Unsettlingly Serious

There was a gnawing unrest somewhere deep in my belly as I walked out of the hospital tonight, and I'm not talking overdosing on Timmy's coffee unrest. I could chalk it up to the communal grief of the seven family members crowded into the small assessment room after they found out the baby had died at 33 weeks gestation. A familiar wave of nausea and dread swept over me as I sat on the edge of the bed, searching desperately with the ultrasound for the flapping heart in the grainy picture. The cardiac anatomy was outlined clearly, sitting eerily still and unfamiliar under the railroad tracts of the spine as the taut belly shook with sobbing.

But if I'm truthful, it wasn't just fetal demise that has unsettled me, its that things are getting serious. The weight has gradually but solidly settled on my shoulders. Surgery isn't just cutting and fun anymore...well, its still fun, but serious fun. I did surgery on a woman for uterine cancer last week, who made zero urine the next day. Zero. Oh, and developed a sky high creatinine (that means renal failure). I felt sick. My night was spent tossing and turning, in my mind replacing every single suture I had placed, each vessel I had cauterized, trying to figure out how I had tied off her ureter or cut an unrecognized hole in her bladder. I woke up soaked in sweat and nauseous (no, I don't have cancer and I'm not pregnant if you're symptom fishing).

Last night I had to deliver a distressed baby by forceps before the attending could make it, egged on by an anxious GP. As the fetal heart rate tapped out ominously, I did the pudendal block, then slid on the forceps smoothly, double checking their placement. Perfect application as the silver salad tong suctioned into place creating the baby's ergonomically designed helmet. Beautiful delivery over two pushes. Perineum INTACT. Impressive, no? No, not at all, you're not SUPPOSED to pull babies out with forceps sunny-side up Einstein, its not AS ergonomical to wear your helmet backwards. Not a delivery I was proud of. The baby went to NICU, not because of the forceps, because of a fever. Obstetrics can be humbling.

The responsibility of the vocation I'm training for is becoming clearer. An obvious result of the increased autonomy I'm given here. I hope I find the balance between the fun and the fear. You see, I've just never been described as serious before, but I haven't been joking as much lately either. My renal failure lady had an intact bladder and ureters and turned the corner just fine, the nurses went out of their way to care for the grieving family and my sunny-side up baby is breastfeeding with mama now.

P.S. I know unsettlingly isn't a word.