| So I was right- it was a good idea to do my two most difficult rotations up front and save neuro and psych for the holidays.
In September/October, I did my OB/GYN rotation, which was actually a pretty good experience. Delivering babies is a wonderful (if mildly traumatic) experience. To see a new human being take its first breath and see anything other than womb for the first time... it's humbling. My most memorable moment was the the time a woman came in from the street with no prenatal care whatsoever, not even a single ultrasonography scan. Most of the residents were already busy in C-sections with other patients, so it was up to one resident, one nurse, and myself to provide care for this woman. We rushed her to one of the operating rooms (just in case something went wrong) and she started having to push right away. If you're squeamish about such things, perhaps you should skip down to the Neurology section. Anyway, she started to push and her bag of water (amniotic sac) burst open like a water balloon against a brick wall. It was impressive! Soon after (and without ANY analgesia) she delivered a somewhat small baby, but a healthy one. It was premature, probably around 33 weeks. They rushed the baby next door where some pediatricians were waiting to take the baby to the Neonatal Intensive Care Unit. The resident went with the baby to the next room.
The nurse and I were left to clean up afterward, which can be an involved process. I delivered the placenta and was getting some clean sheets when the woman told us she still had to push. I thought to myself that maybe some of the placenta was still left, so I encouraged her to push. Well, it wasn't a placenta that started crowning... it was the first baby's twin brother! No one, including the mother, knew she had twins, although it explained why the first baby was premature- twins are usually born around 33 weeks. I called for some help, and then delivered the second baby completely by myself, which was really exciting for me. The resident came in eventually and took the baby next door to the pediatricians. Both infants turned out fine, and I felt really good about the experience. This is actually not that uncommon in Detroit, considering the unique patient population that we have.
In November I had Neurology at Henry Ford Hospital. It was a good rotation in that we had the flexibility to try out different parts of the neurology service. We had a week on inpatient, seeing chronic neurologic patients, and spent the rest of our time going between clinics focusing on headaches, stroke, epilepsy, etc., neuroradiology, neurophysiology, neurosurgery, and so on. It's a very interesting field, and it's amazing to see how much the brain is really doing that we take for granted. Knock out one part of your cortex, and you might ignore half of your body for the rest of your life, or not even recognize it as your own! Knock out another part and you won't be able to form new memories, though you'll have your old ones (not exactly like the movie "50 First Dates" or "Memento," but bizarre nonetheless.) Knock out another part and you'll speak in word salads the rest of your life, or won't be able to move one arm, or so on. It's one big integrated system, and it's fun to try to figure out exactly where the problem is depending on the patient's specific symptoms. For example, if they have spastic paralysis of their legs and no sensation below their belly button, they probably have a spinal cord transection or infarct around the level of the T10 vertebrae. Oh, and I also saw a patient who probably had CJD (Creutzfeld-Jakob disease, a prion disease. Remember Mad Cow Disease? This is in the same family.)
This month I have been in Psychiatry, which is also a really fun field. I've been working in the Crisis Center at Receiving Hospital in Detroit, also known as the Psych ER. It's where patients go who are acutely suicidal, homocidal, threatening, belligerent, violent, hallucinating, or intoxicated with any number of substances. A typical patient is a 30-something male who's depressed and has been talking about killing himself. It will also turn up that he deals cocaine, smokes marijuana, drank 2 pints of liquor last weekend to self-medicate, and may actually be bipolar and have antisocial personality disorder. We've only had a few patients who've had to be restrained physically, and it's actually a very safe place, with very little stimulation for the patients. The rotation has been teaching me a lot of empathy- learning how to understand how the patients feel, remain nonjudgmental no matter how nonsensical their perspective on the world is, and do everything I can to make them feel safe and help them through their crises. It's also very entertaining at times. If you've ever heard a schizophrenic patient talk, it's amazing what they can say. It's almost like poetry- so fluent at times, with incredible vocabulary (including words you've never heard because they don't exist) and it doesn't make a lick of sense.
The other nice thing about the Psych rotation is that we work from 9 to 3 each day, which gives me time to take care of some things at home and get ready for Christmas.
Okay, I'm tired of typing. I hope your Decembers are going well too. |
