Life of a medical student

Not my baby

Life of a medical student part 10: August 2019

Current activity: On call for obstetrics. Munching on snake gummies (believe me you need the sugar to survive). Nomnom.

Pro: I'm on call with my friend which makes the world of a difference. Our work ethic just clicks on the same level that it goes so smoothly and we haven't hung out since second year so there is lots to catch up on.

Con: Ugh obstetrics. A ward of screaming women in labour...

Music track: Undone - The sweater song by Weezer (I've been having a throw-back Weezer music session!! A rock classic!)

Doing two 24-hour calls (Tuesday and Thursday) one day apart is not exactly the brightest idea. I feel wrecked. Even worse I feel fragile. These 24-hour calls are intense. Like they knock you out for 3 days. The day before you're spending food prepping. The day of you are working, running around and dealing with healthcare staff and patients. And let's be honest it is never really a 24 hour shift. By the time you get to leave the hospital after handover rounds and morning meetings it has become a 30 hour shift. Driving home is the scariest because you feel so out of it. You get home and you can't even sleep because your biological clock is like "hey its MORNING!". So there you are, pounding headache and all, wide awake...not wanting to take a sleeping pill which will further wreck your already wrecked sleeping schedule. End up passing out around noon. Putting your alarm for a 3 hour nap because you want to be able to sleep that night. And day 2 post call you feel so so drained. You want to gym but you feel so weak that it's annoying! Now imagine that but doing two in one week.

To be honest...in a weird way you get used to it. You are able to work and function in a sort of inner routine. But it still wrecks you. Funnily enough I saw an article the other day on the news where a doctor in the UK was suspended for doing 24 hour shifts and putting the care of people in jeopardy. I found that hilarious! In South Africa 24-hour calls are a thing. When I start working next year I'll be doing minimum six a month and in some departments you don't even get post-call (the day off after your 24-hour shift), you work on through till late afternoon. It is actually insane. And to think I willingly chose this degree. Functioning on that extreme level is sort of like being in another dimension. You can work and get the job done but you can't really think actively - your mind is fried.

I am currently rotating in gynaecology and obstetrics...and am devastated to admit that alas I cannot love everything in my degree. Because hands down this rotation is NOT for me. I would rather do urology and assist in circumcisions and that says a lot! The department of gynaecology and obstetrics is just so all over the place. It lacks structure and logic. It even attracts a spectrum of doctors that are scattered which is so odd. They lack surgical finesse. The caesarean sections are done so hap-hazardly (granted it depends on the surgeon) and they are so focused on getting the job done fast that it is sloppy. It hurts to watch. I swear for a number of caesareans sections that I assisted in...I wouldn't surprised if most of those patients had post-partum hemorrhages. Also for a department that deals with women in fragile states (because there is never a happy ending or reason if you see a patient in gynaecology) or women in active labour - they are so insensitive. Like hello! This women is having a baby. The least you can do is treat her with some sort of respect and congratulate her on her achievement. As you can see it has not been the most jovial time for me. Don't even get me started on the lack of mental stimulation...it has literally been a mind-numbing six weeks for me.

There have been a few funny what-the-fuck moments though. If you don't laugh about it you'll just end up crying. My friend and I were assisting in one emergency caesarean section during one of our calls. We were both assisting (which is odd as usually you only need the surgeon and one assistant) because the patient was obese (or should I rather say had an increased BMI) and one of use has to hold the stomach fat up while the other two people worked (I so called it! Was hilarious). Anyway my duty was as the assistant suctioning the blood and swabbing clean and holding the uterus up. You know the usual useless things you do as an assistant in theatre. Fully scrubbed in I was suctioning away and when the surgeon took out the uterus to close the incision I noticed the cutest simple ovarian cyst. And I mentioned to my friend "awww look how cute it is" and gave it a poke. Forgot about that and the surgery carried on. Then all of a sudden while suctioning the pooling blood I accidentally suctioned the cyst! Oh shit. Gasping in shock I quickly pulled it out and put it back. My friend started laughing. Then I started laughing so hard that I was crying. I don't know what happens if you suction a cyst. There I was crying of laughter with tears and make-up running down my face yet unable to wipe them away as I was still scrubbed in full sterile gear. The doctor actually looked up at me and exclaimed in surprise "are you laughing in theatre?" I don't think he noticed what happened and I wasn't going to tell him either. That was such a wild experience. Like what the fuck.

Another observation I made in this rotation is that doctors really like sticking their fingers everywhere in patients. And it's not pretty. Nope. Really not. I have also never understood the 'beauty of life' during childbirth. What beauty? I have seen normal vaginal deliveries and caesarean sections and I assure you it is the grossest thing ever. Nothing beautiful or touching about it. Why would a husband/ man willingly want to be there for that? Ewwww. 

I think I have been so sucked into my degree that I have no filter. It is really bad. For example I can now tell you from experience that you should NEVER have an in depth conversation about sexually transmitted diseases with a guy that you like. Do not mention the first penis transplant done in Cape Town (because even though you might think it is general knowledge...it's not). Also if he asks you a question or makes a statement it is definitely not sexy to send him journal articles about the topic as you are trying to be helpful. I am such an idiot. And even if someone asks you about anatomy dissections because they hear you're studying medicine...try not to talk about it so animatedly. It kind of creeps people out. (Even though THEY asked!)

Am I the only one having these awkward experiences? Please feel free to share yours.

xxx

Last minute addition:
I completed my last 24 hour call for this department this morning. During the early hours I was allocated to assist with one caesarean section. Have you ever had a bad feeling before? Like you know something wrong is going to happen. The surgery went south fast (I don't know what the surgeon was doing) and I nearly fainted in theatre. Busy assisting, hands on the patient, trying to control my breathing...that was definitely a first for me. I've never fainted before but I think I was pretty close. Had to excuse myself before they even started suturing the uterus up. Then ended up crying for half an hour hysterical. I spoke with my colleagues and they've also been in theatre with this specific surgeon, they too confirmed that they saw unsafe cases. Maybe saying malpractice is pushing it as I am not the expert. Why was I so heavily affected and not the others? I can handle blood, operations, guts and gore...but what I cannot handle is seeing patients in pain, mistreated, unacknowledged or informed about their medical status in the hospital. That's basic human decency. No matter what level of profession you are.

The baby made it by the way, for that case I was assisting. Apgar scores of 2 and 4. The paediatrician said the baby was "sort of okay" when I asked and had hypoxic ischemia encephalopathy. I honestly don't know what to feel.