After that terrifically depressing post, things cheered up. I found a nice big ob/gyn textbook in the library, recommended by a fourth-year student as the easiest to read. It’s thick, but has large-ish print, as specialty textbooks go. So I took it to lunch, and ate in a corner so I didn’t have to interact with other people, and that made me feel better. 😉

Then after lunch another student and I were “on the board” with the intern (the labor board is a huge whiteboard at the back of the nurses’ station, with places to put patients’ names, their doctors, how far their pregnancy is, how their labor is progressing, and notes on their major issues; the doctors on duty are also written “on the board”), who took us around to see his patients, and talked with us about inducing labor and indications for Csections. I had time to read my nice textbook (far more informative than the little dinky required one) and felt like I was actually learning something. The resident took us to see an ER patient with her, and let us watch while she evaluated a sweet young lady transported in across the state at 28 weeks for ruptured waters and bleeding. By ultrasound, the baby’s cord is right by the cervix, and will get compressed if she goes into active labor. So the doctor and nurses strictly ordered her to lie still and not move out of bed a bit, for the next five weeks. Then the doctor read her the “informed consent” lecture for Csection, blood transfusion, and several other hopefully remote possibilities. I felt stunned by the end of the warnings; I can’t imagine what the patient felt. We did try to repeat several times that none of those eventualities are expected immediately, and the baby is ok, but still. The problem is that when she does need a Csection it’s likely to be emergent, and there won’t be time to explain all that.

Then, at 4:30, just before the night shift came on, a multiparous patient finished dilating, and everyone ran back to her room. By the time they had the bed set up and the intern got gown and gloves on, the baby was coming out. I didn’t try to gown up fast enough, just stood by her side and helped her husband hold her legs so she could push. Even so I managed to get blood on my scrubs. I was not happy with the doctor-patient interactions there, though. She kept asking where all the blood was coming from, after the baby was born, and whether anything had torn, and neither the intern, the resident, nor the attending said anything to her, just muttered to each other about checking carefully for tears. So, they didn’t have to say there weren’t any, but they could at least have said it didn’t look like it, and the blood was from the placenta, and they were just being thorough – which was the case. Just because she was black and lower-class doesn’t mean you have to ignore the patient – especially right after the delivery!

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