Obstetrics Training by Jason Faber

As the sun sets behind the Dayton skyline, I come in from the chilly fall air and begin my next 12 hours on Labor and Delivery.  As I follow around the interns, I try my best to follow the logic that leads one from evidence to action.  Learning to span this gap is the purpose of these two clerkship years.   Unfortunately it isn’t so easy, because from my eyes this movement is almost instinctual to residents, making me wonder if it ever will be so for me.  So I do what every good medical student does in the meantime…I wait…read…study…get some coffee…read again…check back.  The life of a medical student in the clerkship years is spent mostly in limbo.  You begin to feel like you’re waiting at a train station that has no scheduled stops.  Hoping and squinting off into the distance so that you can catch just one train.  You get excited when a whistle blows, but realize that there is no train, or that the train just isn’t stopping for you.  This is very true of a rotation in Ob/Gyn, where I sit waiting to hear that whistle.

Then, in the late evening, they page me for a delivery.  I shake off the daze I was in and move quickly to the room.  Despite how it appears on this end, mom is doing quite fine on the other.  So I find my place holding a leg here, grabbing things there, or simply watching and keeping my eyes and ears open.  The delivery goes smoothly, with the normal progression of hair giving way to a head, to a neck, a body next, and feet at the end.  Excitement, humility, joy, concern, satisfaction, and relief fill the room in a heavy, humid air.  But the work goes on.  Still two beings to care for, only now they are separated by several feet, instead of nothing at all.

As the night wears on, a young mother-to-be and her unborn begin to stride into uncomfortable areas.  Heart rates go down, and quickly the decision is made for a C-section.  My past rotation in surgery has prepared me for work in the OR well, so I now don the cap, gown, and boots with ease, and scrub my hands with a sense of confidence that no microbe will be left.  However, after spending a month of 3-4 hour surgeries in the OR, I’m surprised by the relative quickness and rapidity of the procedure.  Through the belly, into the uterus, delivery, and closing takes less than an hour.

Morning comes, and I pay a visit to the Neonatal Intensive Care Unit to check on a preterm infant of one of the mothers I’m looking after.  The careful design and technology of this place awes me.  It stands in my mind as a testament to the edge of reason and science that can truly change the natural pathways of life.  The infant is stable, breathing well, and kicking both arms and legs, covered in soft hair, yet still so small and fragile.

I make my way back to the Rotunda in the Berry building and stand watching over the people coming and going two floors down.  I watch as a young woman, baby in her arms pushes through the revolving doors and disappears.  At the same time, another woman enters the building through the same revolving doors.  This young woman is pregnant and looks term from where I’m standing.  This is the cycle that I have to learn to live in while I’m here.  But perhaps the most pressing question that I have been unable to answer is how much of all this should I let in.  How much am I unable to stop from getting inside?  I don’t know the answers to these questions, and of course they really have no answer.  So, like everything else, I’ll learn by trial and error.

Suddenly, the pager on my hip beeps.  The train is whistling, and I head off down the hall to Labor and Delivery.