Delivering
08.31.06
For interns, a long and arduous year has recently finished. And now the real fun begins. I’ve been sitting on this story all year, but I’ve been a leetle busy. Much has happened since those first 2 weeks, but the value of patience, attentiveness, and silence hold even more true after 30 deliveries so far…
….Can i tell you about my first delivery as a doctor? It’s my third of the day, but the previous 2 curiously resembled placentas (they were, you see). By early afternoon, it’s time to step it up with a real kid. Mom’s G3P2, is carrying a big baby, and is ready to pop, so they zip her back to the delivery room (aka OR without sharp stuff). Mom’s a real sweetheart, smiling and communicating in her stirups, and Dad’s there too, gowned and peering with awed eyes over her shoulder above his mask. The OB intern had been scrubbed in but for some reason she bailed (someone must have been bleeding out on the wards, I dont know) and I scrub in. She’s pushing smoothly when Cindy, the OB R2, gives me the go-ahead and I step up…ahem, between.
We’ve all had the assistant experience as med students and neophyte ‘terns: We chant along “7-8-9..10.” We watch the hand off from OB or midwife to pediatrician like a benched quarterback. We then have the pleasure of bringing a bouncing baby placenta into the world. It’s a GLORIOUS existence, I tell you. But when you are doing the delivery and it’s your show (well, Mom’s too), it’s like nothing else. I’m wide-eyed and try to take it all in. Under pressure, it’s tough. On more than a few occasions I connect eye-to-eye with Mom and with Dad. I watch them watching me and my reaction to it all. I watch the strip with and after each contraction and concerted push. I watch the head inch closer to me until finally mom is pushing and I’m pushing back, pinching that perineum, praying that the lac gods are shining brightly on me that day.
Finally that beautiful purple head pops out into my hands. Nuchal cord? No cord…but wait…where’s the shoulder? The anterior shoulder!? Suddenly, from behind me, Cindy erupts, shoves me out of the way (hello!? sterile field!) and calls – screams – for back up: “DYSTOCIA!!”. I plant a fist, then a forearm with all my weight behind it on her belly and Cindy pulls the HECK out of that head. You should have seen it. I’d have suspected that thing to pop right off, but when you’ve got 60 seconds to deliver that baby’s shoulder, you’ve got use all of your strength. Just as the attending and peds team are rushing in, the shoulder comes free and Cindy, shaking, sweating, catches that baby. A clamp and cut, a whimper, a heart beat, and (what a rush) the shriek you love to hear. But wait, I’ve got a task at hand. Now to Mom and a placenta to deliver, lacs to repair, where’s my lidocaine, bleeding to halt…but from amongst the madness, a voice of calm…the attending??:
“Don’t worry about the lacs. Don’t worry about the placenta. Just sit back on your hands, let mom rest, and thank God for that beautiful baby.”
And that’s exactly what we do. Moments later, baby is warm and clean and comes delivered in a happy bundle to Mom’s chest, Dad watching from over her shoulder. Silently I stand there with a gentle hand on the cord, watching Mom and Dad marvel in their new child. Again, we share a gaze, brief but long enough to enjoy the moment completely. Nothing needs to be said. In that after-delivery, after-madness silence we feel Life erupt in the room.
