Tuesday, August 21, 2012

The typical patient on L&D

I have finished my clinical duties on OB/GYN rotation. This week we have exams and presentations. So I think this is a perfect time to procrastinate by blogging.

In preclinical years there were rare instances where we saw real patients in hospitals, not hired actors playing the part of patients. One time we were seeing patients on the pediatrics unit. A classmate of mine said something when addressing the parents of an infant that implied the parents were married. But they weren't married and the student felt really awkward.

Now that I've been at this hospital for about two months, the image I have of a typical parent is completely different. The typical obstetric patient at this urban safety-net hospital:
-Teenager or early 20s African American girl.
-The standard age to have a baby is in your late teens or early twenties. I'd say that most of the pregnant patients we see are between 16-22. This means that they're younger than I am. I'm a little bit taken back when I see a date of birth on the chart that's in the mid nineties. I remember the mid nineties! But now I'm not that surprised.
-The baby daddy (terminology is per patient) is minimally involved, if at all. At her delivery are usually her mother, her aunt. A few times I saw the baby daddy cry when the child was born and I was touched by that. But this is pretty rare.
A few days ago I saw a 28 year old patient who was pregnant for the first time. Reflexively I thought that she was old.

Then I saw a pregnant patient in her late thirties so by definition was AMA. Advanced maternal age: 35 years or older at the due date. I thought she was really old. She was starting to have grey hair.

Friday, August 10, 2012

First rotation!

An attending I worked with yesterday asked what specialty I wanted to do. I was honest and said that I wasn't sure. I probably won't decide until the end of my third year, which is as late as possible. He suggested that I write down notes from my rotations so that I can look back on them when making a decision on choosing a specialty.

That is a very good idea, I thought.

Also a couple friends inquired about my blog recently even though it had been on hiatus for months.

So I'm blogging again!

Quick recap:
I'm a third year student now. My first and current rotation is OB/GYN.
Passed USMLE Step 1!
My score was pretty good and I'm pretty happy with it. (Though I really wanted five more points. That's how it always is, isn't.) Good or bad, that uncertainty is over.

A doctor explained Bartholin's gland to a patient this way:
When you are about to eat delicious food, the glands in your cheek produce saliva to lubricate your mouth. Bartholin's glands have a similar function. When you have foreplay, these two gland on each side of the vagina that secrete fluid to lubricate.

I thought that that was a fitting analogy but I think about it every time my mouth waters.