I wrote this at the end of my locum a year ago in December 2019. The last time I worked as a real doctor. I get a lot of surprised or disapproving looks when I answer – no, I don’t miss clinical work (yet).
I did a few short locums as a hospital resident this year. It’s a good break from my non clinical work. Nice to work somewhere anonymous, blending in with second or third year residents, and learning new things. “New” only because I wasn’t particularly engaged with my clinical placements or the idea of becoming a doctor during the medical student years. Remediation. Having said that, by now I’ve met plenty of RMOs who have other medical lives. My pathologist friend who finished 7+ years of specialty training works both as a consultant pathologist and a ward RMO throughout the week. She’s hugely talkative and misses patients.
On the first week of O&G I was figuring out the shorthands and what was considered a normal birth. Like, is 20 hours of labour normal or long? Is 4L of post-partum blood loss an issue? On the second week a few of the co-residents were away and there were lots of mums and babies waiting to be discharged each day. Third week there wasn’t much in the way of daytime vaginal deliveries, though by then I did attend a few Caesarian sections. Made the mistake of wearing non waterproof shoes to theatre – the blood stains are still there after many washes.
After hassling the registrars for a few days, there was finally an opportune time to visit the birth suite on my last day.
“Um, it’s my last day and I have mostly worked as a resident on the postnatal ward…” A lot of my cohort didn’t have great experiences with trying to sign off births as medical students. Hissss, you’d expect to hear, from the midwives and the midwifery students. “You’re desperate to see a birth?” said the team lead, before I finished asking. She was sympathetic. She had worked years in remote and understood why I wouldn’t want to see my first birth (in recent years) working in a remote clinic, where help was hours away. “Tell the midwife and he will ask the patient for you”. He? The young large bloke wasn’t what I pictured but hey, male midwives exist and he was easy going.
The woman in labour happened to be one I had seen in antenatal clinic one or two weeks prior. She was a multiparous woman and had been induced overnight. Things were progressing rapidly. She was talking a bit to start with but the contractions got more frequent and there was a lot of moaning and vocalising in between her desperately sucking on the gas. Her husband sat nearby but didn’t appear too startled – it was their fifth baby after all?
Lots of CTG and vaginal exams. It’s incredible how the perineum changes as the head moves down and out. But baby couldn’t quite get out by himself. The registrar came in to assist with the vacuum suction. The baby was stunned as he came into the world but cried soon after. Placenta delivered and a few sutures for the small perineal tear. Fortunately she delivered pretty much as I finished that shift. I thought I would have had to stay back and camp there for at least a few hours more.
Neonates are monstrous, ugly things. Doing a lot of baby checks, I was thinking how they have some general commonalities to each other, and to us adults. They like to be fed and cuddled (so do I). They like being covered with some sort of swaddle (I like a snug blanket too). They like sleeping in the dark (in the room we renovated, which we never ended up moving into, we installed a second layer of curtains on top of the blinds due to my crazy sensitivity to light). So basically, babies are small humans and that’s beautiful. Beautiful for their families that is!