Perfectly Said

A comment on OB/GYN really hit the nail on the head for me. From Agraphia:

I divorced my husband during the third year of obstetric residency, which was a second residency. My daughter and I hardly missed him by then. He never made it to her school functions, recitals, science fairs, ever. But, I think that was just him. He found time for things he wanted, like on the phone and hanging out rehashing the political garbage of residency with his “family” of residents. He was rarely home when he was there. He was chronically exhausted, mean, and self-focused. He became obsessed with malpractice issues and how to keep everyone from getting his money. I started the first residency “with him” and my focus was appreciating him when he was there, not bitching like I heard so many wives. Our lives were on hold all of the time … at age fourteen his daughter doesn’t know him and doesn’t want to. Nothing is more sad or tragic. I know it would be that way either way. The system of training, indoctrination, and expectations beyond what is humane is the cause. Why do people go along with it … and lose their loved ones/families? It is so unnecessary .. it is about control of money and litigation. He went from being disturbed about the way women and babies were treated and wanting to get a journalist to cover it in his first year, to becoming shut-down and numb so he would become stuck in the financial obligations that keep them there.

If the system would allow real midwifery, the load of the care needed could be divided between doctor, nurse, and midwife. A midwife is glad to be a woman’s primary caregiver and be there throughout, which is really important emotional support. Doctors have to be in the office doing monthly exams, available for surgery and births night and day. It’s crazy-making for everyone except the hospital coffers. If nurses and midwives helped play a part in the care of pregnant women, it would be acceptable for the doctor to just show up at the last minute, do the medical deeds and move on.

Of what service is the current system to women? They are forced to accept only the care of an OB, that when all is said and done is so inadequate and minimal. The tragedy from my perspective is seeing a man turn into someone so nasty to women. Why do we expect them to be all to everyone … so that end up tragically giving such poor quality to all?

The reasons that I feel surgery wasn’t for me drew along very similar concerns. Having a family, who doesn’t want you home, being completely consumed by your job and having nothing to do with people outside of the hospital are absurd events that many residents go through when entering demanding fields. To me, it’s just not worth it. I feel, and hopefully will always feel this way, is that there is no failure more complete and absolute than to fail as a parent.

MS 4

YES!!!!

It is fucking OVER! I'm finished with 3rd year rotations, tests, quizzes, bullshit - FOREVER!!!! No more shelf exams, no more class days, no more stupid classmates who think that submitting their review of a few research papers for publication automatically makes it publishable. No more.

GAHHHHHHAHHAAHHAHAHHAHAHAHAHAAHHAAHA!!!


Can you tell I'm a little excited?

BMI Discussion and AWOL

OK. In response to the comments about the last post related to the “patient” I must admit something: that was me. Way to go Liz...you nailed it.

That’s right. I had you guessing about what kind of shape I’m in, what I might look like, and what you, my avid and voracious readers, thought MSG's fitness level is based on numbers because I'm an incredibly vain person. Happy?

The result? Well, basically most of you had me fairly well described: slightly overweight with a muscular build, often mistaken for weighing far less than I actually do (usually 40 pounds or so). I do not, regrettably, have legs of steel or “guns of nazarone”. Yet. So thanks for playing.

I was thinking about using this as a BMI discussion since I honestly feel I'm not "close to being obese" as the BMI suggests, but I think I’ll hold off on it. Afterall, most of us understand that this particular tool is useful but is clearly subject to interpretation.

******

Yesterday Stepson had his elementary school graduation. I was given a reprieve for the morning, but was supposed to return to the Army base afterwards. Instead I just didn’t go. I was essentially AWOL.

What's interesting to me is the fact that I’ve never done this before – completely forgoing my responsibilities because I despise a rotation. But here it is…I missed a day for no real reason. I just didn’t want to drive that far to deal with that crap.

Do I feel guilty? In some ways, yes, I do feel guilty. But in an abundance of others I feel completely OK. I had a great day with my family and enjoyed a picnic with his classmates. I spent some quality time celebrating Stepson's accomplishments and this movement into a new phase of his life. Hell, in one year we might be moving several thousand miles from him and his asshole dad, so taking time to enjoy these moments is even more important.

The only issue is whether I'll receive a reprimand on Tuesday for not returning. Either way - whatever. I really don't care anymore. I've got a couple more weeks and then 3rd year's over.

Grin and Bear It

OB/GYN. Week 2. Kill me now.

Terrible is a brief enough adjective to describe my experience in OB thus far. I am on an elective week block right now where we tour various fields of the profession. However, since the instruction and directions are patchy at best my colleague and I have no idea what we’re expected to do. To add to this confusion the residents and attendings don’t know either. To further add to this farce is the fact that this is the end of the year. This is not a new bolt thrown in to jam up the works. So why doesn’t anyone know what the fuck to do with us? Yesterday, before rounding with the Gyn/Onc team we were suddenly asked to get a patient presentation ready in 15 minutes. Not fun and pretty much worthless.

My schedule, despite not being part of the labor and delivery team, requires me to arrive at the hospital by 5:30am every morning (except weekends – the one blessed thing about this hell) to round on completely non-English speaking patients. Thankfully I know enough Spanish to get a quick SOAP note and avoid continuously asking the only medical student who speaks fluent Spanish how I would ask: “Do you have blood in you vagina?”

After morning rounds have completed my day varies. I have no idea what to expect nor can I schedule anything around my day. It’s chaos. Absolute chaos. Then, once everything is finalized with whatever I’m imprisoned with that specific day (ironically one day a week we do go the prison) I have to re-round on patients in the afternoon and get all their discharge paperwork ready for the morning (if they need it).

Gyn surgeries are interesting, but when I’m trying to help close I don’t enjoy being told that everything I learned on surgery was wrong. Yesterday I told the resident he was upsetting me after his constant castigations caused me to lose the needle in subcutaneous fat. He proceeded to tell me that grabbing the needle with pickups is incorrect and he was teaching me the correct way. Fine. Your way caused me to lose the damn needle, but whatever. Just get me the fuck outta here.

14-hour days are the norm. Depsite this norm I often find myself standing around with nothing to do yet mandated to remain. Something will come up if we wait long enough.

My wife hates me right now. She’s a single mother again trying to get both kids ready, get them to school, and get to work before 6:15 am every morning. She then has to pick them up, get them fed, bathed, homework done, and in to bed all by herself. I rarely get home before 8pm. I come home stressed and all hell breaks loose because I'm not "helping out". I hate this rotation and the worst is still to come. This is the “easy” portion.