By my second rotation of the third year, I could not help but feel like a superfluous, if not inconsequential, cog in the medical machine. Yes, we are learners and need to see patients in order to become adequate health care providers – but on a busy labor and delivery (L&D) floor, it was easy to become entrenched in the notion that our efforts have little impact on patient care. After all, a resident can conduct a complete history and physical leagues above my own and in only a fraction of the time. Time, as it turns out, is what medical students can contribute most.
It was 3 a.m. on my third night on the L&D service during my obstetrics-gynecology rotation. I saw your name light up on the triage board and thought to myself, “Great, another patient for me to halfheartedly see, present, and write another note.”
I took a big swig of cold coffee as I scanned your chart and proceeded to drag my feet to triage. I knocked on your door and began asking about your chief concern. Even in my state of sleep deprivation, I was able to see that you were scared. Whether it was the quiver in your voice or the glossiness of your eyes, something told me you were worried. I glanced down at your chart, and I could not believe we were the same age. I did for you what I could have done without my bachelor’s degree or first two years of medical education: I listened to your mixed feelings of fear and excitement regarding your first pregnancy, how scared you were when your water broke, and how badly you wanted to avoid a C-section despite the reality you may need one. I reassured you that you were in good hands and that I would do my best to help you throughout your delivery. I completed the rest of the interview, which now felt more visceral after you confided in me. I told my resident about your situation, and she made the decision to admit you that night.
My next shift, I saw you still had not delivered and were progressing through labor very slowly. Much too slowly, in fact, that the team ultimately decided to bring you to the operating room for a cesarean section. Before your operation, I saw you again to let you know I would be in the OR during the case and reassured you once more that you were under the care of the very best. I knew you would be nervous, so I placed my hand on yours and told you in a few hours, you will be with your daughter.
It was a particularly challenging and traumatizing case. The surgeons were able to get to your uterus, but they had incredible difficulty delivering the baby. It was all hands on deck and even necessitated the emergent assistance of another surgeon. I remember the terror vividly in the chief resident’s eyes when your baby would not come out. I became dizzy from the brutality and blood loss of the procedure. I felt a knot in my stomach when I thought of the worst possible scenario and the promises I had made to you earlier. Thankfully, they delivered your daughter unscathed – five pounds and two ounces. A collective sigh of relief could be heard from everyone in the OR. The rest of the procedure went by, and before I realized it, they were getting ready to wheel you to the maternity floor. I un-scrubbed and proceeded to the residents’ workroom to catch my breath. I sat down on the couch, still feeling weakness in my knees. My resident shot me a look of both exhaustion and gratitude from across the room and weakly mouthed the words, “I need a drink.”
I waited a few hours before I went to see you again. It was around four in the morning, more than a day since I first triaged you. I walked into your room and saw you reclined on your bed, coddling your firstborn. “She has your eyes,” I commented, noticing that this time yours were now filled with joy and excitement. I congratulated you and the father, making sure to wish your daughter the happiest of birthdays. Who knew such as small nugget could cause so much trouble? As I was getting ready to leave, it was you who put your hand on mine and said, “Thank you.”
I did not save anyone’s life, nor did I deliver her baby. I was not the reason why her family was complete that day, but I found solace in knowing that I at least helped her in some way. I realized as medical students, not every encounter is going to be a rush of adrenaline, and instant gratification (or any gratification at all) is not guaranteed. While the work we do may, at times, feel stagnant, redundant, or even bothersome, I can assure you that it does matter.
Justin Tiongson is a medical student.
Image credit: Shutterstock.com