Thursday, April 04, 2013

A different species?

Just done two days of obs&gynae and I've experienced the following:
- A telling me how young I look/I must be a medical student*
- B asking me to write diamorphine (IM) because she couldn't do IVs
- C asking me to change an anaesthetist's prescription of IV (intravenous) fluids post-op from 1000ml of Normal Saline to Hartmann's (over 10 hours) because "pushing in that amount of salt would push the lady's BP up through the roof"**
- D urging me to do urgent investigations on a poor lady whose heart rate had gone up to 140 after struggling back from the toilet a few hours after giving birth (other observations completely unremarkable)***
- E asking me to partake in a natural delivery because I was around the ward (now I've got my mugshot stored forever in some random lady's facebook profile just because I was around when that beautiful moment**** happened - even though I hadn't done anything!!)

Wow.

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* Although looking at the faces of those labouring ladies of similar age, with their years of alcohol abuse/hardship etched onto their bodies (link between poverty and alcohol use, stress, etc etc from the time spent in public health etched firmly into my mind), I can understand why.
**Admittedly, this was an agency (ie temporary) mid-wife - and a regular mid-wife and I shared some sniggers and eye-rolling when she'd gone. Which I suppose brought some light into our dark days - she'd been due to return home at 3pm and I 5pm when it'd been 615pm.
Oh for amount of salt in a bag of 'normal saline' for non-medical readers, have a look at this. I hadn't realised there was soooooo much salt in a bag before this.
Although Hartmann's does contain a marginally lower amount of salt, in percentage terms.
***Ok she had had lost quite an amount of blood during delivery, which probably hadn't been fully replaced, so she had the right idea there. I just didn't appreciate being hurried every 5 mins to do further investigations, when I'd had a perfectly decent conversation with the patient who felt perfectly fine. And did an absolutely thorough (proper) examination (with husband present, I must emphasise).
****E was really really nice. Although I can totally empathise with men who lose interest in sex after watching a baby's birth. The lady's partner was there and rather brave, I thought. The sight is definitely not for the faint-hearted - don't believe it when they say it's beautiful - it's not. At all. Although there's something strangely moving about childbirth, I wonder if it's ingrained in us? Sort of a primitive 'lump-welling-up-in-throat-when-faced-with-extreme-agony' reflex?
Oh and after assisting in a C-section (now actually doing the violent pushing/pulling instead of just watching) as well I am seriously thinking of becoming celibate in the not-too-distant future.

So can't be a surgeon because I like my raw steak, and can't do obs&gynae because I don't intend to remain celibate for the rest of my life.

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