Today was my first day in Obs and Gynae, and as first days go, it was quite something.
It started spectacularly, with the most beautiful sunrise I have seen in a while. I even considered taking to a detour to the parking lot to get a good photo (I have a sunrise/sunset/Instagram problem – I know), but I’m glad I didn’t because the view I had from the window in Labour Ward was definitely Instagram worthy. Since I am obsessed with being early (thanks to my mother), I had a few minutes to assess my new surroundings. My first thought was that it was quite peaceful – I was mistaken. Literally, as if on cue, a lady who was clearly in active labour decided to go for a little walk and promptly delivered her baby, right there, in the corridor. Welcome to B4.
And then the flood gates opened. From that moment on there was no more peace. Only chaos, but organized chaos.
We had barely started our ward round when a colleague’s phone rang, with a doctor on the line asking if they could send an eclamptic patient from Oudtshoorn who had fitted post-delivery, and was now intubated. Ten minutes after that, one of the nurses interrupted the ward round to announce that “by the way, Dr Rabe (my favourite) just called and they are sending another eclamptic who is fitting at home.” Casual.
We then started seeing the new patients that had piled up during the ward round. The first lady I saw was term, complaining of lower abdominal pain, most likely in latent labour I thought. I PV’d (did a vaginal examination, for the non-medic folk) her and decided she was 9cm dilated and definitely not in latent labour. I actually thought she was 8cm, but Sister said 9 – and we went with her assessment, given the fact that I have no idea what I’m doing. We quickly moved her to a delivery room and then I looked at Sister asking “Now what?”. “Now we wait for her to want to push.”
In the meantime I went into the next room, to find my colleague prepping that patient for an emergency caesar for foetal distress. We ran her down to theatre, I assisted with the caesar and back up we went to B4 to see how the rest were progressing.
It turned out that the rest weren’t progressing, and that the lady who we were waiting “to want to push” was not wanting to do any thing of the sort. Her contractions were too far apart and too short, and her baby was getting tired. It was then that I learnt of the urgency that the word “Kiwi” can elicit in a labour ward. When my colleague asked for the Kiwi (vacuum extractor) everyone was immediately on high alert. And when I was asked to call the consultant, I knew that shit was about to hit the fan – and it did, quite literally. Long story short, a few minutes and a lot of screaming later (mostly from the doctors and nurses, and less so from the patient) she delivered a healthy baby boy. Not without my colleague being showered in meconium-stained liquor (a lovely mixture of amniotic fluid and fetus poo). And when I say showered, I mean showered. Note to self: bring a change of clothes to work for the next four months.
The granny of this newborn boy was so happy to be a granny and also so grateful to us that he was alive and well. She thanked everyone a million times. She even thanked me, even though I had just stood there, like a fish out of water, while the chaos happened around me.
While all of this was going on, another four babies were born that I didn’t even know about until the afternoon ward round.
Thankfully though, as quickly as it had come, the storm disappeared, and peace returned. As crazy as it was (or felt to me – everyone else seemed quite chilled), I wouldn’t ask for a different version of today. I learnt a few things on my first day, that I wouldn’t have otherwise. I learn that, just like all the other departments I’ve worked in, the sisters at George Hospital know what they are doing. I was reminded that I still have a magnitude to learn in this career of mine. I noticed (not for the first time) that Obs and Gynae is a messy business. And I learnt that when it rains, it pours, but there is a rainbow at the end of the storm in the form of a brand new human being. I also decided, maybe prematurely, that I am going to enjoy this rotation – despite the smell of placenta.