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Keeping the Beat: The Rhythm of Residency As an OBGYN

I journey onward with the hope that in future situations I will react with the same well-trained instinct that my chief resident displayed today. My motivation is hearing that cry, seeing that pink skin, and ensuring the safe arrival of the next generation into this world.
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Doctor using stethoscope on pregnant patients stomach
Doctor using stethoscope on pregnant patients stomach

"Dr. Herlihy I need you to come see Ms. Reyes," the nurse said. "She's 30 weeks along, she broke her water at 4 am this morning and she's having a deceleration. The baby's heart rate is dropping."

"Ok," I reply. "I'll be right there."

My pulse quickens as I hang up the phone and hasten to see my patient. I have been a doctor for eight months. Already I am assessing patients, managing labor and delivery, and most importantly activating the chain of command in the event of an emergency. An emergency on the labor floor, I have learned, is not an uncommon occurrence. We have double the number of patients listed on our census, as each pregnant mother shelters a fetus, a patient with whom we cannot communicate but whose needs we still must address.

I kneel by the bedside as Ms. Reyes lies comfortably in bed talking to her husband by video chat. I look at the fetal heart rate monitor and see that the baby's heart rate is dipping. "I need you to hang up now so we can examine you," I say, calmly masking my rapidly growing concern. My chief resident comes in with a speculum and I quickly don sterile gloves, insert the speculum and see the umbilical cord protruding from the cervix, trapped beneath the baby's head - a cord prolapse.

The chief resident instinctively barks out orders and everyone springs into action. "Call anesthesia, call pediatrics, get two units of blood on the floor, and open up an operating room! Nola, I need you to elevate the fetal head. Get on the stretcher. We're going to wheel you in with her."

A cord prolapse is an emergency that requires an immediate cesarean section to prevent the blockage of blood supply and oxygen to the baby. I jump onto the bottom of the bed and replace my hand to hold the baby's head above the umbilical cord. I am covered with blankets to preserve our patient's privacy, and together we are rushed to the operating room. We are transferred to the operating table, the umbilical cord still pulsing between my outstretched fingers. I crouch at the end of the operating table and the sterile drape is thrown over me.

I no longer feel the cord pulsing, a signal that blood isn't flowing, so I shout to alert the surgeons. I hear the clang of instruments, and the baby is out in less than a minute. I crawl out from under the drapes and watch as the pediatricians resuscitate the baby. He begins to breathe on his own, his skin flushes pink, and after a vigorous back rub he lets out a cry. A wave of relief sweeps over me as I hear the reassuring announcement "One minute APGAR is 9," which means that the baby is healthy. While I wish to linger and savor the moment, there are twelve other patients in labor whom I cannot neglect so I leave the operating room to check on them.

Being a hospital resident is notorious for being mentally and physically challenging, and obstetrics and gynecology is one of the most demanding fields. As an intern, I am at the start of an exhilarating journey in which I am sprinting to sharpen my skills as a physician. I must train my mind to remain calm and rational because levelheaded decision-making is critical to the survival of my patients. It requires sacrificing life outside of work to sleep at the end of a long day so I will be sharp for the next day, the next patient, the next emergency.

I journey onward with the hope that in future situations I will react with the same well-trained instinct that my chief resident displayed today. My motivation is hearing that cry, seeing that pink skin, and ensuring the safe arrival of the next generation into this world.