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Ob/Gyn
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i thought i'd use the beginning
of this email to address some administrative issues that have come up with
people over the last few weeks. first, these are technically called "bupdates",
pronounced as 1 word, 2 syllables, rhyming with "update". not like
"b-update", 2 words, 3 syllables. but whatever. secondly, i have
double spaced this email in order to aid reading because i've heard there
is some cluttering and difficulty without it. i make no apologies for the
lack of capitalization or my choice of paragraph breaks. and, as always, there
will be punctuation marks ad nauseam. as you can see, i'm very amenable to
your suggestions, so feel free to let me know how i can make this a more enjoyable
experience for you and yours. i try to throw in real stuff with comedy and
some kind of lesson (kind of like g.i. joe, "knowing is half the battle"),
and i usually try to add some depth/layers with various book/movie/tv/cultural
references which you may not catch until you read these the fourth or fifth
time (which i assume all of you do :)
it was quesadilla week at the ol' bobby household (not a nationally observed
holiday, just a private celebration). as some of you may know, "quesadilla"
is spanish for "cheese-dilla" and dates back to the time of the
aztecs. bellybytes.com says that it's "not just a prelude to a Mexican
meal; it's now a great beginning to a healthier, lighter sandwich". i
have no idea why i just shared all that.
so i'm no longer on surgery. one thing i miss: the residents. the surgery
ones were so great to us. plus funny. we used to spend breakfast talking about
the patients (i.e. you see yours and discuss with everyone else so everybody
knows about all the patients) and they'd always give the patients nicknames,
either some play on their name or on what they looked like (e.g. "the
mullet king"), etc. very 3rd grade, but very funny. and not in a mean
way, but just in good fun and because it was easier to remember them that
way. anyways, we had one guy who had fallen 50 feet off a bridge and then
had a piece of concrete land on him. his nickname was 'wile e. coyote'. still
makes me laugh out loud when i think about it (and he wasn't hurt too badly,
so it's not that cruel).
monday i jumped into ob/gyn (obstetrics/gynecology) total culture shock going
into ob/gyn. i left surgery with 3 girls and like 30 guys, and now everyone's
a chick. the estrogen is palpable. atleast everybody smells nice. and this
was all pretty new to me, minus the baby i delivered a couple years ago and
the week of ob/gyn lectures during my 2nd year (which completely evacuated
my brain after the test). to quote prissy "lawdy, we got to have a doctor.
i don't know nothin' 'bout birthin' babies."
an interesting bit of history i learned this week: apparently people used
to have babies before there were doctors. strange as it may sound, this is
considered a "natural" process and in no way pathological; who knew?
and contrary to everything i've learned from "saved by the bell"
and various other tv shows, most babies are delivered in hospital rooms, not
elevators or taxis. but seriously, i've gotten to see/do tons in l&d (labor
and delivery) in these past 6 days. vaginal deliveries, lots of c-sections,
egg harvesting (for in vitro fertilization), tubal ligations (aka tying tubes),
amniocentesis (sucking out the fluid around the baby for tests), and d&c's
(aka dilation and curettage; sad stuff, cleaning out the uterus if the mom
loses her baby early on). all in all it's been pretty cool. babies are fun.
and i rescind my former statement that delivery is beautiful and gross (the
gross part, not the beautful part). all of the non-baby stuff that comes out
used to be gross when it was the first procedure i ever did a couple years
ago. but coming off of surgery, it's not too bad at all. after being peed
on, pooped on, bled on, eviscerated on, vomited on, etc., the blood and fluids
and stuff aren't so bad. and i like getting to deliver the placenta. we call
it the med student baby because it's always our job to get it out. slippery
little thing, kind of like the vaselined watermelon in the pool game (for
those ever involved with youth ministry). and it's really neat just to be
able to share that moment with the parents (the baby part, not the placenta
part), and everyone is great about letting me do stuff to/for them. the only
thing i don't like is all of the screaming and crying from the moms. i mean
come on ladies, suck it up, it's just a little pushing. k, before i get nasty
emails, i was totally kidding about those last two sentences. i can see why
they call it "labor" and i think that word doesn't come close to
describing the process. elementary chaos theory and euclidean geometry tells
me that when you try to get something that big out of something that small,
bad things are gonna happen. thank goodness for the epidurals. the anesthesiologists
are greatly loved down there.
the c-sections have been fun. it takes me back to my surgery days. ahh. a
little snip, a little pull, and boom, baby. one time we cut into the uterus
and the sac was still intact and you could see the hand of the baby in all
the juices (kind of like in the matrix in those little incubators). pretty
cool. then the uterus gets completely pulled out of the belly and sewn up.
reminds me of a coconut.
oh, and lest i neglect to mention, the hours in ob are superb. we work in
shifts (either 6am-4pm, 4pm-11pm, or 11pm-8am) and it's so great not only
to be there a max of 10 hours, but also to know when you're coming and going
(unfortunately with less hours, you miss stuff. we had 3 different twin births
in the past day, but none on my shift). this will last for a couple more weeks,
then i'm in college station for a couple weeks with 8-5 kind of hours. time
rules. we also get special forest green scrubs which i really like after being
in blue ones for so long. and the best part of all of this is the panda bear
with the red nose. on the way from the delivery room to the recovery area,
there is a little picture with animals, and the panda in the middle has a
red button nose that the new moms can press, which plays a little lullaby
all throughout the hospital. i'd hum it for you, but i don't think the tune
carries through email. but if you're ever in the hospital here, you can listen
for it. wherever i am, it makes me smile when i hear it.
on a sad note, we have had some ladies lose babies while i've been here. usually
they come in because the baby has stopped moving/kicking, and find out that
there are no fetal heart tones. when that happens they put a little sign on
the mom's door with a purple leaf with a little drop of rain on it. i hate
seeing those things. but it has given knew meaning to "gave His only
begotten Son". i'm not a parent and i know nothing about kids, but i
can see how much it hurts these people and i mourn and weep with them, and
the sorrow is over a child whom they haven't even seen, who's only existed
in them for a handful of weeks. how much more painful is it for a Father who's
been with His Son forever, having to give Him up. and there was the physical
suffering and the mockery and the shame and all that to go along with the
death, which is bad. but i think the worst part for the Father was having
to forsake the Son, and turn His back on Him, and pour out all of His wrath
on Him, and the curse of the Law and all of the other devastation and junk
that came with sin. and it was for me and because of me with all of the benefits
going to me. and not only that, it wasn't done begrudgingly, but with pleasure
- Isaiah 53:10-12:
but the Lord was pleased to crush Him, putting Him to grief; if He would render
Himself as a guilt offering, He will see His offspring, He will prolong His
days, and the good pleasure of the Lord will prosper in His hand. as a result
of the anguish of His soul, He will see it and be satisfied; by His knowledge
the Righteous One, My Servant, will justify the many, as He will bear their
iniquities. therefore, I will allot Him a portion with the great, and He will
divide the booty (hah, the bible says "booty" :) with the strong;
because He poured out Himself to death, and was numbered with the transgressors;
yet He Himself bore the sin of many, and interceded for the transgressors.
anyways, that's just me trying to make lemonade. all i can really do for the
parents is pray that they are comforted and can somehow see/cling to truth
in all of this.
that's just part of the crazy ups and downs of l&d. and i'm only a third
of the way through.
and let me just end by saying that ncaa rules are stupid. in an extra point,
players should be able to jump and land on anybody they want (except for the
kicker). geaux tigers (and, suprisingly, gig'em aggies!)
bobby
day 13:
i have been living and working among the tribe of women. i feel that i have
gained their trust. they are a peculiar species with strange habits, but i
feel we have much to learn from them. they are territorial and protective
of their young.
and . . . scene.
but seriously. sorry for the delay in writing. long weekend. it seems like
the less i have to do, the more there is to do.
good week, same ol' baby stuff. there was one really happy thing; we had a
mom who was 28 weeks pregnant with twins and going into labor. we were able
to hold her off for almost a day with drugs, but she started to have some
bleeding so we had to do an emergency c-section (at 3 in the morning, fun
times). twins usually come early any ways, but this is too soon and we worry
about unformed lungs and brain bleeds and problems with their gut dying. to
help that, we usually give steroids to help mature them faster, but these
had gotten less than a day's worth. so they came out (girls) and got intubated
and taken away by the nicu people. in the nicu they got some junk squirted
in their lungs to help with surface tension/keeping them open, and now they're
both doing fine.
one sad thing i saw was a pregnant lady (4th time, 4th father) who came in
because she had contractions after being hit by her current boyfriend. that
stuff angers me to no end. i can understand hitting women when they talk back
and stuff, but not when they're pregnant (kidding). but luckily not too much
damage was done. the bad part is that she was here with her 15 month old daughter
(precious, sweet little girl; i got to play with her for a little while :),
with no one else to watch her. and it's really difficult to have a little
one running around when your lying on a bed strapped to monitors. it was 2am
so we didn't have any options to take care of her (and the mom wanted to call
the boyfriend to come get her), so she wound up leaving after a little bit,
against medical advice, and going back home/to him. hopefully nothing happened
to her baby. but i feel so sorry for her little girl, having to live in that
situation. the other two kids were in grandma's custody, but i don't know
why this one wasn't. i'd hate to work for child protective services and have
to see those people/situations all the time. very sad.
one thing i like about being around newborns is hearing the stupid names parents
give them. one lady found out she was pregnant in jail and named her kid "Felony"
(to go with her sister "Justice"). the longest name has been "Nylondraleshane".
then some people name their kids after words they hear in the hospital (and
obviously don't know the meaning): for instance, "Chlamydia" and
"Meconium" (chlamydia is self explanatory, meconium is the babie's
first poopoo, dark green stuff). and there was also a little boy named "Sirius
Lee" (seriously!)
my spanish abilities got pushed to the limits this week. i had 4 years of
it in high school, but the only obstetrical spanish we learn is how to say
"pregnant" - if any of you have ever taken spanish in school, you've
all heard the story of how some gringo girl goes to spain and tries talking
and at some point tries to say "i'm embarrassed" by saying "estoy
embarazada" and then gets funny looks because "embarazada"
is the spanish word for "pregnant". classic tale, probably just
an urban legend, but all four of my teachers used it. anyways, so it took
some work and i had 4 different patients who were english-free. one was a
sweet little 18 year old mexican girl who reminded me of this girl that stayed
at the same house i was at in costa rica a few summers ago named "nela"
(short for "marinela"). anyways, this one had pyelonephritis (a
kidney infection), plus she lost her baby after 11 weeks. so i got to see
her a couple times and got somewhat close to her and the woman who was taking
care of her while she was in america. i could understand them for the most
part, but taking a history and asking medical questions was a little harder.
it was kind of like playing "taboo"; i had to describe what i was
talking about without using any of the related words (which i didn't know).
good times.
i also learned this week that no one knows why in movies with laboring women,
they always tell people to "tear up bedsheets and boil some water".
the bedsheets part makes some sense, for cleanup or diapers/swaddling and
that kind of thing. but the boiling water has no medical role whatsoever (and
if any of you know why, let me know). our general consensus was that it was
a way to get rid of the men who would just get in the way. and on a side note,
i can't believe people used to give birth in their bed. cleanup would've been
killer, especially since they didn't have tide with bleach. and once all that
blood et al comes out, who'd want to sleep there again?
on another sad note, the "twinkie" went bankrupt this week. let's
observe a moment of silence . . . . . . . . . . . . . . . ok, that's enough.
i blame all of you atkins diet people. there's just no more room for the high
fat, high carb, semi-food snack cake.
on another happy note (sorry for the emotional roller coaster of this email),
i bought an old nintendo this week, the same one i got for christmas as a
6 year old. it's wicked fun to play all the old games and harken back to my
childhood. i think i'm having a mid-midlife crisis. i guess i didn't have
enough stuff to waste my time. i blame the internet and credit cards, they
make impulse buying so easy. but if anyone wants to play mario or zelda or
mike tyson's punchout (the nice mike tyson, pre-jail and ear biting), call
me.
ummmmmm, k, i got nothing else.
i'll be in college station the next couple of weeks (starting saturday), so
emails might be delayed or non-existent.
quantum materiae materietur marmota monax si marmota monax materiam possit
materiari?,
bobby
hey
remember me? bobby. . .medical student. . . strapping young lad; any of that
ringing a bell? sorry that it's been like 3 weeks since writing, but i've been
otherwise occupied. and you should probably expect irregular intervals for these
things for a while, due to lots of traveling and {editor's note: this part originally
said "watching astros", but as of 10:13CST, that will no longer be
a problem} and college football. plus it's hard to be introspective and "on"
every week. but i'll do my best. so what's been going on? well, i spent a couple
of weeks in college station doing a gynecology rotation. much thanks to the
storries and lombardis for hosting me for a week each. as the great latin poet
anonymous said, "hospitality is making your guests feel at home, even though
you wish they were", and they did and i thank them. i had a great time;
it was good just to see and hang out with lots of people i hadn't seen in a
while. i also got to go to a bunch of kids' flag football and soccer games.
i saw the coolest 3rd/4th grade boys soccer game ever. it was the semifinals
of the playoffs, tied at the end of regulation. and i don't care how girlie
or european you think soccer is, there's nothing more exciting than penalty
kicks: one kicker, one goalie, one shot. it was wicked awesome! and they were
tied 1-1 after the first round of 5, so they had to kick some more. seems like
lots of pressure for 9 year olds, but great to watch. i also got to go to an
aggie game with my sister and do some yells i hadn't done in a while and see
them b.t.h.o. kansas state. work was really cool too. it was just me and the
docs (no residents or other students), so i got to do a bunch of stuff. it was
usually surgery in the morning and clinic in the afternoons. lots of taking
out uteruseseses and that type of thing. there was one lady with a huge fibroid
(benign tumor) on her uterus. another sad case was an 82 year old lady with
a huge stomach mass (she looked pregnant) which turned out to be ovarian cancer
that had seeded her entire belly and was on all of her pelvic organs and bowel
and liver and everywhere. there was really nothing we could do but closer her
up, too much to even try to do any good by taking things out. the rest was pretty
normal stuff. but i also got to deliver another baby, and twins by c-section.
the only scary part going in was the fear of major pimping, since i was the
only student there and the focus of all the attention. plus two of the docs
i operated with taught me pelvic anatomy during the 2nd year, so i had to know
every muscle, ligament, space, etc., and the blood/nerve supply to everything.
luckily i studied tons beforehand, and although it was pimp-tastic, i got most
of the stuff. then i came back here for the last week of ob/gyn, mainly just
for testing stuff. we had a written board exam, and an osce. "osce"
stands for objective something something exam and is basically a practical-type
exam with 10 stations and real people at each one pretending to be sick or pregnant
or whatever (to get a mental picture, think seinfeld when kramer "had"
gonorrhea - the haunting memories of lost love; 'our eyes met across the crowded
hat store. i, a customer, and she a coquettish haberdasher. oh, i pursued and
she withdrew, then she pursued and i withdrew, and so we danced. i burned for
her, much like the burning during urination that I would experience soon afterwards.'
anyways, now i'm pretty much done with ob/gyn. so in a new section of the email
entitled "retrospecticus", we look back on my previous rotation and
see what i have learned.
1) women don't like to be told they aren't in labor. especially first timers
who come in every 6 hours when they're contracting.
2) pms is a real thing. i used to think it was just a synonym for all ladies'
monthly cycles and an excuse for women to ridicule and be ornery to me. turns
out it's an actual diagnosis/syndrome. who knew?
3) contrary to television, most babies aren't delivered in cabs or elevators.
apparently that's another falsehood perpetrated on the american people by the
left-wing, ultra-liberal, fascists in hollywood. (confession: i don't know what
any of those three words mean, but it sounded good)
4) women are extraordinary creatures whose bodies do extraordinary things (and
i'm only partially saying that because most of my audience is women)
5) it will take a long time until i'm attracted to any woman again. i've seen
too much and know too much and i've just been super-saturated with them. it's
kind of like aversion therapy in psychology (where you make someone smoke tons
of cigarettes until they never want to touch them again) or eating a bunch of
those marshmallow peeps at easter and getting sick and not wanting to eat more
for another year.
and this isn't something i learned, but something i've been thinking about lately:
what ever happened to killer bees? i remember seeing a map of america and mexico
on the news as a kid, and it showed them moving up into texas and freaked me
out. they were supposed to swarm all together and attack people and stuff and
i was afraid to be around any bees. but, somehow, i'm still alive. and i'm allergic
to them too, which made it even worse - not "my girl" allergic where
my airway swells up and i can't breathe, just local swelling. and to throw in
a little weekly trivia: where are the three places i've been stung by a bee?
hint: all are above the waist. winners get $50 donated to some charity in their
name. only one winner per household. employees of bobby inc. are ineligible.
void where prohibited.
okay, now on to what i've been learning. well, not so much learning as struggling
through. i don't know if you're like me, but sometimes i just get wearied by
life and jaded and pretty much just tired of myself and people and things. that's
especially true since med school. a lot of the time i think "why am i here?"
and quitting seems so sweet. it takes up 8 years of my life and over $120,000
of my non-existent money. there's tons of crap and personalities to put up with.
it keeps me from doing things i want to do with family and friends, and enjoying/spending
time with the people i love. and it doesn't help that a lot of my other friends
up here feel/have felt the same way, and we just feed off eachother's loathing.
and then also i find that the things and pleasures i seek after are empty and
fleeting and everything just seems futile. so, when junk comes up and i have
questions or wrong attitudes, the critical next step is to turn to scripture
and see what it says about all this. so i go to ecclesiastes, which, if you
haven't read, is basically a wise teacher guy using his experience and a socratic
teaching method to figure out what the meaning of life is. basically he feigns
ignorance and asks "will this make me happy" of a bunch of stuff (and
actually has the resources to try it), with a secular, humanistic point of view
of God and death. every once in a while he throws in some hopeful truth about
God's dealing in the matter, but for the most part he deals with the futility
of all the things of life - which actually fed my feelings even more, because
i found myself connecting more with the humanistic side of the author: vanity
of vanities, all is vanity. what advantage does a man have in all his work which
he does under the sun? a generation goes and a generation comes, but the earth
remains forever. "behold i have magnified and increased in wisdom more
than all who were over jerusalem before me; and my mind has observed a wealth
of wisdom and knowledge. .i saw that wisdom excels folly as light excels darkness.
.and yet i know that one fate befalls them both. .the wise man and the fool
alike die! so i hated life, for the work which had been done under the sun was
grievous to me; because everything is futility and striving after wind. i realized
that this also is striving after the wind. because in much wisdom there is much
grief, and increasing knowledge results in increasing pain." i said, "come
now, i will test you with pleasure. . . i built houses for myself, i planted
vineyards, i made gardens and parks, i bought male and female slaves, i possessed
flocks and herds larger than all who preceded me, i collected silver and gold,
and the treasures of kings and provinces, i provided for myself male and female
singers, many concubines. then i became great and increased more than all who
preceded me. . . and behold all was vanity and striving after wind and there
was no profit under the sun. i hated all the fruit of my labor for which i had
labored under the sun, for i must leave it to the man who will come after me.
.therefore i completely despaired of all the fruit of my labor. .all his days
his task is painful and grievous; even at night his mind does not rest. this
too is vanity. anyways, that's just part of the first two chapters but perfectly
describes my thoughts right now. being a doctor pretty much leads to all of
that: gaining lots of knowledge, having status, wealth, things, pleasures, working
hard. this guy did it all to the utmost and he finds he all fleeting and useless
and vanity. i just get tired of it all.
now this is usually the part in the email where i tell you how i learned the
right way to view all this and how i've grown spiritually and all that junk.
but i'm not gonna do that here for a few reasons. one is because i'm not to
that point yet. i know the right answer (because i read the end of ecclesiastes
and the rest of the bible), but it's not a truth i'm experiencing in my heart
or thoughts or actions right now (prayer request), and it would be hypocritical
to pretend like it was. another reason is that in case you've gone through that
or are going through, i wouldn't want to spoil your joy in finding and working
through those issues on your own (or to spoil the ending to ecclesiastes before
you read it). and lastly, i want to leave the email with me struggling and dealing
with stuff, because i think it's encouraging and helpful for others to see.
i like seeing that in others, not only so i can pray and support them, but because
it means that they're not complacent and happy with who and where they are.
life is a struggle all the way through, punctuated with victories and failures
in the middle, and i think when we represent life as always hunky-dory, we make
those dealing with big things feel isolated and shamed by it. if there isn't
some tension between who you are and who you should be, between how it is and
how it could be, then you either have too low of a standard or too high an opinion
of yourself. anyways, that's where i'm at and have been at for a while. any
thoughts or verses or prayers are appreciated.
i'll be in corpus christi for the next three weeks doing pediatrics at driscoll
children's hospital up there, but you'll hear all about that soon.
have a super week.
i am bobby feaster and i approved this email.