OB-GYN-L Messages for March, 2008: Re: Today was a GOOD day

Re: Today was a GOOD day

From:

AllanHo@aol.com

Mon Mar 3 01:26:02 2008

There's the problem Allen. You interpret my post as gloating. That was never the intent, and I'm sorry if that's what you thought. The clinical part WAS pedestrian, and if everything had gone as intended, it would have been just another ordinary day, not a tragedy. When i left the hospital a week ago Friday, I had assumed that my good friend's grandchild would arrive over the weekend when I wasn't there. When I returned on Monday, I was happy to hear that I hadn't missed the birth, and assumed that I would be attending a c-section as pediatrician sometime that week, or that I would miss it entirely anyway if they brought her back for an afternoon c-section, since I only work mornings. When I arrived Thursday morning, I was pleasantly surprised to see that my good friend's daughter was in labor with a vertex baby, but figured that, being a primigravida who was only 1 cm, and not likely that any further augmentation would be a good idea because of the decels, she would probably get sectioned later, or at the very least, deliver vaginally much later in the day, after I had left. I was pleasantly surprised again when she was found to be 9 cm a little after 10 in the morning and that I probably would be able to be there for the birth, assuming she was able to push the baby out. I assumed that, because it was a decent-sized baby, it would take her the better part of 2 hours to push it out, so when I saw the decels after 10 or 15 minutes of pushing, I figured she was probably nowhere near delivery yet and would need a c-section. I was again pleasantly surprised to find that she had already brought the baby down to forceps/vacuum territory. I informed the OB simply because I didn't consider it quite "outlet" and because it was a "big" baby. I was AGAIN pleasantly surprised to find her crowning when I returned to the room. The ultimate outcome was a nice vaginal birth and that I did get to be there, and my intent was simply to share the elation of that moment with my friends here at OBGyn.net. The midwives apparently understood, as I expected they would. I wasn't gloating.

We don't hand our patients off from doctor to doctor. The patient's FP resident provides continuity and follows the case all the way through. The attendings are usually quite peripheral unless there is trouble. I too did all my own OB for over 15 years, taking call for my OB patients 24/7 unless I was out of town. It was a great experience, but I eventually burned out. My current schedule works for me because I have a 21-year-old son who became addicted to a computer game, flunked out of the Big State U, and is now doing well in community college. I have to be home by 2PM to unlock the internet for him so he can do his homework before going to evening classes. My priorities have changed. Kids have a way of derailing our best-laid plans. Another reason the good days are precious.

Such is life.

Anna Meenan, MD, FAAFP

Anna,

This version of your story makes more sense. I AM happy for you! Your first version sounded like mockery of obstetrical practices! That's why I asked you whether you were being sarcastic. I guess the lesson from this ruckus is that one would need to tell a story differently depending on the audience.

Allan

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