The Splinting of My Fractured Soul: A Case Report

"Listen, this rotation is hell, and its soul destroying, and you just have to get through it."

Why?

I don't wanna play anymore.

The end of my string is slowly approaching. I've been doing 1 in 2 call. That means every second day you stay at work for 26 hours or so. Which means everyday you go to work and it doesn't end until tomorrow. Its exhausting. Draining. Yes, it drains my very soul. So I've started a soul account. Trick is, you have to pay in more than you pay out.

You forget who you were before you were a forceps, vacuum, and C-section machine. Did I have a personality? Was I interesting? Did I care about life? Was I passionate about anything? Doubtful.

There was a big deposit into my soul fund last week. A dear friend from medical school stumbled into the Ass Room (i.e. Assesment Room at labour and delivery). His wife and him were a source of profound inspiration to me in school and all-around make me believe that there is in fact hope for the poor and marginalized in the world. They are passionate advocates of oppressed people groups, from Sudan to Kurdistan to northern Alberta. Eloquently they speak out against soulless corporations and the injustices that happen in the interest of financial gain. And they do it all with such incredible optimism and humility, all the while affirming and challenging those around them, that it makes me giddy with hope. As if that isn't enough, they throw some pretty incredible Kurdish New Year's parties!

They delivered a skwocking hairy little miracle of a guy. Rarely have felt such privilege in delivering a child as I did with them that day. It was indescribable. The lump of emotion in my throat chocked me. To deliver a new being, warm, squirming, and slimy, who, along with his two sisters will undoubtedly change the face of the world made me remember a little piece of who I am and who I want to become. It felt good to feel again. No mindless numbing, just raw and real.

Dee-der-doo-der-dee. Dee-der-doo-der-dee.

And then my pager went off. So I ran downstairs to the rotational forceps delivery in the operating room of the woman I had only met once, which failed and we had to to a C-section anyway.

Shoot. Maybe six billion little miracles is enough.

Before they were discharged from hospital my friends came to find me down at the delivery suite to give me much needed hugs and invite me over that evening. It was lovely. The nurses and attending obstetrician who were around to witness this asked me in quiet voices afterwards.

"Sheona, do your patients usually invite you over on the way home?"

Oh yeah, and I say yes every time. No professional boundaries here.

I am Convinced that Given a Cape and Tiara I Could Save the World

I broke.

Late in the afternoon after not eating since six in the morning. In the residents lounge after a hug from my fellow junior, we laughed maniacally at the craziness of the day and inexplicably, uncontrollably, the laughter turned to tears. Hot and stinging they coursed down my cheeks.

Last week a job that usually takes four people, a chief, high risk resident, low risk resident, and the elective C-section slate was left to Andrea and I. Two little second year residents. It was only for two days, but it tipped me over.

Its near impossible to put into words the intensity of it. In the delivery suite you have two complicated medical patients, one who just got off the plane from Ethiopia with pulmonary edema and on the edge of a seizure. A set of twins at 28 weeks delivering early. Then all the regular, normal, low risk women in labour. All this AND the dreaded transfer phone. It's ring heard above whatever other chaos is currently reigning, it belts out at a different tone and takes priority. BC Women's is the center for all the emergency transfers across the province for any pregnant woman anywhere who is in trouble and needs a center where premature babies and sick mom's can be handled.

Dr. McTerrified is on the phone from Fort St. Nowhere. Invariably speaking a mile a minute, sometimes a little shake in their voice. With a woman who is in preterm labour, has a blood pressure of 230/120, and is peeing out protein by the truck load. So you answer calmly (despite you own underlying terrifiedness), get all the details, make sure they have had steroids for baby lungs and douse out the fire of their blood pressure. Then you have to decide where they can go. To Prince Geoge, Kamloops, Surrey... no beds. Victoria? Nanaimo? No NICU beds. To us? No NICU beds. Edmonton? Calgary? And the last last final resort: Washington State.

All this with 8 nurses breathing down my neck to check patients, with questions and suggestions. Then one of them blew up at me, frustrated for something I thought I had already taken care of. My calm reply and innocent apology didn't seem to be received. Couldn't she see the drowning in my eyes?

I have a 'Lovely Theory'. Here's how it works. All acts of jerkdom, meaness, and ignorance can only be responded to by loveliness, humour, and humility. Theoretically, the jerk involved will eventually feel like such an idiot for being irrational that they in turn will be lovely. Alas, I'm starting to question the premise of said theory.

I talked to my incredibly wise little sister at week's end, post-call, semi-coherent. Explaining the gory details as she listened. "Rho, they broke me. And I didn't think they could. I'm not sensitive, I have thick skin!" Her reply?

Did you have your Cape? Where you wearing your tiara? I don't think they broke you, its just a chip. You're just cracked, not broken. Crying is okay. In fact, it makes you human.

Human?

Now where did I put that purple cape with green sequins?