ndab Ah Yes, Medical School: A Tip Of The Cap

Friday, October 14, 2005

A Tip Of The Cap

Proving that this site is not just here for me to vent about all that is difficult, frustrating, and utterly vomit-inducing about medical school, but also about educating the public on various medically related topics, I would like to submit the following entry inspired by my two call nights on the labor and delivery team. Since I got into a bit of trouble with my last post and kept hearing about people hacking up their Cheerio-O's after clicking on some of the (cough) purely educational links I spent countless...umm...minutes scouring the internet for, I should warn you that what follows is a pretty graphic account of some of the more vivid and disturbing things I have seen lately. What on Earth could I possibly be referring to? Some hideous uterine surgery? Yet another rant on the smells du jour emanating from vaginas? The time my older sister put me in a dress when I was three years old, only to find out that I had peed all over it in my first (and most successful) act of sibling defiance? No, no. What I want to tell you all about is much simpler than that, much more basic to the ties that bind us all in that vast tapestry of humanity. Yes, ladies and gentlemen, I would like to talk about that special thing known as...the miracle of life:

What was a slow call night changed with a simple tug, as the residents decided it was time to break the water of one woman in labor in order to help her proceed with the delivery. For those of you who don't know, this involves taking a plastic stick with a little sharp edge at one end, sticking it into the vagina, latching it onto the bag, and tugging to your hearts content until a nice wad of mucous and urine bursts onto your (hopefully) gloved hand. I hope you aren't grossed out yet, because this gets much worse (and by "worse" I mean more miraculous, of course!).

We left the room soon thereafter (because there is usually a few hours of delay between bag rupture and the actual delivery), returning to the call room and the comforting confines of Sex and The City reruns while we casually glanced at the fetal heart rate monitors. However, five minutes later, we heard some serious moaning from the delivery room we had just been in, and everyone raced to the room to discover that the delivery was now imminent. When I arrived in the room, the patient was moaning, her legs bent and spread, revealing a pulsating vagina that was bright red. She started groaning in agony as the next contraction began while the residents encouraged her to push as hard as she could. Her face turned bright red, while beads of sweat trickled quickly down her face. Meanwhile, her husband stood there, hopeless and helpless, watching the proceedings with eager anticipation and a drop of guilt for being the reason why she was in all this pain in the first place*.

And then, something started happening. A baby's head emerging from the orifice that marked the origin of its creation one lusty, bourbon-filled evening approximately nine months prior? No. Actually, it became apparent that the fetus's heart rate was dropping dramatically. Using a complicated formula that weighed various metrics, data points, and fetal heart scores to determine a subsequent course of action (simply summarized as "Holy crap! Crap crap crap!"), the residents decided an immediate intervention was necessary to save the baby and the mother. Interestingly, the intervention at hand can be found in homes across America. Yes, using the finest technology that the American health care system can buy, the senior resident took a suction cap, stuck it on the head of the decompensating fetus, told the nurse to "let her rip", and started bringing the baby out with each contraction using a modified vacuum. She was literally sucking the baby out of the womb, and my mouth was gaping wide open out of shock and a tinge of fear, because, lets face it, I once broke a vacuum accidentally sucking up a penny on the floor, so I can't imagine what kind of damage it could do to a baby's head.

After three attempts at tugging, with one trial that resulted in the vacuum popping off the baby's head because the resident was pulling so hard, the baby finally started emerging. A few more maneuvers later, and the baby was finally out, a NICU team waiting to receive her and make sure her decompensating heart or sucked out head were not reason for long-term concern (they weren't). However, on the way out, the baby did leave a little goodbye note to the mom in the form of ripping the mom's vaginal wall all the way down to her rectum. Ya, you read that right. Making the phrase "Hey baby, can I put it in that other hole tonight?" all the more complicated, this poor woman now had a direct communication between her vagina and her rectum, a complication of pregnancy that will almost universally lead to bowel incontinence (in other words, poo all over the place, all the time) for the remainder of this woman's life despite the best post-partum surgical correction.

Then it got even more fun: the placenta still had to be removed. Except as a result of a prior C-section, it had adhered to the muscular layer of the uterus (called placenta accreta - Does all this fancy doctor talk turn you on? I'm really that desperate. But I digress.), so all the tugging of the cord wasn't helping in the slightest. The resident knew what she had to do, something so shocking, so vile...ah screw it: basically, she stuck her hand up the woman's vagina, reaching in further and further (and further!), until her arm, all the way up to her elbow, was inside this woman's nether regions and fishing around to pull out the fixed placenta. She then repeated this same arm exploration two more times. My mouth, previously wide open, had now fallen all the way to the floor, as I had never seen anything quite like that (although I guess this can't be too shocking to you porn fiends out there). I must admit, reader feedback notwithstanding, an "I shit you not" is in order here.

Luckily, the placenta was removed, the baby delivered, and the mom still in one piece, quickly calmed by the cries of her new baby and the chance to hold the baby in her hands for the first time.

What did I learn here? Well, basically, it can be summed in two succinct thoughts:

1) Thank God I don't ever have to go through that. As suggested by the title of this post, I have a newfound respect for what women have to go through to deliver a baby vaginally, and I can't even begin to imagine how terribly painful this must be for them. Now of course, not all deliveries are riddled with complications like the one I just described, but still...well, I'll take the prostate, thank you very much. I realize this newfound appreciation I have for the pains of childbirth may be simply stating the obvious for many of you, but this is really something that is hard for any 20-something male to appreciate unless you actually witness a live birth fraught with complications (and my hunch is the vast majority of you have not seen a whole lot like this), hence my desire to share.

2) That whole miracle of life thing really doesn't begin to describe the mucous, urine, poo, smells, pain, vacuums, and so on that are actually inherent in the process of delivering a baby. So maybe instead of "miracle" we could refer to it as "The unfortunately designed method of life delivery, full of bodily secretions, that I guess is a miracle but is still really gross." Just thought I'd throw that out there.


*That sounded nice, eh? The husband all caring and stuff? Well, it turns out that's just me drifting into fantasyland and not actually a representation of reality. Do you really want to know where the husband's eyes have been focused in the three deliveries I have been involved with so far? The Apprentice, Monday Night Football, and that bastion of riveting television, Telemundo. Christ, guys, is it really that hard to focus for like 10 minutes while your wife/significant other/whatever is pushing a watermelon out of her vagina? It's just poor form. That said, it was a damn good episode of The Apprentice.

97 Comments:

Blogger superdeens said...

You are hilarious! I am at once both fascinated and disgusted with your medical descriptions. It's like seeing the dead squirrel in the middle of the road and having to slow down to take a good look. You're my new favorite pastime.

11:17 PM  
Anonymous med student from the other side of the world said...

your description was disgustingly perfect. that said, ah yeah, i'm still interested in doing o&g... i'll be doing episotomy repairs with shaky hands.

and thanks for entertaining me with ur blog entries. they've helped me destress.. ;)

12:52 AM  
Anonymous ilyka said...

Oh no. Oh NO. I'm not even through reading this and I'm already horrified. Particularly:

"Except as a result of a prior C-section"

She'd had a prior C-section but elected to give birth vaginally this time? Does that have anything to do with her suffering the vaginal tear, or am I being retarded?

12:53 AM  
Anonymous ilyka said...

Awww, this is so cute and so sweet, it kind of made it all worthwhile (even the grossness):

". . . this is really something that is hard for any 20-something male to appreciate unless you actually witness a live birth fraught with complications (and my hunch is the vast majority of you have not seen a whole lot like this), hence my desire to share."

And re: medical terminology being sexy--if only it were, I wouldn't kvetch about how poorly-paid transcriptionists are. I'd be content with being paid a pittance if I had the perk of arousal every shift. Unfortunately, life is not Fantasyland. So, no.

1:02 AM  
Blogger beertapgirl said...

Okay, as a woman who has given birth vaginally, with no drugs mind you, it is really a tremendous thing. I have to be honest though. The first thing I asked my mom and sister after the delivery, was not how beautiful the whole thing was, but whether or not I poo'd during pushing. Yep...you got it. Me, the ever hygenic, perfect hair during delivery one....poo'd. I don't care what anyone says...labor gives yourself a whole new look. And it's not always that new mother glow. Generally...you look like shit. No glamour here. Just the "miracle of birth".

Way to go Fake Doc on your first vacuum baby. Was it a "conehead" baby? Usually "vac" babies are.

Also, love this blog. Keeps me laughing even when I don't want to. Being a single mom, I need all the laughs I can get. Keep 'em coming.

1:29 AM  
Blogger LK said...

Hi I just happened to land on your blog via Blogger's recommended reads. Although, i'm not sure if the entry i just read is recommended to the general public. Nevertheless, despite the subject matter, I think your writing is amazing. It really holds my attention even though i don't want to keep reading about the horrors of childbirth. (Ignorance is bliss, they say) anyway, thanks for a very... educational "public service announcement."

1:41 AM  
Blogger milkberry said...

oh. my. god.

okay so i never actually read something quite like that before. in discovery channel they make it sound so miraculous.

your grossly vivid post actually made me feel guilty for causing that kinda pain to my mom, but at the same time i was laughing and "euwww"-ing at the same time. hahahah weird.

no wonder moms are so sad when their kids dont appreciate them.

3:03 AM  
Blogger Geoff said...

Did the method of baby extraction (vacuum cleaner!?!) cause the tearing to occur?

3:13 AM  
Blogger Steven said...

I had breakfast an hour ago (UK-time), and I'm now feeling sick...

And it was very educational too. Makes me not want to become a doctor.

3:40 AM  
Blogger essjay said...

You are sooooo bookmarked *claps*

Excellent blog, am off to read more!!!

4:23 AM  
Blogger Theresa Tate said...

I hope you realize that there is a different, and far more enlightened approach to childbirth than what you happen to be experiencing and describing here. Yes, it is funny and all that - as well as extremely sad. OK - I used to be a total natural childbirth freak until I ended up trying to have to homebirths and ending up delivering my daughters in the hospital both times. I know the necessity of medical intervention when it is really needed.

That said, I have attended many births where babies have been delivered in ways which are calm, peaceful and though not completely without pain or stuggle, a wonderful experience for the mother, father and baby. What you are describing is the typical botch-job that can occur when people do unnecessary interventions (e.g. breaking the waters to speed it all up)which then lead to further complications...and it all goes downhill from there. Ever heard of letting nature take its course? Massaging the perineum to encourage stretching? Helping the mother breathe through transition? Supporting the perineum during crowning?...

I could go on about this, ad nauseum, but suffice it to say that I hope you spend some time with some nurse-midwives who actually know what they are doing, so you can experience birthing as it should be: a natural and inspiring experience for all concerned.

6:09 AM  
Anonymous Anonymous said...

I do love your blog....House of God with a modern twist. As a surgeon I have to say you got most of it dead right however I would warn you (as a mother and a militant beliver that MOST births are NORMAL PHYSIOLOGIC FUNCTIONS and do not require medical intervention) don't let your first rotation on OB/GYN brainwash you into believing that doctors are necessary for all or even most births!

Did you stop to think that maybe if the resident had let mother nature do her job (e.g. don't try to hurry things along by rupturing membranes, in general don't be quick to induce, etc.) effacement and dilation would have progressed and the decels might not have happened and the woman might have been able to deliver without all the "help" (and without a 4th degree tear).

And to ilyka, though ACOG is coming out against VBAC, it is more for legal than medical reasons and the concern is for uterine rupture not placenta accreta. The tear is more likely to be directly related to the medical "interventions" than to anything else.

And finally though a 4th degree tear is not something that is desired it does not universally guarantee a permanent fistula.

6:15 AM  
Blogger If I tell ya, I'll have to kill ya said...

hehehehehehehehe

this blog is my latest obsession. love reading everyword.

medical lingo is great for initially attracting intelligent women, but no it doesn't turn one on.

a doctor boyfriend once held my hand gently during a candlelit dinner, and whispered sexily, about how taking extra tabasco sauce with my pasta was carcinogenic. sexy? i think not!

6:36 AM  
Blogger Carina said...

Doctor's wife here, and I have to say that you're really funny! You're as funny as the Placebo Journal, and that's saying something. I've just sent Doug, the doc behind the Placebo Journal, the link to your site.

Having been through two natural births, I have to say that what you saw was close to a worst case scenario. They had to break my waters both times (which occasioned all sorts of crochet jokes on my part, as that's an H sized afghan hook if I ever saw one), and the worst tearing I had was with my first when she came out too fast for the OB who had to take a step back to catch her and couldn't rotate her in time. It was only a second degree tear, though. With my second, who was two pounds heavier, my midwife was so good at moving and manipulating him that I only had one stitch.

Btw, you have the mentality of an internist. You should think about internal medicine--never know what you're going to get and always interesting. My husband loves it now that he's an attending.

7:33 AM  
Blogger addiern said...

Yes... I am not only an OB nurse but have also delivered 3 babies without epidural, the last drug free. two of which were preemies and 1 (my 4 pounder) with a nuchal cord X 2. So,I try very hard to have compassion, and sympathy for each delivery I am in on. I've been there, trying so hard to stay calm in emergent situations. The fight or flight has kicked in and luckly i have fought and not left! I am so glad you shared this miraculous story! You are awesome, and single too? You will make young lady very happy someday, to bad I"M not Jewish.

8:05 AM  
Blogger Lauren said...

oh. my. god. That sounds like a horrible birth experience. I have to say that having spent the better part of 6 years on Trying to Conceive BBs and reading hundreds of birth stories, that is the absolute worst birth story I've ever read.

I agree with the reader who recommended that you spend some time with a nurse midwife to see a delivery more in line with what nature intended. I've read beautiful stories of home births and water births that were just breathtakingly beautiful (despite the potential for poo).

Still, I always love reading your descriptions.

8:07 AM  
Blogger SPC said...

You don't say wheter or not the husband spent a week in hospital with a skull fracture when he fell on the floor. That is the only "ordinary" part I see misssing. The usual result is that the mother has to come visit him long after she is discharged.
Oh well, would have made a reasonable ending. Pat

9:29 AM  
Blogger Wendy C. said...

Wow - funny stuff...and kind of pathetic. To think I missed out on all that excitement having my children at home...btw, I think amniotic fluid (not urine)is what comes spurting out when the "water" breaks, but hey, I'm not a med student or anything :-)

I just love your stories!

10:15 AM  
Blogger MooseHP said...

Man, your blog is great... I dont know if I want to laugh or puke... anyway every entry is way funny and realistic.

10:29 AM  
Blogger FUNKYBROWNCHICK said...

I, like the rest of your readers, am *HOOKED* on your blog. Seriously, you're a really talented writer. (Publish!!!)

... and, given the images in your other post, I swear my finger actually started SHAKING as a moved it over the embedded mouse on my laptop and double clicked the links above ... I shit you not! ;)

10:38 AM  
Blogger Febrifuge said...

Okay, this blog rocks. (Thank you, Blogger 'recommended reads'!) I'm way behind you in the process - only doing prereqs now (and admittedly, I'm heading to PA rather than med school, so I may be as much as 35% less crazy). But I think we have a similar understanding. If I were on my own machine rather than wasting time in the computer lab, I'd bookmark you right now.

Also, yuck. I'll take an amputated finger over a birth any day, thanks.

10:45 AM  
Blogger The Smith Family said...

Maybe you should hire a doula for your future wife! As a student midwife,I attend deliveries all the time, and frankly, the tear was most likely caused by the Vacuum and the pulling etc. by the resident! Also, most of this stuff can be avoided by a homebirth! They are wonderful! And believe it or not SAFE and Gentle. Just something to think about.
But aside from that, this is probably the funniest blog I have ever read!

11:02 AM  
Blogger The Smith Family said...

Sorry, forgot to mention- it's probably amniotic fluid, not urine, that comes spurting out! ;)

11:06 AM  
Blogger Kevin Jordan said...

Thank you so much for such a detailed and graphic story of the so called 'miracle of life' (not really)! I can't imagine having your vigina and rectum become one big gaping hole because your vigina was ripped during delivery.

Not that it grosses me out much... I enjoy reading your blog because not only is it interesting but one day I want to study medicine but I have a long ways to go as a 10th grader. Your blog is very 'insightful'.

=)

11:26 AM  
Anonymous Dr_Dave said...

Dude, I find your shit hella funny.
Surgical resident in Australia, my most hardcore memories from med school were of O&G - mixture of rabid anti male med student atmosphere, but one magical night where all the midwives inexplicably took me under their wing and I delivered 5 babies (none of whom caused external anal sphincter destroying vaginal tears).
Keep it up (and don't be lured away from surgery by all the hot O/G chicks!)

11:46 AM  
Anonymous Anonymous said...

Having recently given birth, I totaly agree that it is very, very stomach turning and I would never want to watch someone else do that. I too asked if I shat on the table. My poor husband kept saying no, but I think he was just lying to make me feel better.

12:00 PM  
Blogger Sabine said...

Thanks! Tomorrow night (Sunday) I'm heading for the hospital and will be induced on Monday morning. I think I can handle everything but the ripping. Yuck. I'm starting my perineal (spelling?) massage this afternoon!

I'm thankful my husband doesn't watch TV!

12:33 PM  
Blogger The Fake Doctor said...

To Ms. Tate-
I searched my inbox (where all the comments go) to see if you were there...and I didn't see anything. I am not sure which comment you are referring to (your other one on this most recent post is still here), but I apologize if you have been inadvertently deleted previously. Please feel free to re-post whatever you'd written beforehand, whether positive or negative.
the fake doc

2:04 PM  
Blogger Danaë said...

E-freaking-gad. The one vaginal birth I saw in nursing school was enough to solidify my decision never to have a baby, and it was routine(except for a small episiotomy, and the fact that the mother was like fifteen, which around here is actually pretty much de rigeur).

Thanks for solidifying my decision to get my uterus forcibly removed by vultures.

2:31 PM  
Blogger Danaë said...

PS:

Awesome post.

You know, sometimes reading some of the self-righteous comments is almost as entertaining as the entry itself.

2:38 PM  
Anonymous cobiance said...

did the mom have nice feet?

3:02 PM  
Anonymous Anonymous said...

Man .... what will be when you 'll at Proctology!!

I'm a brazilian doctor and Add your blogger to laugh every time I read your texts

a HUG

Doctor Celso Sao Paulo Brazil

3:35 PM  
Anonymous Anonymous said...

Oh, man, I truly feel sorry for you. As bad as it was, though, you do realize how much worse these things can get, right?

My first child ripped up everything in her path on the way out. I'd been measured for a C section, but her head wasn't the problem. She happened to have wide shoulders and they didn't give the way a baby's head does. I ended up needing a transfusion. This was a little slow in coming because they couldn't find a vein (that runs in my family). I was actually a little shocky by the time they sent me to recovery. Not so much that I didn't know I was starving, though. I remembered that part really well.

So, for my next one, as soon as I the contractions started, I did the exact opposite of everything they told me. I sat down and had a big meal and went up to take a bath and wash my hair. It never even occured to me to ask if I'd pooped on the table. Probably because I didn't really care. At least I wasn't hungry.

For that one, I got a little too much epidural and was numb when it came time to push. I think a nurse really pushed my baby out from pushing forward on my stomach. And I had my water "popped" for both of them. So, is there such a thing as a "normal" birth. I kinda thought they were each as individual as the people being born.

Somehow, I don't think this is the specialty for you. All the very best of luck in choosing and practicing. I like the fact that you are so affected by the things you are experiencing. It may make things harder for you down the line, but I think it's a trait shared by the very best doctors.

You go, guy.

4:21 PM  
Blogger Stina said...

Ran across your blog. Laughed my ass off. Bookmarked it, and love every minute of it. I have an 11 year old who was a 32 week preemie that weighed 4.15. He is a monster now. No tearing, but 36 hours of labor later, I must say that it is NOT a miracle, but rather bad dinner theatre. Had enough neo-natal staff watching my crotch for an hour, that's for sure!

Keep up the good work!

4:29 PM  
Blogger SignGurl said...

Reading your entries is like eavesdropping in a hospital. Thanks for sharing your experiences so eloquently (and hilariously).

4:34 PM  
Blogger Theresa Tate said...

Hi fake (some day to be real) doc,
Sorry if I made an error - I didn't see it when I browsed earlier - but did see a: "post removed by author" - I'm also glad to see the female surgeon weighing in on the same issues as me - and with a lot more direct experience, I'm sure. I know you are in the crazy process of medical boot camp right now - but try to stay open to a other approaches:)

Hey, I'm suprised you have time for this!

4:47 PM  
Blogger Meghan Lee said...

If, by the end of your residency, you decide that medicine is not for you, you should definitely try your hand at sitcom writing. You are hilarious!

Also, my b/f is in his second year of trying to get into Med school. I am sending him a link to your blog about the application and interview process. Very good info!

5:02 PM  
Blogger Sarah said...

You missed your calling...you should be a writer...hilarious stories :)

5:02 PM  
Anonymous Anonymous said...

ok what i want to know is
1) what causes that umm vaginal ripping?
2) theres no treatment or surgical corrections for that bowel incontinence thing forever?

its a major concern for women who are thinking about having children..how common is this? thanks

5:41 PM  
Blogger Cameron Lawrence said...

1.) I can't believe I read that whole thing, although it was well-told.
2.) I am with you on being grateful I am not a woman. MAN.

I'd thank you for that sobering discourse, except I'm still a bit agitated by the whole thing.

9:11 PM  
Blogger Krislan said...

disturbing but astonishing! you just gave me a brand new perspective on childbirth -- "However, on the way out, the baby did leave a little goodbye note to the mom in the form of ripping the mom's vaginal wall all the way down to her rectum." --- uggh, i can just imagine

What happened to the poor woman? Is it possible to do surgery on her vaginal area, to avoid what you said a lifetime of 'bowel incontinence'?... thank god i wont have to go through this

9:25 PM  
Anonymous Anonymous said...

Blecch. That poor woman! Surely surgery will help her??

Oh---and when I have kids, I will *flee* from the residents. I know they've gotta get experience, but the ones you mentioned seemed to have botched things up pretty well.

10:21 PM  
Blogger Sofi said...

I would post, but I just can't tear myself away from Telemundo long enough to type anything insightful.

10:23 PM  
Blogger Ilene said...

Oh man. You break water and it's usually amniotic fluid and a damned lot of it -- not urine. And...anyone there heard of an episiotomy? About the whining on your last post's links -- you clicks on the word "cervix", you takes your chances. Thanks for writing this!

10:53 PM  
Blogger missbhavens said...

Oh, yeah. Those damn vacuums. They'll get you a vaganus every time (that's what we call 4th degree tears on my unit...it's a funny term, but not a funny problem to have!). That was a world of trouble you witnessed...vacuums! Vaganus! Accreta! Oh, my! Accretas are really uncommon, though, and not necessarily related to a prior section. My question is, why wasn't it spotted on an ultrasound? Then she wouldn't have labored at all what with being a 100% hemmorhage risk. If they sewed up her vaganus right, she won't have poop problems...until she's really old, anyways.

11:29 PM  
Blogger Azeem said...

This comment has been removed by a blog administrator.

11:34 PM  
Blogger Azeem said...

Thats one experience I wouldnt like to have.I am preparing for pre-medical exams to get in to MBBS but expericiences like these are a cause of worry to me,i dunno whether i cud stand all that stuff

11:35 PM  
Blogger Terri said...

This comment has been removed by a blog administrator.

11:36 PM  
Anonymous CuriousGrl said...

I randomly found your blog and I will forever be a reader!
One question, you being the Fake Dr. and all..
In my Psych Sexuality class we recently covered conception and childbirth and I never got to ask the question:
What does an episiotomy procedure consist of? I know it's supposed to prevent the tearing of the vaginal wall but I don't know how!

Keep writing, thanks for giving us all something to look foward to!

11:42 PM  
Blogger Wendy said...

My cousin had to have suction on both sides of her head....so she came out looking like Mickey Mouse! But seriously...the pain you endure in child birth is only really the first of many. Being a mother (and father) is fraught with feelings of inadeqacies,insecurity,and endless sleepless nights wondering if you've been a good parent, and will my child be safe in this big wide world?! When I have to let them drive alone..or have their heart broken..or go to Medical school :). But lets face it..it's all worth every minute when the child smiles his/her first smile while looking at your face. Grows their first tooth...performs in their first school concert,...Or if you're truly blessed graduates from Medical school :).

11:55 PM  
Blogger Alex said...

*stares at screen with wide, unblinking eyes, traumatised for life*

I am never, ever going to have children.

*grin*

How did the lady end up?

12:46 AM  
Blogger Lexis Excellence said...

http://skits-o-frenic.blogspot.com/2005/09/los-angeles-on-drugs.html

Dude, do yourself a favor and read that.

And then try to explain to me, one doctor to another, how or why such a thing could ever happen.

You seem to have experience with it.

1:56 AM  
Blogger The Bored One said...

um....ouch! Im havin second thoughts about joining med school next year....and a lot of thoughts about having a baby!
but the descriptions were eeriely accurate or so my mom tells me...thank the lord i was the easy baby...she was in labour for twelve hours with my brother...maybe thats why hes such a pain even now
but keep up the good work...i cud use the inspiration while im made to work my ass off to get into the damned med school...

2:26 AM  
Blogger Terri said...

Being a hospital medical transcriptionist, I encounter a few "holy shit" moments now and again, but never with so much humor and flair. I would love to hear the dictation for this, well on second thought, no I wouldn't... Good luck in your career, keep your sense of humor, and for God's sake don't ever let yourself run out of rubber gloves!

2:39 AM  
Anonymous Anonymous said...

i'm guessing you are pro-episiotomy now??

2:54 AM  
Blogger jbrown said...

This comment has been removed by a blog administrator.

3:42 AM  
Blogger Sonia said...

Aaaaaah!! I don’t know if I wanna have a baby anymore. Does the vagina tearing till rectum thing happen all the time???

5:55 AM  
Blogger kero said...

the first time i delivered a baby vaginally, i decided that i'd think twice before getting pregnant. i couldn't imagine myself going through the same process all mothers-to-be undergo. and that's just the actual delivery. episiorrhapy is another story. made me wish i was born male. it was like a jungle, trying to put things together (definitely, not without pain) so that the vagina would be as good as new, ready for the next encounter.

goodluck to you for the rest of your rotation.

6:07 AM  
Blogger Earl said...

As one of many reading your blog, I can only say that the medical area is not your only talent. What a way with words and humor!

Keep on, my man! You have a book (or more) in you. Keep it up!

7:26 AM  
Blogger Cathie said...

Start saving up now for the big piece of sparkly jewelry that you will need to buy your future wife after she gives birth and also the cleaning service for the first 6 months of the new baby's life. I think these things are a small price to pay for not having to give birth. I have done it twice. You are right, it is not a "miracle". Epidurals are great.

Your writing is fantastic. Keep up the good work, I've always wanted to know what Med school was really like.

9:53 AM  
Blogger mandy said...

This was quite an interesting entry. Like a car wreck--you kow you aren't supposed to watch but damn it you can't stop looking! Great blog and look forward to reading more of your half assing it through med school.

10:34 AM  
Blogger Emily said...

amazing. I now will link you to my blog, so that I may read you more often for my amusement. Thank you, thank you, thank you.

11:09 AM  
Blogger Alfie said...

o__o

Ah the memories of sex ed. Abstinence and C-Sections forever! :D

11:53 AM  
Blogger Bejeweled said...

That POOR patient...why on earth didn't she get an a episiotomy?? And why are VBAC's pushed so much?

To all the women out there that think they can deliver at home....what the f--- for? Anything can & will go wrong...do u think the infant will remember that they were born in their parents bedroom as opposed to a hospital where they a much safer.

11:55 AM  
Blogger LeAnn said...

Thank God for epidurals. Thank God for the C-Section. And thank God for doctors who know what they're doing.

And as for the pains and odors of childbirth, the memories and resudues fade... eventually. Thank God for that.

12:10 PM  
Blogger alap said...

In my 45 day obgy posting during internship I delivered around thirty babies ( i am from india so no dearth of babies). I never thought I would ever be able to look at the screaming, suffering and the concoction of urine, excreta, amniotic fluid and blood in a lighter vien... until now. I was laughing my ass off while reading your blog. I know where to come now when the frustration mounts up.

12:45 PM  
Anonymous Anonymous said...

Hahahah--hilarious as usual. I'm an MSIII also and interested in OB-GYN so I'm loving these posts. Just FYI for those who commented...by the end of the 9 months most of the amniotic fluid is made up of the babies urine so he was right in calling it urine--it's the babies, not the moms. Keep the laughs coming.

3:39 PM  
Blogger cluelesscarolinagirl said...

Thanking the gods above that my husband is sterile and we adopted....

4:45 PM  
Blogger Mhlanguli Ncube said...

you make me glad i chose mathematics over medicine. i feel your distress!

4:49 PM  
Blogger Alissa said...

This was a really good posting. I mean you could not have decribed it better. When I saw my God sister born it was a gross sight. But it was nothing compared to what you had to see. She came out just fine despite the fact that her mom tried to squeeze her legs back in once the head came out. But the placenta came out by itself. It needed no help at all. And that damn placenta is something gross. It looks like purple and blue hamburger meat. But I can definelty relate to what your saying and I enjoyed the blog.

5:23 PM  
Blogger Manda said...

holy shit. i'm sorry, but that was graphic. aren't you violating some sort of privacy act? :-)

i've been through vaginal delivery myself, and it wasn't fun. but it WAS A miracle because of the beautiful little boy i got from it. :-) to just think that he was LIVING inside me for 9 months before that wonderful day when he was born is the miracle.

the night my son was born, we had a few mishaps too, mostly the fact it was a full moon, during an ice storm, and the staff was short-handed completely so everyone went into labor on the same night with all the medical staff calling out. makes for interesting memories. :-)

best of luck in your career.

7:02 PM  
Blogger Exceptional1 said...

WOW I cannot believe it...I mean I have a 5 year old son and I would have never pictured it that way. Well goes to show you there is a lot that we do not know and have never seen before. I do wonder how people handled it back in the OLD days...I know that I went through my own pregnancy but I did not have to actually see it for myself. I was too busy pushing the baby out. Hehehehehehehe

7:06 PM  
Blogger Ms. M said...

Man O man! I work in a level 2 nursery, not as an MD or nurse, I have never even seen a delivery but I do hear some good stories. None, NONE have compared to what you have experienced and shared with us. If I could, I would take the prostate too. Good g-d I will go through my 9 months of gestation (if ever it happens) in utter fear of what awaits on delivery day... you spend too much time in hospitals and you become sure that someday, you will be the one on the bed. Fantastic blog, but I know you know that. FYI, if you do a rotation in Toronto, I know lots of gorgeous, brilliant single jewish women. Hope to see ya.

8:37 PM  
Blogger Daphnewood said...

that was PERFECT. I have a teenage daughter and I am going to make her read this. That ought to make her think twice before putting out.

we have been debating your "I shit you not" all week. It is an anthem they all use, no matter the specialty, all the way up to the chief resident. So you can be rest assured that no matter what field you choose, you'll already have the lingo down.

8:37 PM  
Blogger ArleneWKW said...

I thoroughly enjoy your blog. Thankfully my 2 childbirth experiences were not so eventful. The second time around had a rather wonderful component. I was able to experience my contractions as beats in a primal dance that connected me to women from ages past and across the globe who had experienced or were experiencing childbirth. I've long forgotten the pain that I was able to blunt with this little fantasy. I feel priviledged to have been able to experience childbirth.
And I feel priviledged, a different kind of priviledge, to be able to read your wonderful blog.

9:35 PM  
Blogger Audi said...

Well when I delivered my second child my husband fell a sleep. I'll take the TV any day.

Love the blog. Started reading last week and now I can't stop!!!

10:13 PM  
Blogger Litahnee said...

Hmmm... I have not experienced vaginal childbirth but it is quite appealing. Why wouldn't you want to go through an enormous amount of pain and potential tearing whilst being left with little dignity?
And then there are those nutters that are appalled by public breastfeeding. What wankers...I mean if half the world has seen your vag and even stuck their arm up there (and not in a sexually consenting way) exposing a bit of tit is hardly blushworthy.

10:19 PM  
Blogger ruz~* said...

omg! i can't wait to give birth! :D :D :D

11:15 PM  
Blogger Mindi said...

This is one medical transcriptionist who adores you! I only hope your dictation is as good as your storytelling! Keep up the good work. It's nice to know that some of the boneheads I type for - er I mean well-trained medical professionals, have a sense of humor!

12:56 PM  
Blogger Asif said...

Nice work.
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9:27 PM  
Blogger Sherry T in Va said...

Oh, man am I glad I found your blog. I am an RN and have worked er and many other areas in the past 15 years. Not too many people understand our sick humor that is at times life sustaining. I will be back for more of your humor !
Good luck in your journey.

11:51 PM  
Blogger Leesa Dee said...

I once asked a vet when he was squeezing the black, smelly crud out of my dog's anal glands and I was trying not to gag, what the worst thing about his job was.
His reply: "The paperwork."
So I reckon there's somethings that are worse than the organic ooze.

1:49 PM  
Blogger SaraSmile said...

You'll have to check out the story on my blog of the birth of my first daughter sometime. Not as gory LOL but definitely funny. Though I don't recall if I mention in it how badly I tore, almost as badly as the woman you describe here (thankfully, no permanent incontinence)!

Oh, and that birth was 100% natural, my water broke on its own, and my baby was 7 lbs, 12 oz, a very normal size... For Baby #2, the doctor was just about to do the episiotomy when she saw me starting to tear, tossed the needle with the numbing agent to the side, and cut me... and with Baby #3, I tore again (though she was a large one, at 8 lbs. 11 oz, and induced to boot...)

9:32 PM  
Blogger Crafty Mom said...

Okay I just found your Blog, & I'd like to say that I love it! Your medical descriptions couldn't be more accurate;I've been a Registered Nurse for the last 20+ years & I witnessed a few of the events you describe ever so accurately. I love your style, you are totally hilarious! "Dr. House" eat your heart out! Reading your Blog is better then watching the top rated Medical TV show, which by the way I happen to love too. Please keep doing what you do. Thanks, I'll be back to read more.

5:43 PM  
Blogger nurse pica said...

as a nurse i have to say that i honestly do like to see the doctors perspective on things. i too am in my third year, but in my BSc in nursing.

i remember once during a c-section under GA, the baby was brought out and it actually spat and farted noisily before the midwife took it away to be weighed ect. lol!

1:25 PM  
Blogger Margie the Pickle Princess said...

When I had my son, I had the same thing happen, that is externally it didn't seem like I ripped that bad, but I ripped half up my uterus and all the way through to my rectum. I had a midwife, and it took her over 4 hours to figure it out. By the time she decided she couldn't fix it and needed to "rush" me to the hospital for emergency surgery, I had lost half my blood to a hematoma and internal bleeding. But I didn't get that poo problem! I didn't even know about that, thank heavens! I guess I was "lucky." I love telling young pregnant women about it. They turn the most suprising shade of white. Great fun!

3:21 PM  
Anonymous Anonymous said...

Wow!! And people wonder why I beggeed for a c-section for my second delivery (after suffering through vacuum and forcepts during my first delivery). One vaginal delivery was one too many. Slice and dice me anywhere but DOWN THERE. Hasn't medical science evolved enough to spare us the "miracle" and just give us the "surgical" to prevent stories like these?

7:56 PM  
Blogger Regan said...

WOW! But I must say thanks for being real for all us potential mothers out there that only hear about the "cute" parts to childbirth.

11:30 PM  
Blogger A. said...

You write quite well; I agree with the PPs who think you'd make a good sitcom writer. I found your blog via blogger's flogging it on the homepage. Very funny, very well done. Having had two v-births sans drugs (the second of which was jump-started with the "crochet hook"), I highly recommend you attend some waterbirths (or water labors). Very little intervention is necessary and since the skin is already supple from the water, not much tearing either. Keep writing; I will keep reading. oh and good luck on the finding a single Jewish female front. Cheers!

12:19 PM  
Blogger Linda said...

I hope you get a chance to see some normal births (although perhaps not likely in a teaching hospital) and write about those too, for the benefit of readers might otherwise be inclined to regard stories like this as evidence that birth best happens through surgery and lots of drugs.

10:12 PM  
Anonymous someone who has been there said...

For those of you really concerned about having babies and episiotomies, I have one simple tip. Don't lay down. If your perineum isn't in the doctor's face, it can't be cut.

The pain of giving birth is nothing compared to the pain and difficulties of the interventions used during "normal" birth in the hospital. And FYI, having an episiotomy cut, vacuum, forceps and laying down all increase the chance of tearing during childbirth. As does an epidural, but nobody likes to hear that!

7:57 AM  
Blogger cheesemeister said...

Gad! Was it too late to do an emergency c-section because the baby was already in the birth canal? I've heard of cases where they pushed the baby back up in and did a c-section. Would that be better or worse?
I'd like to say why are some men such idiots (the husband.) But maybe he was focusing elsewhere because he felt helpless. So I'll try to be nice about it.
Peace.

11:29 PM  
Anonymous Anonymous said...

why don't you have a photo in your profile, i mean you could put up an airbrushed pic of george clooney :) unbrushed wouldn't be so bad either.

7:13 AM  
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3:24 AM  
Anonymous Cheap Steroids said...

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