"I'm Having a Baby: OBGYN"

Actually, that title is a bit of a lie. I already had the baby. A little baby boy. I delivered precious Maruee at 4:35pm yesterday! Very cute. Did a pretty good job. I am actually not sure who the father is, but I'm sure he's a nice guy. No, no, now I remember. He was pretty much an asshole. More on that later.

The mom was nice. She did very well for a first time mom. So y'all have babies soon so I can deliver them. I'm not so good at commanding the chicks though. I get all nervous and I think it's best not to say anything. What I do feel like saying is, "Yeah, look, it's hurting me, too, so push damn it!" Or, "Yeah... yeah... yeah... we don't got all day, aiiyt?" Or, "Hey, I'm gonna step out and when you're ready to push, page me. Okay?" Or, "Hey you're making me look bad here. My grade is depending on this." (Any suggestions on how to say all this tactfully would be much appreciated.)

Life is okay right now. I'm on my third day of Obstetrics and Gynecology rotation. I am actually learning stuff, it's amazing. My darn back is killing from delivering the baby, of course, and from standing in the operating room for over seven hours yesterday doing C-sections. I managed to squeeze in 2.5 hours of sleep last night when I was on call. I promised my self I would not write a long entry. I am supposed to be reading. But I am in need of some human contact right now, so sitting by the computer somehow makes me feel better.

I love being back in the South. (I did my undergraduate here.) Yesterday one doctor actually said, "That might could be a hemorrhage." Ahh, nostalgia.

It amazes me how many kids are born to single parents. The jackbutt I was talking about thought he was pretty darn nice for making it to the delivery room. He looked all bored and quite inattentive to his 20-year-old whatever she is to him. When we tried to involve him he said, "Nah! I've already been through all this. This is her first baby, but my second."

ZATS a n-i-i-ice one, buddy. Man! Note to file: Have babies only with really nice guys. Beyond that, the residents here take a lot of time to teach us. I am actually excited when I am on the floor. No scut work either (stupid errands people make you do 'cause you are at the BOTTOM of the totem pole!).

P.S. Lots of Hispanic folks here so my Spanish is improving. I'm learning a bunch of phrases that'll be useful for my next salsa run.

"The Scoop on Poop: Outpatient Medicine"

I am doing a month in outpatient Medicine and am thoroughly enjoying it. Last week was Gastrointestinal (gastro=stomach and intestine=rest of tummy) medicine. This has made for a week of intriguing conversation. "Doctor, I can't move my bowels. I mean, I was on the toilet thinking which end was coming out first!" (You gotta say it with southern accent to get the right effect.)

Next came, "Hell! I dreamt last night that I had diarrhea. I haven't moved my bowels in weeks!"

"My whole insides feel like they are gonna burst. It's like a tinkling... kind of a snarling... kind of a gnawing kind of a pain, you know what I mean doc? I think it's my nerves."

Needless to say, nothing is too personal. Nobody walks out of here without giving me an extensive Bowel Diary. (We used to get kurkum-ed for that kind of a talk.)

One doctor always ends his exam with "Okay, now I just have to finish the exam where I will gently have you gently turning around for me so that I can do a gentle rectal exam." One patient said it best: "HAH! This guy is sneaky! Next you're gonna tell me a gentle enema and colonoscopy!"

I think my giggling ran longer than the doc would have liked. Anyway, that was probably more than you wanted to hear. But, I do have advice for all you secretly suffering. Two words: Fiber One. The best and greatest of cereals. Tastes decent, too. Half a cup a day, plus skim milk, plus four glasses of H20 daily and you'll thank me. I won't send you a bill either.

"Playing Volleyball with a Live Heart: Surgery"

So, surgery is over! Life seemed like it was a two-month black hole during that period. I did get to do some really cool stuff. Actually, mostly watching, but I got to hold a heart. I saw many a by-pass surgery and stitched up people.

I have sworn to myself never to have surgery. You think doctors know what they are doing when they put you to sleep. But sometimes they just dig around in there like a kid playing in a sandbox. No rhyme or reason to it and more "Ooops"'s than they care to inform you about. It was interesting though to see a live human body. Seeing the blood makes it pretty different than gross anatomy.

No real gory stories to impress you with. Nobody died in my arms and I never fainted or anything. The most difficult part about third year is figuring out what your role is. Doctors don't expect you to know anything and don't want you doing much. Patients, on the other hand, are prepared for you to do their open-heart surgery. Everybody else thinks you are just a pest and in their way. It's difficult determining what you can and can't do, and knowing when to ask questions and what questions are too basic to ask etc. You have to be confident even though you sometimes have no clue what's going on.

My favorite sister edited this video for her job on what makes the best employees, and the answers kept playing in my head: "anticipation!" It's hard during an operation to anticipate what you should do that can actually be helpful and appropriate.

That was the difficult part. The fun part was waking up at 5AM every morning. Surgery did change me in some ways. For one, I was almost brain washed into thinking it was the only field of medicine that actually does something. I found myself saying to my classmates who were doing other rotations, "What on earth do you guys do all day anyway??"

Not that surgery is like this lifesaver. Actually sometimes patients survive despite what we do and not because of what we do.

And as for my feminist beliefs, lets just say I would be banned from sisterhood. It first started with me letting dumb chauvinist statements pass, then it progressed to giggling at these jokes, then to many, many dreams of quitting school and marrying a rich man and thinking "Why didn't someone tell me about this brilliant idea?"

I won't proceed lest you lose complete respect for me.

One Degree of Separation: Psychiatry

I am doing my psychiatry rotation. After surgery, I really appreciate waking up as late as 7:15 AM. Weee! The hours are great so I am able to do road trips, breathe, eat non-cafeteria food, listen to the news, memorize all Britney Spears songs, check email, get into major discussions about Jennifer Lopez's and Puff's relationship, go grocery shopping, wear non-scrub clothes....

I am currently working in Crisis, which means people with mood disorders (depression, bipolar) and substance abuse problems. It is actually the mild side of the field, so, in a way, I am relieved. The hard part is of course talking to these patients and knowing what to say and how to extract relevant information from them.

There is a science to it, but socially, it's still hard. There is very little that we do in terms of physical exams (stethoscope, stay home!).

It is mentally draining as you can imagine, but at the same time uplifting because you see people come out of really desperate and despairing mental states. The shocker today was when we were doing rounds. One of the patients turned out to be this hall-mate of mine from college. It confirms my suspicion that we are all on the brink. She was actually helping me relax and grasp the whole idea that a kid my age could indeed be stuck in a psych ward. She spoke confidently about how she would be okay and recover from all this.

I assured her I would keep her confidence. "I know," she said. "But I'm not ashamed!"

As usual, I take more from my patients than I could possibly ever give back.

Update: October 2000

I am studying for boards. Don't ask. I've also decided to take the year off between third and fourth years. Many have shown their disapproval, "mmn ale arfesh temertishin b'tCHerisheee?" For me, this marks the year where I will officially have lived in the States longer than I have in Ethiopia. I've never had an identity crisis, but still the memories of home are starting to fade, and fewer and fewer people are left for me to go back to.

I have been thinking of going back home permanently, too. "Ahh! You'll never go back. That's the same thing my father said when he came here, over 40 years ago," my friend in high school told me during my first years here. The words ring in my head today. The temptation to stay here is strong and the longer I wait, the less the incentive and the weaker my initiative to go back.

I hear stories of people who have gone back... some were revitalized, some under-whelmed, some swore never to return. I go for many reasons. Is there really a place for me there? The basic premise of practicing true medicine in its purest form, of being a physician, of healing the ailing... wouldn't it ring truer in Ethiopia where we physicians are needed more? To be real doctors don't we need to practice medicine in Ethiopia?

The sheer thought of it is quite overwhelming and sitting down to think about it makes me cry.

I am going to work in a clinic there for fourth year elective.I am not unrealistic about what to expect.