Archive for May, 2011

Notes vs real life

May 20, 2011

Exam for paediatrics, surgery and obs/gyne impending in three-ish weeks. The familiar exam lock down has begun (in that I care more about getting a box of A4 printer paper than the fact I have no clean clothes).

Binding, highlighting, reading, cramming. All mixed in with trying to go to as many clinics as possible and sit in with as many doctors as possible to glean as much clinical information as possible in the vague hope that it may be on the exam.

But the normal stress of studying has been tempered into a duller force when, in a clinic with a lovely consultant, I saw a patient who had lost a baby at 23 weeks. Seven days later she would have been in an ambulance with a midwife to a tertiary hospital with neonatal intensive care and a significant hope that care could be given. I had seen a 24 week lady a few weeks earlier in labour ward. But this patient’s baby had been 23 weeks gestation. Not 24.

So many times I’ve written in my notes treatment plans for “<24 weeks vs >24 weeks” or reminders that a loss of pregnancy before 20 week is a miscarriage and after 20 weeks is stillborn etc. Reminders with underlines or highlighted text. Because it might be on the exam.

It was a confrontation to be meeting a woman who has lived with the distinction between <24 weeks and >24 weeks.

She seemed okay. Her partner seemed okay. They asked normal, expected questions. She wasn’t teary. They had grieved expectedly. The consultant asked the name of the baby, and congratulated them reverently on the birth of their child (it seemed strange but they smiled and seemed to appreciate it). The doctor referred to the baby by that name for the whole consult. They were told the results of the tests, that the most likely cause was an infection (chorioamnionitis) and asked if they wanted a copy of the autopsy results. Yes, that would be nice. Thanks so much. Some more information about future pregnancies and they were gone.

I held it together for the rest of the day until that evening when I had a fight with the Dutchboy which ending in him being incredibly confused as to why our argument about dishes involved me ranting about the unfairness of the existence of baby autopsies.

Baby autopsies may be the crux of the reason I don’t think I could do O&G. And entirely the reason I think O&G drs are amazing.