Farley and I had to give our case presentations to one of the directors of our OB/GYN core rotation today. I think it went really well. Dr. Hardcore had us give the presentations to him and he questioned us so thoroughly that we were extra prepared for today. I really knew my patient's case well, which made answering questions about her much easier because I was confident that I knew her well. Farley did such a great job that the doctor wanted a copy of his presentation. Overall, we were successful and did a great job this morning.
Dr. Hardcore told us to go home and rest (we were out late last night and had to make changes to our presentation so we were up past 2:00 and had to be up at 6:00 to get to the office to do our presentations by 7:30). Anyway, we had to be back for our lecture at 4:30. It was Dr. Hardcore's turn to lecture us. He decided to let his 4th year medical student who was doing a sub-internship in OB/GYN do a presentation on thrombosis and pregnancy. She did a great job and it was her last day as a medical student. She doesn't officially gain the title of Doctor of Medicine until her evaluation is submitted and I am sure it won't feel real until she walks across the stage at Madison Square Garden in June and has her doctorate in her hands, but she is done with medical school! After the lecture we returned for a surgery and the 4th year scrubbed in and got to close up the entire surgical site herself. She did a great job.
I was the next due to scrub in and we had a c-section to do. The surgical assistant wasn't there at the start of the surgery (there is only one working at night and perhaps he was in with another surgeon). Dr. Hardcore said, we will just start without him. I was the surgical assistant. Surgical assistants go to school and get specific training in helping with surgeries; however, in Miami, many of the surgical assistants are often physicians from other countries who have not taken the US boards and done a residency in the US. I think all of the surgical assistants at the hospital I am working at are Cuban or other Caribbean or Latin American physicians. Anyway, I had to do all of the pulling that bothered me to watch in my first week of the rotation (I had to use my whole body weight to help open up). When they open the uterus, they are very careful. After he made the initial cut, he told me to push down until I opened up the uterus. I was not strong enough to do it. Also, I could feel the baby and was petrified of hurting him. So, Dr. Hardcore had to open the uterus. Then there was a little beautiful BOY right there. I started helping him out and the cord was wrapped around his neck. It was crazy because as quickly as I said, "the cord is around his neck", I had removed it! Victory!! Then as he was being delivered, I saw that there were not one but two full knots in the cord. But this little boy was doing great after the delivery.
Next, Dr. Hardcore said, "put your hand in her uterus and get the uterus out." Apparently it is a very common that medical students are too gentle and he is always telling us to do our job so I had to do my job and get this placenta out. I think in our defense, we are always afraid that we are going to hurt someone and we don't know exactly how much pressure to use because we don't have experience. I guess we are getting experience now. Next, I got to sew up the uterus. I didn't tie the knots because my gloves were slippery because they were covered in blood. Then I got to help him perform the tubal ligation. I even got to cut (well really cauterize) one of the tubes after he tied it off and had everything prepared. I also got to suture the fascia, and the subcutaneous stitches of the skin. Midway through the surgery the surgical assistant came in and Dr. Hardcore said that I was doing a good enough job that the surgical assistant could skip this surgery. I know that I do not have impressive surgical skills yet (I am only a 3rd year student), but it was a honor for him to say that I was doing a good enough job to assist him alone.
It was amazing.
I love it! I didn't think I'd like the surgery aspect of OB/GYN, but it was fun. I can see my sutures getting better and better. I am growing so much as a professional. I don't think that I am going to fall in love with surgery and decide to be a general surgeon, but anything is possible. Like I have discussed before, I have been interested in OB/GYN for a long time, but I really thought I'd go into pediatric oncology. I am shocked at how much I love OB/GYN. I am still not convinced that I will want to do an OB/GYN residency rather than a pediatrics residency, but I am so happy that I am enjoying this rotation. I feel like I have more options now.
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