brought me orange juice and then I was in the hall, alone.

My disappointment was palpable when I walked back into the OR, non-sterile, thus taking my usual spot in the corner, no longer part of the surgical team. The attending OB/GYN looked over at me and I waited for a reprimand or at least a joke at my expense. Imagine my surprise when...

"Did I ever tell you about the first time I passed out? I was a fourth year medical student..."

Relief ensued... and gratitude... that the best teachers are those who remember that they were students once too.