Tuesday, December 8, 2009

She Growns Up

I don’t know how it happened. But it finally has. I am starting to feel like a bona fide doctor.

As you can read in my previous posts, the first couple of months of intern year were racked with insecurity. For instance:

The first week of my intern year, my 2nd year resident and I got called to a postpartum hemorrhage on the floor. One of our recently-delivered patients was found to have active vaginal bleeding a couple hours after the birth of her child. We rushed to the bedside. There was blood all over the bed, her hospital gown, and her legs. She was crying. Before I knew it, my 2nd year bolted into action. She was calling for vital signs, IV access, Pitocin, Misoprostol. She shouted out an order for Morphine to make the patient comfortable. She gowned up into sterile gear and started a vaginal exam at the bedside. Before I knew it, she was using her hand to clear out the uterus. Out came handfuls and handfuls of clot. In less than 5 minutes, the uterus had been evacuated and the bleeding had stopped. I will always remember that moment in my intern year. It was one of awe – awe regarding my resident’s ability to keep her cool and bring order to a frantic clinical scenario. It was also one of terror – terror regarding the idea that in 1 year, I would be expected to handle that situation with the same level of calm and skill. It seemed a daunting task.

Fast forward to my first shift on OB nights. It was 2am. The high pitched squeal of my pager shot me out of my near slumber. “Postpartum hemorrhage, pt J.K. in room 5015.” I jumped from my seat and headed towards the elevator. On the ride up, I recalled the steps in the management of post-partum hemorrhage in my head. Before I knew it, I was running it. I was calling for vitals, calling for IV access, for Pitocin, Misoprostol. I was clearing out her uterus. I was calling for a stat hemoglobin. Before I knew it, the patient was stable and her bleeding had stopped.

It didn’t hit me until later, when I was recalling the experience in my head, that I had missed something. That feeling that had haunted me for months – the panic, the insecurity, the tachycardia – was not there. In its place was an excitement, a sense of pride, and a rush that shouted “yes! I did it!” Yes, folks, I am growing my doctor wings.

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