OB/GYN Rotation – Day 8

Little by little I’m becoming more and more confident in being able to handle the more routine OB appointments. Tomorrow I’m going to come in with a plan for all the patients and then ask if I could start handling some on my own. We’ll see if I can muster up the courage come tomorrow. But something happened today that kinda motivated me more towards this.

We had an encounter in which the subject was pretty delicate and tragic. While we were talking to the patient, I couldn’t help but think about how I would approach the conversation if I were to do it by myself. How would I have let the patient know that I hear her and that I care? What would I do? Where would I sit? What would I say? My attending tried to normalize the situation and was very direct about ways we can address what she was experiencing, but I couldn’t help but think that this approach, while perhaps valid, was a little cold and maybe not what the patient was quite looking for in that moment. I am still just a medical student, but I came into medicine partially because I want to be with patients in these vulnerable moments and support them through those moments at their own pace, and I am a strong believer that part of the art of medicine is know when to be a problem-solving scientist and when to be just a regular human being.

I don’t blame my attending for this and obviously he knows more about clinical medicine than I probably can even conceive of right now. But he seems also somewhat burnt-out, and I’m not surprised why. The way the health system here is set-up is not super friendly for Ob’s. He works super hard for ungodly long hours, with what seems like little respite. I can tell he cares and that at the end of the day he finds joy in what he does; in working with patients, with the staff, and with students, which it what makes me sympathize with him more and also makes me concerned for my own future.

Anyways, my opportunity came. My attending left the room to find the MA and it was just me and the patient. I was trying to find some words of comfort after what seemed to me a reductive encounter for a sensitive situation. However also I was also thinking that I didn’t want to overstep my bounds, or worse, say something that would somehow cause more distress. I ended up standing there awkwardly for a little longer, then (not-so) stealthily slunked out of the room when an MA came in with some paperwork. I still keep going over it in my head and tell myself that if I started that encounter on my own, I definitely would have had no problems addressing the situation as I normally would, which is partially why I feel so bad. Why couldn’t I say anything? Should I have said something even while my attending was in the room? I didn’t want to interrupt him or say things that contradicted what he said or that invalidated his approach, but I also felt like I should have tried to open an opportunity for the patient to speak freely and express her thoughts without feeling like she was being rushed or like we were just trying to treat her and send her on her way.

In starting this rotation, it’s been easy to forget that I do bring to the table quite of bit of experience working with patients and working with people. I have my own style and my own approach to working with patients, and I want to be able to showcase that. Obviously learning the basic of the rotation is requisite to getting that chance, but I think I’m ready.

In other new, I did my first couple Pap smears today and was involved in a colposcopy and cervical biopsy. It’s sad that it’s taken me doing this rotation to truly appreciate all the discomfort and pain that is involved in routine care of individuals with female reproductive organs.

I brought leftover fish and veggies for lunch and after we finished up with our last patient, I went to nearby Sonic to get a corndog. Came home to change, went to the library to finish up some work, worked out in a nearby park, returned home, made a burrito with some of the leftover and then finished the rest with some rice. I also made some more progress in the pineapple I have sitting in the fridge. Then I finished off the night with a peppermint tea.