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A medical student on her obstetrics rotation: Behind the scenes

Freida McFadden, MD
Education
May 23, 2015
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An excerpt form Baby City: An Inside Look into Labor & Delivery.

I am going to make this medical student cry.

I don’t know how I know it, but somehow I can sense it. I know it the second she walks into the resident room on labor and delivery at Cadence Hospital, her perfect blond ponytail swinging behind her. And I’m certain of it when she holds her slim hand out to me and says, “Hi! I’m Caroline! I’m the new medical student!”

No, I am not exaggerating those exclamation points.

“I’m Emily,” I say. (Note the lack of exclamation points.) I stay in my seat, but I reach out to take her hand, which is as smooth as a baby’s bottom. And I’ve touched a lot of babies’ bottoms lately, considering I’m working on labor and delivery right now. “I’m a third-year resident.”

My co-resident and sometimes friend, Jill, who also happens to be the chief resident for OB/GYN, looks down at Caroline’s outstretched hand and shakes her head. She leaves Caroline hanging as she says, “I’m Dr. Brandt.”

Actually, maybe Jill will make her cry.

“I’m so excited to be here!” Caroline says, practically bouncing on the heels of her practical shoes. She’s wearing the requisite blue scrubs — if she weren’t, Jill would be chewing her out as we speak. “I’m really interested in women’s health.”

“Do you want to do OB/GYN?” I ask her.

Caroline shakes her head, trying not to look too horrified at my question. Most people are freaked out by the very idea of doing what we do every day. I have Caroline pegged as more of a family medicine or pediatrics type.

“I want to go into family medicine,” Caroline says. Bingo. Then she adds, “But I’m considering a fellowship in women’s health.”

Jill snorts. She doesn’t think much of family medicine residents who want to horn in on our territory.

This is our second day on labor and delivery, which somebody years ago nicknamed Baby City, like one of those discount places that sells TVs or computers. Baby City, as in bring home the baby of your choice in any shape or size at low, low, low prices! Of course, it isn’t really an accurate comparison. You don’t get to choose the shape or size of your baby. And I definitely would not describe the prices as “low, low, low.” If this were a real store, we’d definitely go out of business.

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We were sort of hoping that we wouldn’t get a medical student this month. I do believe in teaching and all that crap, and I was excited about having medical student when I first started out in residency. But since then, I’ve learned a very important lesson: Most medical students are very annoying. Occasionally, we’ll get some rare gem who is just wonderful and who makes our lives easier. But the vast majority seem to be lazy, whiny, and disinterested.

Or in Caroline’s case, overenthusiastic. Which is very possibly the worst of all.

Caroline hovers in the center of the room, as if afraid to sit in our presence. Jill looks up in disgust, and rubs her temple with one skeletal hand. In residency, many people tend to get either really fat or really skinny based on what they do with food when they’re stressed out. Jill obviously starves herself when she’s under stress, as evidenced by the fact that I can make out every single bone in her hand. I bet I could count her ribs.

I wouldn’t say this to her face, but if Jill gained about 15 pounds, styled her hair, and put on some makeup, I think she would be gorgeous. She has wispy white blonde hair that is clearly natural based on the roots and the fact that there’s no way she has enough time to dye it. Her crystal blue eyes are always slightly bloodshot with purple circles underneath, and her high cheekbones only make the hollowness of her cheeks more exaggerated. I don’t think I’ve ever seen Jill looking any less than gaunt and completely exhausted.

But she’s only got one year of residency left. Maybe after that, she’ll start taking care of herself again.

“Emily,” she says. “They just put The Princess in a room. Why don’t you take Caroline here to go see her?”

“The Princess is here?” I ask. “Why?”

“Elective C-section,” Jill says.

I sigh. Figures.

I turn to Caroline. “Do you want to come see a patient with me in triage?”

Caroline’s eyes light up like she’s a puppy who just found out she’s being taken for a walk so she could go pee.

“Oh, yes!” she gushes. If she had a tail, she’d be wagging it.

The Princess is well-known to pretty much every resident in OB/GYN. We take turns doing outpatient clinic throughout residency, and The Princess seems to show up there almost daily. If this woman breaks a nail, she needs her OB/GYN to check it out and make sure it’s not early labor. She’s been asking for a C-section since she was 32 weeks pregnant. The part that surprises me is that we’re actually doing it. When did we start letting the patients run the asylum?

Caroline follows me down the long hallway to triage. I’d prefer if she walked next to me, but instead she walks directly behind me. I feel like I have a stalker. I keep turning my head, to see if she’s still behind me, and being slightly disappointed to find her there.

The Princess is in room 2 in triage. I pick her chart off the door, and quickly ascertain that she is only 37 weeks pregnant. Pregnancy is supposed to last 40 weeks, so I can’t imagine why she would be getting an elective C-section three weeks before her baby is done cooking. Presumably, there’s a good reason. None of the attendings that I work with would deliver a baby early just because the patient asks him to.

Well, none except one.

Freida McFadden is the author of Baby City: An Inside Look into Labor & Delivery.

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A medical student on her obstetrics rotation: Behind the scenes
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