This month I have been going through my obs/gyn rotations - this being one of the most challenging rotations because most of the time everything that you do is urgent. In obstetrics you treat two lives together, so any decision which is made must have benefits that outweigh the risk to the other person.

Our OBG department is divided into inpatient and outpatient blocks. The outpatient services include gyn OPD, antenatal clinics, daily family welfare clinics and a special clinic each afternoon, which includes an infertility clinic, HRT clinic and a cancer clinic. In the inpatient block there is a maternity ward, a septic ward, a general gynecology ward, a cancer ward and a labor room (of course without which, talking about OBG doesn't make much sense!) Each of us is assigned a unit to work on and a unit typically consists of 2 consultants, 2 senior residents, 4 junior residents, 3-4 interns and 4 medical students. This demands long working hours (even by the standards of medical students) and in particular, the labor room posting is something that really takes the juice out of you.

During my first week of rotation I met and chose my patient to follow. She was a young woman of 20 carrying her first child at 24 weeks, barely out of childhood herself. She had finally convinced her OB to refer her when she ruptured at 22 weeks. This meant bed rest, loneliness and stress. I didn't feel that I was helping her by waking her up at 5:30 every morning to poke at her belly and inspect her fluid leakage, but we managed to get to know each other throughout the couple of weeks that followed. She was convinced that the baby was a boy although he refused to show himself on ultrasound. She was also convinced that he would be healthy and would be her first and only child. She was 26 weeks along when I walked in one morning and saw the haggard faces of the night call team. Bits and pieces of information floated around..."six fetal deaths overnight"..."that PPROM in room 14"..."never want another night like that one again..."

One of those fetal deaths was my patient’s. Her baby slipped out at 11PM and lived for about 4 hours as a result of pulmonary hypoplasia from the lack of amniotic fluid. She asked if I knew that he had been a boy, just as she had predicted. She had named him and told me he was beautiful. She went home immediately so as not to be surrounded by the sounds of labor and crying babies; I still think about her.

I'm towards the end of this rotation now and the thing I like about it is that you witness the beginning of life and lay your hands upon a new human being for the first time. But you may also see the end of that life too…
 
Off Duty
This month has been quite busy, although I’m now in the habit of feeling like this at the end of every 4 weeks. We had our annual Dr. I. S. Bal Memorial singing competition. This is also a platform for our previous students association to invite interns to join the association and felicitate with them. I had the feeling that, in the same way, we will be leaving the college next year. It was a feeling of the joy of completion and the fear of missing all the friends you have been together with, except perhaps for a few who might have a residency at the same place as you. OK let’s stop thinking about all this, I have another one and a half years until I have to face the situation so until then, enjoy.

Bye all of you, I’m afraid I’m getting late for clinics!