OB Baptism

My mother tells me I was baptized as an infant.  Sadly, I cannot recall the details of that particular occasion, but I do remember with clarity the baptismal event from my obstetrics (OB) rotation during the third year of medical school.

Together with a classmate and good friend of mine named Bryan, I had been assigned to a week-long stint on the nighttime OB service.  This nocturnal exposure serves purportedly to provide med students with additional opportunities for delivering babies and to teach the students to work with less supervisory oversight than during daytime rotations.  In reality, Bryan and I whiled away our overnight hours by surreptitiously swiping saltine crackers and peanut butter packages from the nursing station, consuming absurd quantities of caffeinated beverages, and trying to appear studious.  Every few hours, a delivery would commence, at which time one of us would accompany the residents to the patient room and “assist” with the birthing procedure; typically, the residents would deliver the baby, and the student would undertake the esteemed and vital task of delivering the placenta.  Crucial as this curricular exercise may seem for the training of physicians who probably will never practice obstetrics, even its scholastic value was eventually exhausted, and Bryan and I began to yearn for slightly more educational experiences during our remaining nights on the service.

The additional instruction we sought came one night in the form of an emergency Cesarean section due to fetal distress.  Because Bryan had already participated in three deliveries that night, I volunteered to take the case.  When the external heart monitors began to show dangerous decelerations of the fetus’s heart rate, the team decided to rush the pregnant woman to the OR for a “crash C-section.”  Imagining dramatic, cinematic shots of me running down the corridor while shouting commands and saving lives, I hurried after them.  After locating sterile gloves, protective shoe covers, hairnet, surgical gown, and goggles; after getting lost in search of the operating room; and after contaminating myself at least four times while scrubbing my hands, I finally entered the OR ready to assume the customary med student role of standing in awkward proximity to residents and retracting abdominal fat.  In a curious twist of fate, no residents were available to participate in the surgery, leaving only the surgeon, the OR nurse, and me in the room.  As such, I was in a prime position for the events that ensued.

“Stand over there, student,” the surgeon ordered, pointing emphatically with forceps to a position for me on the other side of the operating table.  He then made a lower abdominal incision on the patient to reveal her gravid uterus.  An enormous, tense, reddish balloon, the uterus seemed to fill the woman’s entire pelvis and abdomen, and I could appreciate that it was under extreme pressure from polyhydramnios, an abnormal buildup of the amniotic fluid that usually circulates within the uterus to provide a protective environment for the developing fetus.  As the surgeon placed his scalpel for a low transverse hysterotomy, the type of incision used to open the uterus in order to extract the fetus, I felt a premonition of doom and began to back slowly away from the table.  Too slowly, as it were.

Scarcely had the scalpel blade made its mark when, like a perverse version of Old Faithful, the woman’s uterus spewed forth a stream of amniotic fluid, with my chest as the direct target.  Staggering backwards under the force of the fluid, I cried out in shock as the deluge instantly soaked through my operating gown, my scrubs, and my undershirt, splashed up under my mask onto my face, saturated my underwear, and ran down my legs into my shoes.  The eruption ended as abruptly as it had begun, and for a few seconds, the only sounds in the room were the droplets falling off of me onto the floor and the cries of the newborn baby that had been handed over to the neonatology team.  Stunned and somewhat nauseated, I looked up at the surgeon and asked, “Sir, with due respect, may I go change clothes?”  He laid down his operating instruments, looked squarely into my eyes, flashed a malevolent and wicked smile, and replied, “Absolutely not.  You have been OB baptized.”

For the next ten minutes, my wet feet squelching in my shoes each time I shifted my weight and my body becoming increasingly hypothermic as the amniotic fluid evaporated from my skin, I stood next to the operating table as the surgeon closed the incision sites and completed the cesarean procedure.  Four-letter words probably not befitting a person so recently sanctified ran through my mind until the surgeon, with another morbid chuckle, finally permitted me to leave.  I fled to the locker room where, though nothing could be done for my soaked shoes, I quickly changed scrubs and dropped my saturated undergarments into a nearby biomedical waste container.

I then returned to the student quarters, where I found Bryan.  As I entered the room, he cheerfully asked, “So, how did it go? Did you learn anything?”  “My dear friend,” I replied, “It was a religious experience.”

Author: Thoughts, MD

Itinerant doctor | Intermittent blogger | Dilettante Photographer

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