It has been quite a hectic week. It started off quite slowly. We had only 1 lecture on Monday, then we moved into Mobray Maternity Home. Its a 4 story large building which deals with all but the most complicated issues relating to childbirth. There are 9 of us currently staying at a residence building maintained by the university of cape town on the premises of MMH. I think it is a two story house that has been converted for the purpose of housing us students while we’re doing our obstetrics bloc their. I am staying in a room with 2 beds in it by myself. It has 2 windows, 1 overlooking some slummy area of Mowbray and the other looking onto the hospital.The curtains are thin and the flood lights of the hospital emit enough light for me to think that it is twilight all night long. There is also some air conditioning device that makes a loud humming noise 24/7. My bed is adequately comfortable, though it has a deep middle depression. I am using hospital linen, which smells slightly fecal, but I’m ok with that. The residence is quite and decent. I am enjoying staying there. Of the 9 of us on this sub-rotation, there my 2 close friends, who do 1 shift, 2 botswanan guys who do another shift, 2 botswanan women who do the third shift and 2 other other South Africans who take the 4 shift. We woke nights and have lectures and tutorials in the hospital on all week days. My group, for some reason, took the first day, the Monday, but I couldn’t do the shift because my dad was getting married on Tuesday.
Trying to attend a lecture of tutorial is not the most easy thing in the whole world. Often they are in obscure venues and the person running them is late because they had some emergency. I spend quite a lot of the lecture time arbing around. One lecturer we have, named Prof De Groot, who has been a doctor for 50 years and probably lecturing on obstetrics for as long, gave us a few fairly good tutorials. He told us this story about a woman who had had 2 cesarean sections for cephalopalvic disproportion and so desperately wanted to delivery the baby via a normal vaginal delivery, that she stayed home that she stayed home and pushed for days. When she eventually presented to MMH she had killed the baby, ruptured her uterus and caused avascular necrosis of her bladder, leading to a vesovaginal fistula which leaks urine constantly.
I went home at about 1 and helped cooked some snacks for the wedding. My aunty arrived, with my cousin and her 2 young children. I fetched my sister and once I had returned Sue’s youngest sister, who’s my age, had arrived with her boy friend as well as the marriage officer. The wedding was a fairly brief ceremony which took place under the tree in our back garden. It was meaningful and cute. My dad and Sue were absolutely glowing once it was done. We snacked, chatted and champagne was served. I hung around for quite a while, then lifted my sister home and rushed back to MMH for my catch up night shift.
I was on shift with the 2 Botswanan girls of whom I am quite fond. We have a fun teasing relationship. Once on shift I got 3 deliveries quite quickly. The first delivery was almost as I arrived. I walked through the labour wards, which are 7 ajoined, yet private rooms along a corridor. 1 Woman was about to deliver, so I asked the sister if I could deliver her and she oked me. After an hour or 2 another woman who I was monitoring delivered, and then, after inspecting the placenta and cleaning up I was walking passed a curtained off ward and a doctor said loudly that the woman behind the curtain was crowning and she wanted help. I performed that delivery. I then assisted in the resuscitation of a new born who had merconium stained liquor. The resus was quite hectic. The child needed to be intubated. After about half an hour of bagging the child was breathing its self. Later, on observation, it was posturing, a sign that it had brain damage from the period of time when it had no oxygen. As the day ended and the 7th of February came into being I was inserting a catheter into a fat black lady’s bladder. What a great way to start my birthday!
There was a period of time which was intensely boring, between about 1am and 5h30. The sister decided to show us around the ward. Now, there is something that really irritated me about nurses showing us around the ward. They spend a seriously large amount of time showing us simple things that we have no use for, and then brush over things that we don’t know and need to know. For example, the sister will spend 20 minutes (no joke) explaining to us about exactly what is on every shelf in every labour ward, but not about intubation. She will also show us things that nurses need to do and we don’t. Like assorted record books nurses need to fill out. The tour drove me nuts. I wanted to gouge my eyes out. I met a sweet woman whose job, it turned out, was to clean up bloody thing at night. She only works night and has been doing this jobs for years and years. She just mops and hoses down blood stained garments. Its really arb.
I urgently needed a mobile cot for a baby, so I went into the sluice room, tried to lift this dirty towel out of one and to my absolute horror there was a miscarried baby in it. I was freaked out for 10 minutes. Towards the end of my shift my 4th patient for the night delivered. I finally realised how amazing an organ the vagina is. It is the organ of colour. No other organ can produce every colour of the rainbow. Yellow of urine leaking, the light coca-cola brown of hypertensive liquor, bright red of fresh blood, dark red of clotted blood, green of merconium stained liquor, black of merconium, white of vaginal discharge, blue of hypoxic babies, grey of deceased masserated babies, pink of healthy babies, cloudy light blue of membranes. I am utterly blown away and disgusted by childbirth.
I managed to attend 2 lectures during the day, and a another one of those boring nurse tours during which I canned myself from lack of sense. During the second lecture, an excellent one from which I learned a lot, I was both sweating and shivering. I realised that on a scale from 1 to coping I was at a 1. I went to bed from 10h30 till 1h30. I then ate a bit and hung out with my vasity cronies. I went to a friend for nag, then hung out with another friend. I went home for a lovely chicken braai and then went back to Uni to sleep.
On Thursday and Friday was I was still recovering from the sleep deprivation. I really felt horrible and sore. I struggled to stay standing during tuts and to concentrate. There were a few good tuts and a few very boring tuts. I slept during almost every break we had on Thursday. On Thursday night I went out with one of my best friends, and their dad from Holland that I had never met. It was such a privilage to meet their dad, after all these years of friendship.
I was on shift again on Friday Night. By afternoon on Friday, sleeping in every break > 30min, I had recovered from the previous night shift. I cooked pasta for my team and then we went up to ward. The fun theme for the night was patients going to caeser. I assisted with my patients caeser. It was quite hectic because the woman didn’t want her baby. She was using the oral contraceptive pill, which failed, and she fell pregnant. She had a previous Caecer for either CPD/ fetal distress or failure to progress. She failed to progress, so we took her in. All the staff, equipment, medicines, etc for an unwanted child. We tried to give her a spinal block, which was taking too long to kick in, so we gave her a general, then the spinal block kicked in and her blood pressure dropped to 50/30, which is hectically low. I helped by dabbing the wound, retracting tissue, pulling tissue and following, which involves holding the thread being stitched and following it into the the hole made by the needle. Scrubbing in was difficult. I had to re-scrub once and get 2 new gowns because I contaminated them while getting into them. Surgery is very similar to dissection.
I half-heartedly monitored patients for the rest of the night. A patient in cubical 1 was shitting profusely and howling the entire night. When a mother had twins the presenting twin is referred to was twin A and the second twin to come is twin B. When a mother is shitting the joke is that she is delivering twin A. She really howled all night. Wow. She had polyhydraminos – too much amniotic fluid, so the doctors were worried about her. There was such a lovely woman with a baby in cubical 3. The woman in cubical 2 also howled a lot. Cubical 4 had twins, cubical 5 had a 16 year old G2P0 planned pregnancy, which I just didn’t deal with, and cubical had a patient I was monitoring with poor maternal effort. She hadn’t delivered by the time I went off shift. Cubical 1 delivered with such a fuckload of amniotic fluid, it was hectic.
I went off shift, exhausted, dirty and unimpressed. I feel very drained
powered by performancing firefox
