And It’s Finally Over!

4 04 2012

It’s been a while since the last update, and a decent amount has happened.  I finished Ob/Gyn, took the shelf exam, had a week of blissful vacation time, and started pediatrics this past Monday.  I don’t think I’ve been able to talk about my two weeks in Gyn-Oncology, so let’s start there.

It’s all about women’s reproductive tract cancers, mainly ovarian, cervical, and endometrial, but they also take care of vulvar and fallopian tube cancers as well.  As you might imagine, it’s an extraordinarily depressing line of work, what with all of the melon-sized ovaries and cancer caked in the abdomen and chemo and hospice that goes on every day.

But at the same time, it’s fascinating.  Especially the surgeries, during which they make a looooong incision from stem to sternum and dig around in the belly to remove as much of the cancer as possible.  I saw an ovary the size of a honeydew melon last week come out of a frail little lady.  Another poor soul had her entire omentum (the apron of fat that drapes from the upper GI tract like a sheet over the front of the belly to cover the abdominal organs) caked and matted together with metastatic cancer.  And it was positively fascinating.  Of course, I feel a little guilty about this, because things that are really cool to me are really dismal for the patient.

Unfortunately, the way that the segment of the clerkship was structured, it sucked (for lack of a better word) about 98% of the time.  Gyn-Onc where I was assigned had only two residents, and the attendings traveled back and forth between that hospital and one across town.  This meant half the number of cases to begin with, and there were three students on the rotation.  There were very few surgeries (barely 2 for each of the students each week), which, again, great for the patients, but not so good for us.  So we mostly sat in the documentation room of the clinic and tried to study.  When there were patients, the attendings saw them, the residents acted like students, and the students stood in the corner converting oxygen into carbon dioxide.

Riveting, I know.

The residents, as with most I’ve encountered during Ob/Gyn, were less than helpful.  They did that thing where they expected me to be somewhere, didn’t say when or where, then gave some combination of scowling or rolling their eyes when I either asked for clarification or didn’t end up in the right place on time.  Mostly they just acted like we, the students, weren’t there.

Between the depressing nature of the content and the sheer boredom that came from hour after hour of time wasted tagging alongside people who largely ignored the lot of us, this was not the best experience.

I will say, though, that a couple of my coolest moments in medicine so far came out of this sub-rotation.  During a lymph node dissection, the attending actually let me touch the aorta, and to feel it pulsing through my glove was one of the most incredible experiences I’ve had yet.  In the same surgery, I was mesmerized by the sight of the bowel, half-spilled over onto the patient’s chest, still peristalsing like some pale, glistening snake digesting a rat.  And there is very little comparison to the amazement that I felt in watching the heart beating through the diaphragm.

That about sums it up, really.  I wish I could say more about the patients, but the truth is that I had very, very little face-to-face contact with any of them (a dozen at the very most), and even that was made up of very short conversations largely conducted through a resident or attending.  While this had the potential to be a very powerful rotation, the combination of surly people, tedious hours of boredom, and overall atmosphere of misery made me practically skip out of there when the thing ended.

Because I love Scrubs, here’s a fun clip:

On the whole, I don’t think I can do Ob/Gyn.  Well, of course I can, I just do not have any sort of desire.  There’s a lot of truth to the tendency of specialties to self-select; that is, people with personalities tend to gravitate to certain specialties, and we all know that misery loves company.  Delivering babies is pretty “boss” (as my brother would say), and it’s very hands-on, but these reasons alone are not strong enough to compel me to put up with the rotten hours and terrible co-workers and the constant possibility of being sued even if you do everything right.  Granted, some of this will change slightly from place to place, but it all seems similar enough that I’m planning to steer clear, even though I am unimaginably grateful to have had this experience.

To those of you who are Ob/Gyn docs, God bless you.  Thank you for doing this so I don’t have to 😉

Anyway, that’s enough of that.  I’m on to pediatrics now and will update about that very soon.  I will say this, though: in the first morning on inpatient peds, I saw more laughing and joking around than in the entire 2-month block of Ob/Gyn.

And to end on a fun note:

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2 responses

15 04 2013
network.nature.com

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16 05 2013
Glia414

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