Saturday, December 10, 2011

Door Number Three

Newborn child, seconds after birth. The umbili...Five days ago, six if you count Monday and orientation, I walked onto the obstetrics unit, knowing little more than Prissy (Gone With the Wind, 1939), who freely admitted she knew "nothin' about birthin' babies." I guess that means I knew next to nothing, which is okay; if I knew at the beginning of this rotation what I hope to know at the end, there wouldn't be much reason for what comes along in between, would there?

As it stands, I've already learned a few things, among them that I'm not inclined to drop a slippery newborn despite the fact, as a kid playing Little League, "Butterfingers" could easily have been my nickname. There's something about holding a baby who's just taken its first breath, that makes you hold on for dear life. Maybe it's parenting instincts kicking in, but the thought of losing your grip doesn't cross your mind. Holding them close with a quick, welcome-to-the-world snuggle in the crook of your arm, while passing them to the NICU (neonatal intensive care unit) team, you bet, but letting them slide through your fingers? Uh-uh.

And then, there's the matter of learning about the mess. Childbirth really is messy business. Television prefers spit and polished, shiny clean new babies who don't make anyone squeamish. Not so Mother Nature. There may be some blood, especially if junior's exit from the womb produces a tear in mom's vagina. There's amniotic fluid when her water breaks, though that usually occurs earlier, unless she's having a C-section, in which case the flow of amniotic fluid is more like a flood. To top it off, there's meconium -- baby poop -- mixed in for good measure. Martha Stewart would cringe.

Honestly, though, I don't mind the mess. Life is messy. Personally, I think trying to eliminate the messiness nudges more people toward neurosis than the other way around. It certainly is a driving force in narcissism, where the appearance of perfection is all-important. Babies have an entirely different perspective. Forget all that other stuff, okay? Mom was toasty warm, will someone please wrap me in a blanket? Ah, there we go, that's better. Mm. Thank you very much.

What I'm particularly enjoying about this rotation thus far is the tacit understanding that some things can only be learned here. Internal medicine teaches you how to write a good clinical note, surgery how to behave in the OR, pediatrics how to deal with kids and parents, psychiatry how to manage things going wrong, and then rural and family med puts it all together. None of them, however, specifically target birthing, prenatal care, or women's health (gynecology). So, in a sense, it's expected that a student is literally starting over at the bottom. You can use skills gained elsewhere to a certain extent and yet, so much is totally new. Every day is pregnant (pardon the pun) with possibilities and you never know what's waiting behind door number three.

(GNU Free Documentation image of a brand new newborn via Wikipedia)

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