MS3

Oh, hey guys! Yeah, I know. It's been a couple of months since I've written anything. Sorry. It's just that things are kind of busy during third year! And stressful! Plus, up until last week, I was elbow deep in vaginas (okay, sorry. That was gross. And only partially true).

I had meant to write at least one post during each of my rotations, but that failed after R1 (pediatrics). Now, I've completely missed OB/GYN (R2) and I'm onto Family Medicine (R3).

Here are some general thoughts about being a third year medical student:

• My new name is "Medical Student." As in, "Medical Student! Shred this document." Or "Medical Student! There is a chart in the hall and someone needs to see that patient." Or "Medical Student, you are sitting in my chair... Now, you're standing too close behind me." I've realized that I'm pretty much interchangeable with any other person in a short white coat. The other day a resident (who I had worked closely with for a couple of weeks) mistook me for my classmate, who is blonde. The best part was that he just walked over and started listing off tasks I should do while I shook my head in defiance (I was on a completely different service at that point). In his defense, he felt pretty bad about it.
• I feel like an idiot 90% of the time. Simple tasks, like cutting a suture or making a phone call, are suddenly incredibly difficult. You guys! "Cutting a suture" sounds fancy, but it is literally cutting a string with scissors. But you have to hold the scissors a certain way. And you don't want to cut the string too long/short. Sometimes the string is thicker and more difficult to cut. And you have to use the tip of the scissors so as not to risk cutting tissue. AH! STRESS. Don't even get me started on phone calls...
• I live in a constant state of anxiety/discomfort. This is because we are constantly changing services or clinic locations; just last week, I worked at 3 different clinics, each one totally different in the way things were done from the other. Every time we are in a new place, we need to figure out our roles and expectations for us. For example, at one clinic I was simply shadowing (lame) while earlier that morning I had been independently seeing patients, writing notes, and presenting my findings to the attending physician who did very little to double check what I had done. Of course, nobody explicitly says what we're supposed to be doing; we just have to figure it out. This can be on a even more basic level. Once a fellow med student and I awkwardly hovered in the residents' room with our lunches for 10 minutes, waiting for the residents to give us permission to eat/tell us where the lunch room was. We would have asked them, but they were in deep conversation (basically gossiping) and it was not our place to interrupt.

Despite these things (and I'm sure there are more - feel free to add your own experiences in the comments), Third Year is fun! Yup, you heard me. Even though I feel like an idiot and I'm constantly nervous about screwing up, I finally get to talk to patients and do doctory things. For example, a couple of weeks ago I delivered a baby. You guys, I delivered an effing baby! So what I'm saying is even though I'm kind of a stressed out mess, I'm also kind of loving it.

I can only guess...

Heyhey! Sorry for the lack of blogging. It turns out that going to the hospital for 4 hours every day followed by 4 hours of 1:1 spanish classes is kind of hard work/tiring. Plus I've been really into my book (girl with the dragon tattoo). Oh and I'm lazy. Anyway, here's an update on what's going on here in Honduras:

Last weekend we took a trip to Cayos Cochinos which is a group of small islands off the coast. We took a small boat over there and then cruised around the islands. The islands look like the stereotypical tropical paradise with white sand beaches, palm trees, and crystal clear turquoise water. We stopped a couple of times to snorkel - there is a huge barrier reef off the coast of Honduras and so the diving and snorkeling is really good here.

Everyone had warned us to be careful about the sun because everyone gets sunburned on the trip, so I planned ahead and bought a longsleeved shirt to wear snorkeling (as we all know, I'm like a vampire and can't be out in the sun for very long/ever). At the mall in La Ceiba (which is strangely similar to malls back in the states... Including the prices) K, S, and I searched everywhere for a longsleeved shirt. Just when we were about to give up (there were literally zero longsleeved shirts at the mall... Maybe because it's ridiculously hot here), I came across a gem: a mint green shirt with the phrase "I can only guess where I'll be tomorrow" in SEQUINS!! Obviously I bought it and wore it snorkeling (and I'm proud to say that I didn't get burned). S and K also got them in different colors and we're looking forward to debuting them back at school (test days? Poster presentations during retreat? I can only guess...).

On Monday we started going to the public hospital in La Ceiba. We split our time between the emergency department (which is more like urgent care) and labor and delivery (which is more like a baby factory). The hospital has very little supplies and uses hardly any technology. I found the lack of technology particularly interesting because the doctors totally manage without it; I kind of think it makes them better doctors. In L&D they do everything by hand (finding/counting fetal heartrates, determining the position of the fetuses, counting contractions, etc.) some of which we would never learn to do in the US because we wouldn't need to.

In general L&D is crazy. The women receive no pain meds and have to walk themselves over to the delivery bed. The entire process is completely solitary: the woman has to labor alone (no family allowed) and there is nobody giving them support while they're delivering. The doctors barely even talk to the women or fill them in on what's going on.

Okay. Enough about the hospital for now. I'm actually on the island of Roatan right now (my view while writing this is pictured) and I think it's time to enjoy the beach.

Sent from my Verizon Wireless BlackBerry

Baby!!

Yesterday, something amazing happened: I had a baby! Wait. No. My UTEACH Mom had her baby!! Since February, I've been participating in a program called UTEACH, where I was paired with a pregnant woman and followed her to all of her doctor's appointments leading up to her delivery. Yesterday morning, I got the big call (okay, text) saying that she was in labor. Here are some highlights from the big day:

• When I got to L&D, the first thing my UTEACH Mom said to me was, "I got an epidural! I can't feel my legs!" At this point, she was only dilated 1cm and was having slightly irregular contractions (she had come into the hospital because her water broke at about 4am. They didn't call me until 9:30am... I'm glad they let me sleep in a bit).

• I spent about 4 hours just chilling in the laboring room with my UTEACH Mom, her mom, her step-mom, and her husband. Just the 5 of us... chilling.... for 4 hours. I had met her mom and husband and a few times at various doctor's visits, so at that point, I felt like part of the family! While we waited, the moms talked about their experiences with childbirth. It was probably one of the most feminine conversations I've ever been a part of.

• My UTEACH Mom and her husband had made various mixes of music to play for the big event. The mixes ranged from pop music, which played during parts of the labor, to soothing relaxation/spa music, for the delivery. They played it from their ipad (so cutting edge!).

• I love how being in labor is pretty much the only time you can order people around to help you and it is entirely acceptable. There were plenty of demands of "more ice!" (she could only eat ice chips), "rub my hand/back/belly!" "be quiet!" "change the music!" "Get this baby out!" from my UTEACH Mom. Overall, she was doing great, though.

• After hanging out for like 4 hours, I talked to the Residents (who were pretty much awesome) and they told me it was going to be a while until she went into active labor (the "pushing" part), since she's a first-time mom. "What's a while?" I asked. "Like tomorrow," they said, "We'll call you when she goes into active labor." So I went home. Like 20 minutes after getting home, I get a call from the hospital: "We're so sorry! We just checked and she's fully dilated! We were totally surprised! You should probably come back soon." So I drove back to the hospital.

• By the time I got back to the hospital, my UTEACH Mom was already pushing during her contractions. I'm pretty sure we were all pushing and breathing with her the whole time. The phrase: "Cleansing breath in and push 2, 3, 4... 10" became very familiar. To help her push, we would hold her legs or push against them. Watching a labor/delivery is difficult because you feel so helpless. For the most part, all we could do was help her breathe and cheer her on (at this point, we're almost beyond the "making her comfortable" phase). Many words of encouragement were given throughout: "Great pushing!" "Amazing job!" "You're so close!" "You're doing fantastic!"

• From my position (I was a leg holder), I had a perfect view of the baby making his way out. The last few contractions before the big moment were agonizing; we could all see the baby's head and so badly wanted to help get him out. When the time finally came, it was truly amazing. Suddenly, there was a baby! Relief and excitement filled the room. Honestly, I was entirely overcome with emotion (luckily, I held it together and though my eyes teared up a bit, no tears were actually shed). I can't even fully describe why. Seeing a new life emerge from his mother and begin was overwhelming and amazing.

• My UTEACH Mom's husband (my UTEACH Husband?) was such a trooper. But I think the final push sent him over the edge. As soon as the baby was out, he was like, "I've gotta get some fresh air" and left the room. I think he almost fainted! No wonder guys don't have babies; I don't think they can hang.

• One of the residents was beaming at me throughout the entire delivery. It's probably exciting and fun to share such "first-time" experiences with medical students. To be able to share, first-hand, why they love their jobs. Very inspiring.

• After the baby has come out, while they're still delivering the placenta, there was an odd, quiet moment. The baby had been swept away by NICU (he ended up totally healthy), the husband was catching his breath, the mom's were playing paparazzi with the baby, and my UTEACH Mom was kind of left alone on her bed. It went from everyone around her to nobody (except for the doctors delivering her placenta and getting everything in order) almost instantly. I was glad I was there to comfort her so that she didn't have to be alone, waiting for her baby (she hadn't even seen the little guy yet).

• Another great moment (I almost lost it again) was when mother and son met face-to-face for the first time. She let out a combination of a squeal of excitement mixed with a cry of relief as she held her baby for the first time. And then, "OMG, I can't believe this came out of me!!!" Classic. (I was thinking the same thing).

Overall, this was an amazing experience. To be able to follow a pregnancy all the way to the end was very special and rewarding. I also learned that 1) it would be pretty rad to deliver babies as your job and 2) I could probably have a baby, too (childbirth has been a major fear of mine for a really long time... but after seeing my UTEACH Mom get through it, I know I could too... not that this is happening anytime soon).

*Also, for the record, the pic above is of a random baby and not my UTEACH baby.