AS SEEN ON TV
Seems like just about every show on TV has to have at least one, and sometimes two, baby delivery episodes. Well, here's my first, sort of.
Due to a mix-up on my part, I come into the hospital a little after 7 a.m., an hour earlier than I needed to come in today. Fortunately, I'm not covering medical "urgencies" this morning (defined as when a physician has to see a patient immediately).
So I decide to get some breakfast in the cafeteria.
As I turn around, this thin Asian femme about my age, comes up to me, and asks where the third floor is. The third floor is pretty much all Ob/Gyn and Labor/Delivery stuff. I don't go to the third floor often. It scares me.
"Well, I think you can take --," I begin.
"Can you please show us?" she asks in a slight accent (maybe Chinese, but definitely not a Korean one).
As I'm registering the word "us," I see behind her is her companion hobbling through the hospital entrance, panting, and about 9+ months pregnant.
"She's in labor," the friend answers.
"MOTHERFUCKER!!" I manage to not say aloud.
Now, I can't think of too many things more frightening to a man than having a pregnant woman in labor coming right at you.
Even as an internal medicine doctor, there aren't too many things more frightening than having to take care of a pregnant woman either. As an internist and hospitalist, I can take care of all sorts of medical and emergent problems with adults, male or female. Teens too. But little kids, babies, and especially pregnant women make us internists all a little uncomfortable (not my field).
"Okay, let's take this elevator," I say. I rush to the the elevator, jamming the button as if I am personally alerting the United States President that it's DefCon5 or something. I turn to see the pregnant woman still lumbering in the lobby, panting, sweating, groaning. And I hear a black woman walking by saying,
"Dayam, she needs a wheelchair."
I forgot about that, stupid stupid me! I rush past her and tell her to wait as I go to the hospital entrance, wondering if there's an EMERGENCY WHEELCHAIR HOTLINE for situations like this. I see the security guard casually chatting to the doorman, and two wheelchairs behind them. I ask for one in subdued panic mode, and the doorman answers,
"Go right ahead, Dr. LILLIES (not my name by the way)."
Yeah, great security/doormen we have. Their job consists of sitting on their butts all day and they don't even notice a woman in labor enough to help her or even offer her one of the two red wheelchairs behind their asses. Thank someone this isn't an airport.
The pregnant Chinese woman is in a lot of pain now. I wheel her into the elevator, accidentally bumping her foot into the back of the tiny elevator. DOH! I'm sorry! She's probably thinking she should have stayed in the cab right about now.
Another person gets on the elevator and has the nerve to press button "2." Bastard!
It's almost surreal, like one of those TV shows where a baby is born in a taxi, at home, or ... IN AN ELEVATOR!!!
Delivering a baby isn't that difficult. I mean if your average cab driver, or even George Clooney can do it, I sure can.
It's the fear of birth complications that unsettles me.
I don't remember too many deliveries during my Ob/Gyn rotation as a medstudent. One of the few I do remember was after this lady delivered, she would not. stop. bleeding.
Great Goddess of Blood, it was like a waterfall of blood coming out of her womb then. The floor was soaked with blood. My shoes were soaked, even through my scrub booties. I remember the Ob/Gyn senior resident at the time, this 6 1/2 foot young but silver-haired joker, sitting in the Captain's Chair between her legs, turning around and giving me a wink because just 15 minutes earlier he had given an impromptu lecture about how to stop bleeding in such a case. This was about midnight.
As he went down the list of medications and maneuvers in an increasingly desperate effort to stop her bleeding, the Ob/Gyn doc's voice started to rise, and his humorous calm was replaced with unsettling urgency. As my first night on call that month, I couldn't do a thing but watch.
I think it stopped eventually and she was alright. Otherwise, the next step was to go to the O.R. for her, and I probably would have remembered that.
On a side note, I was still pretty green as a medstudent then. My first two rotations in the hospital were Pediatrics, and Ob/Gyn. After those two months, I knew I did not want to go into anything that dealt with babies.
Back in the elevator, I'm thinking about these complications ... the only thing I remember about stopping a postpartum bleeding woman is to massage her uterus so that it clamps down on the vessels ... but was that the first thing to do or the last? It would have to be the ONLY thing since there aren't any crash carts or meds in the elevator.
... And what if a blue baby pops out (heaven forbid) and it's a PEDIATRIC CPR?! With just me, in this tiny elevator.
Now, one of an intern's (and probably a student's as well), scariest nightmares is to be the first one at a code (or CPR). Passing a test on what you are supposed to do, and actually doing what you are supposed to do under life-and-death circumstances for the first (half-a-dozen) times are two entirely different things.
Your intern year is a deeply religious experience in that you are praying to all Christian, Greek, Norse, Hindu, Cthulhulian, whatever, gods every time that CPR TEAM STAT call goes out .. praying that the first person at the CPR is not you. (Of course, after seeing how many people do not survive CPRs or worse, what happens to them when they do, some may tend to lose that religious faith.)
My point being that I was feeling like an intern again, only I was trapped in a tiny metal box, waiting for this potential delivery (and possibly worse) thing about to happen. Only I was not praying to any gods. I was relying on pure desperate scared male psychic energy ...
HOLD ONTO THAT BABY HOLD ONTO THAT BABY ....
Even worse, I know as much about giving CPR to a baby as I do about giving CPR to a cat.
Well, no, I do know that instead of using two hands you use two fingers on a little baby, and gently at that. And you give tiny breath puffs as well (they've got little lungs remember). But how many compressions per breaths? It's different for babies. 5? 10?
HOLD ONTO THAT BABY HOLD ONTO THAT BABY ....
DING!
Just then the elevator doors open. Floor 2. I barely suppress the urge to kick the old guy in his bony ass as he walks out of the elevator ever ... so ... slowly.
"How long has she been in labor?" I ask as the doors shut.
"Oh, about two hours," her friend answers, probably more calm than I am.
I know I'm a doctor and all, but I have no idea if two hours is a long time or not (again, not my field).
It sure sounds too long when it's just you and a pregant woman in an elevator.DING!
Floor 3.
And baby still in mommy! Hallelujah!
I start to steer the wheelchair toward the finish line, I mean, the L&D nursing desk, but the friend takes over and says nicely,
"That's okay, I can take her there. Thank you so much."
Yeah, I'm relieved nothing happened, but ... for a second ... I also want to see this cute little Asian baby being born. I've seen deliveries before but I don't think I really "got it" as a fellow human being back then, or as a potential parent. The whole glory of life thing. Birth of the future, and all that.
I suppose I'll get my chance soon enough though.
Plus, I guess it would have been pretty weird if I stayed. And I still have a full day of work ahead of me.
I sigh, for multiple reasons.
DING!
After breakfast this morning, I see yet another pregnant woman on her way to the elevator, this time in the other wheelchair. She looks quite comfortable though. At least the doorman had his eyes open this time.
My real day is about to start so I hurry down the hall in the opposite direction of the second pregnant lady at that point.
For multiple reasons.
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ABOUT BABY CPR : I reviewed it.
Begin with: 2 breaths -
then 5 compressions (1/2 to 1 inch) - then 1 breath -
repeat 5 compressions / 1 breath cycles three times and check baby again. Repeat cycles of 5:1.
More baby CPR info here.
(The site is a little out of date as far as adult CPRs. A study in the New England Journal of Medicine last year showed that very little is gained with breaths in adult CPRs. So just call for help and beat on their chest until the ambulance arrives.)
ABOUT CAT CPR : I don't know cat CPR and I don't care to know it, because ... The LIGER! doesn't believe in life support or Western medicine for that matter. He just doesn't want to go through the hassle.
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Why guys suck, or What not to say when you are a guy. By Abby.
Cybergeisha Miyu could almost get me interested in J-Pop with her writings and site design ... but alas, my heart belongs to another genre (K-Pop, of course).
