Thursday, January 26, 2012

Republican Rhetoric

Today a republican member of the US House of Representitives informed me of the reason medicare & social security have failed: birth control pills & abortion.

His rhetoric is that when social security was created the average family was having 4 children.  It was established to account for 4 children in each family growing up & paying into it.  Then along came the evil pill that lowered the amount of children to aprox 2.2.  This means that there are less people to pay into it and therefor has led to the demise.

While there are many issues to be had with this statement, I keep fixating on a specific womens-lib one. Didn't family planning give women the freedom to stop child bearing & rearing and go back to work?  Therefor doubling the work force and negating the problem of half the children?

Wednesday, January 25, 2012

Bagpiping- I need to learn ASAP!

Yesterday a group of us 3rd year medical students had an informal dinner Q&A with the 4th years.  Most of the information about 4th year and residency applications is stuff I've already heard.  Plus, I'm currently in limbo about whether I'm taking a research year next year or marching forward with 4th year.  I wont know that until fellowship decisions are sent out in March.  My response to the uncertainty is to just be in denial about having to do any planning for after June. 

The two things I did learn:
1) I may have a very difficult decision to make regarding my future and I may have to make it soon.  ob/gyn vs. urology?!!
2) I need to learn to bagpipe.  The 4th year who matched in urology at his #1 program said that he included a line at the bottom of his CV regarding personal interests/activities not relating to med school.  It was a long the lines of "eagle scout, world traveler, and enjoys bagpiping".   He said that every interview he went on asked about the bagpipe!  I have nothing like that to put down!!!  It seems that I have no interests & no life outside of med school!

Monday, January 23, 2012

Need an answer

Today, for the first time in my 3rd year clerkship (or at least the first time it mattered) I was asked WHY I want to go into ob/gyn.  Normally they just ask what you're thinking about going into...

I fumbled and felt like nothing I said was sufficient.  It almost seemed as if I was sucking up to the 4th year resident who had asked. 

My old answers:
-I'm passionate about women's reproductive health
-I wrote my undergrad thesis on pregnancy & birth through the lens of medical anthropology which is what brought me to med school
-I want to be an abortion provider
-I like surgery, but would prefer having more continuity of care than gen surg offers 
-The more I learn about embryology the more fascinating I find it
-It was between ob/gyn & peds but it turns out that I like surgery
-I think women are being short changed by a lot of current ob/gyns, and I know that I can offer better

And my new answer:

Sunday, January 22, 2012

Random Stats: OB/GYN version

On my 3 weeks of ob/gyn so far these have been my ratios.  They aren't lining up well with national stats at all...
baby boys to girls: 71.4%
c-sections to vaginal deliveries: 57.1%
episiotomy rate on vaginal deliveries: 66.7%
use of vacuum suction or forceps: 14.3%
inductions at 39 weeks: nearly 100%

I don't know how much this speaks of being in the conservative south or having an older male preceptor?  Or both?

Monday, January 16, 2012


USMLE step 2 schedule:
CK- Friday 6/22/12
CS- Tuesday 9/4/12

Onto the next step of med school!

Friday, January 13, 2012

Why I will be a provider

A woman at the end of her first trimester was referred to the MFM clinic for multiple fetal anomalies.  The follow-up ultrasound confirmed the these anomalies and a showed a few others that hadn't been noticed previously.  The fetus is showing a distinct constellation for a significant chromosomal anomaly that is not compatible with life.  Chances are high that she'll have fetal demise prior to delivery, and if not, the baby will not live past a year of age. 

The couple was understandably devistated.  This is not easy news to hear and digest.  This was a wanted baby.  They wanted to know what comes next and wanted to know their options.  The otherwise fabulous doctor skirted discussion of termination.  Even when the woman asked directly about abortion: "who could do it for her? where would she go to have it done?  does it pose any risk to her health?" answers were vague and indirect. 

In the end, she and her partner have a horribly difficult decision to make.  They need more information before they'll even be able to make a decision.  However, if termination is the decision, she should have access to local, safe, and compassionate care.  She ideally should be able to have an abortion preformed by her ob/gyn or the MFM doc she's seeing, the people she already trusts, already has a relationship with, and who already know the whole complex story.  She shouldn't have to travel over an hour away to go to one of the sole providers in the state.  She shouldn't have to comply with mandatory state waiting laws and other such rules.  She shouldn't have to walk through a line of picketers. 

This is only one of the heart-wrenching stories I've been witness to over the last 2 weeks of ob/gyn clerkship.  I'm repetitively seeing the casualties of the war on family planning and reproductive health choices.  I may only be a single person, but I take it upon myself to be a solider fighting in this war. 

Monday, January 9, 2012

Playing catch!

I caught my first baby today!!!  Then, tonight, I caught my second!!   [and I didn't drop them!]

As awkward as it was to be draped in a sterile field moving my hands into new positions, it is absolutely amazing.  I was the first person to lay hands on these two new beautiful beings.  I was allowed to be present at, and to be part of, a hugely piviotal moment in these families' lives. 


Sunday, January 8, 2012

Role reversals

I spent Friday in the emergency room, as a patient.  A bad cold superimposed with some type of viral stomach bug turns out to be a pretty awful combination.  Particularly when the patient is a type 1 diabetic who can't stop vomiting.  The family med doc who I saw in clinic Friday morning decided that a shot of phenergan along with a trip to the ER for some IV fluids was exactly what I needed.  Turns out that I also needed some IV zofran to actually stop the vomiting, a chest XR to rule out pneumonia, phenergan and cough syrup to take home with me, antibiotics for sinisitus, and a weekend of sleeping to break the fever and kick this bug. 

I really don't understand why our patients seem to like the ER so much.  The beds are uncomfortable, the IVs sting, the hospital gowns leave little to be imagined... It was not my ideal way to spend a day. I am very grateful for the treatment I received though.  And that they respected my knowledge of my diabetes as that isn't a fun fight to have when sick.  I am also grateful for the classmate who spent the day in the ER with me and the others who have been taking care of me all weekend.  While I don't feel perfect, I definitely feel better.  Here is to hoping I have the strength to pull off a 30 hour ob/gyn shift tomorrow as I've already used up one precious sick day. 

Tuesday, January 3, 2012

OB/GYN day 1

Today marked the beginning of my ob/gyn clerkship.  It involved me sitting in a small classroom for 8 hours that fluctuated between way too hot and way too cold listening to a plethora of lectures of female anatomy, incontinence, prolapse, normal & abnormal labor and the such.  All the while trying not to blow my nose raw or cough up a lung... yay for an end of break cold.  Tomorrow I get to do more of the same.

So far I have learned that an ob/gyn's ego is much smaller than a surgeon's.  Multiple times we were told that "we know that nearly all of you will go into something besides ob" and "the point we want you to remember when you leave ob/gyn behind is..."  This is compared to the surgeons who believed they were G!d's gift to man, and that we, medical students, would be absolutely crazy if we went into a specialty other than surgery.   The feeble humbleness of the faculty today was a bit off putting.  Also off putting was the story one attending told about killing a baby while showing us a picture of a ruptured ectopic pregnancy (no more than 6 or 7 weeks) that caused the woman to hemorrhage.
With all of the information they are giving us over these 2 days of standardized orientation, there has been no mention of birth control, family planning, or elective abortions.  And there is no such lecture on the clerkship schedule as of now.  NONE.  This is not because family planning is irrelevant to the life of an ob/gyn... Simply a lovely reminder that I go to medical school in the conservative south.