I seem to know nothing...

My Ob/Gyn rotation has been pretty awesome so far. I love the mix of surgery and clinic experience along with the continuity of care. But probably my favorite thing is that your patients look forward to seeing you. The tone is very different in OB and for the most part, you bring good news everyday. It's def my second choice, after ER. I still stay true to my ER :-)

So as we go on all of these different rotations and learn so much more everyday...I still feel overwhelmed on the days when I hit the wall. The wall that is the limit of my knowledge that really makes it clear how much more learning I have to do, and how little I still know. As med students we can learn pretty quick and adapt to a new skill after a couple of tries, but today, I couldn't help but feel like "holy crap, will I ever be good at this?!"

I was put in charge of a delivery, with the doc watching over me of course. I had to coach mom through breathing and pushing...luckily she was a G5P4 and it took all of 2 pushes to get the baby out. But the scary part came when the doc told me to think through it and get the baby out on my own.  So there I was trying to count and freak out at the same time. The head crowns and I"m thinking ok no big deal, check for nuchal cord, suction baby, pull down for shoulder, pull up for next shoulder.....of course this one was difficult. The baby had a VERY TIGHT nuchal cord that i couldn't reduce and i looked at the doc and he looked at me like "ok what do you now??" In addition to freak out, i gave him the "holy crap you actually meant i'm really doing this on my own" look back. So when I asked about all of the things i could maybe do to release this cord and got the answer "try it", I got the impression he wanted to see me struggle. So, tight cord, doesn't reduce, i try to just get the baby out. In a quick thought I looked at the doc and asked if i could just cut the cord...but of course, "no don't even think about it!"  Crap.  After a few seconds, that felt like 5 hours, of "thinking" my way through the delivery, baby slides out and was fine. A little quiet at first because of the cord, but overall baby is good and I'm drenched in sweat! The doc tells me I did a good job and says "ok now the hard part"...repairing the secondary laceration...awesome, as if i wasn't already shaky!  

Anyway, after all of that I'm pretty relieved that it went well and actually grateful that doc made me sweat a little. The toughest part of this stage in the game is thinking on our feet, well for me it is.  It's like all my knowledge gets erased, i freak out, and I seem to know nothing anymore...its all gone in an instant, just blank. I might as well be drooling lol. So i really appreciate it when docs make an effort to show us how to think in crazy situations. Even if i'm not going into OB, it's a great skill to be able to step back in your mind and think through a problem with all the information floating around in your head. Woman screaming, monitors beeping, nurses asking questions, doc staring at me, blood everywhere, vagina tearing...it was stressful!! And through all of that, i'm supposed to be calm?? I guess the more you do it, the easier it gets to drown out everything but your thought process. One day I'll be able to do that...hopefully sooner than later. And hopefully that feeling of "holy crap I know nothing", starts fading.  But until then, baby steps, trying not to let a pimp question erase my memory of

everything i've learned!