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.
Friday, February 11, 2011
Saturday, February 5, 2011
Breech Baby Breech!
Beeeeeeeep beeeeeeeeeep beeeeeeeeeeep.
My phone call to an old friend is rudely interrupted and I go into the kitchen and grab the phone to answer the page.
Code pink, vaginal breech, primip with meconium.
At first I think the maternity nurses are playing a joke on me, knowing what the wet dreams of OB residents are made of. But no joke, its for real.
Everyone is there, the OR staff, several dozen folks from NICU (it seemed) and no obstetrician (yet). The baby's heart rate looks lovely, so I consent the mom for a STAT C-section just in case and tell her all about breech deliveries...truth is, we can see a scrotum coming out each time she pushes which would make a C-section quite challenging at this point.
The Grandfather of obstetrics rolls in calmly, shirt and tie with scrubs top over top as his signature outfit, and peaks over my shoulder. His only words, in his usual unflappable manner and quiet voice:
Looks like the little guy's pecker is pointing up there, I suppose you'll be getting ready for an episiotomy.
Right, of course...as I scramble to get some local anesthetic. The delivery is beautiful, the kid starts screaming and the crowd disperses fairly quickly.
I notice a huge blood clot has dolloped onto my jeans during the process, which I hadn't had time to change on the way in. Well, in the grand scheme of things, that delivery was worth a good pair of jeans!
As I head to the nurses' station to do the paper work feeling rather exhilarated, the Grandfather says: Great job, now you can do them in your practice, right?
Right.
My phone call to an old friend is rudely interrupted and I go into the kitchen and grab the phone to answer the page.
Code pink, vaginal breech, primip with meconium.
At first I think the maternity nurses are playing a joke on me, knowing what the wet dreams of OB residents are made of. But no joke, its for real.
Everyone is there, the OR staff, several dozen folks from NICU (it seemed) and no obstetrician (yet). The baby's heart rate looks lovely, so I consent the mom for a STAT C-section just in case and tell her all about breech deliveries...truth is, we can see a scrotum coming out each time she pushes which would make a C-section quite challenging at this point.
The Grandfather of obstetrics rolls in calmly, shirt and tie with scrubs top over top as his signature outfit, and peaks over my shoulder. His only words, in his usual unflappable manner and quiet voice:
Looks like the little guy's pecker is pointing up there, I suppose you'll be getting ready for an episiotomy.
Right, of course...as I scramble to get some local anesthetic. The delivery is beautiful, the kid starts screaming and the crowd disperses fairly quickly.
I notice a huge blood clot has dolloped onto my jeans during the process, which I hadn't had time to change on the way in. Well, in the grand scheme of things, that delivery was worth a good pair of jeans!
As I head to the nurses' station to do the paper work feeling rather exhilarated, the Grandfather says: Great job, now you can do them in your practice, right?
Right.
Saturday, January 29, 2011
Uganda's Top Five
5. Sam Luboga - His gentle manner and soft voice win you over in seconds. He has every right to be a successful academic general surgeon with a healthy ego to boot but his humility is palpable. As we sit around a table in the now empty waiting room of St. Stephen's hospital he tells us the story of how the small community hospital came to be.
4. Jean Chaimberlain - They told me she was a spit-fire but I must say seeing is believing, (I briefly may have even mistaken her passion for hypomania at one point). An obstetrician originally from Ontario, she has dedicated her life to developing a Masters of Public Health in Maternal Mortality at Uganda Christian University where currently professionals from across East Africa are being trained. I felt privileged to meet some of her students and was blown away by their dedication and passion, some were government health officials, nurses, social workers and business people who all work full time in addition to taking the course. She makes no excuses. Not for her faith, nor for the relentless drive she has to affect change in a world where a woman dies needlessly every minute of everyday from a pregnancy related cause.
3. Veronica Najjuma - She must be nearly 60 but to me her wrinkled face seems ageless. Rarely without a smile, always some type of floppy hat on her head as she sets out into her community of Kisenyi with a message. Whether related to cervical cancer or a town meeting, she spreads the word with determination. She's a village chairperson and one of the research assistants that I've written about previously. In January of this year, I visited Kisenyi again, but this time with an entourage from UBC. Among them, the head of gyne oncology, the Canadian infectious disease in pregnancy guru and of course my fearless research supervisor herself! I have worked with these attendings in a very different context than the dust and garbage that surrounded us in the slum.
Veronica had been charged with a tour of Kisenyi which she took seriously. First to the houses that had been burned down just three days before, two children had died. The wooden shacks are crowded so close together that the fire had destroyed a dozen houses within only a few square meters. Next she lead us to the brothels. We sat in a tiny courtyard, crowded on tiny wooden stools as Veronica chatted with these women about HPV self-collection. To be there, having my attendings, a group of driven women who are leaders in their fields, sit and witness the stories of a group of women so different from themselves, some of the most marginalized, was a powerful and moving experience. They had recently been involved in an HIV microbicide trial and were wary of pelvic exams, saying speculums had caused HIV in some of their friends. Veronica engaged them in conversation, her openness drawing them in.
2. Florence Mirembe - aka The Queen of Africa. Previously the head of the department of Obstetrics and Gynecology. She may have done more than any other woman in Uganda to forward women's health. She is a trained obstetrician-gynecologist and a long-standing professor at Mulago Hospital. I remember going to morning rounds before I had met her and leaning over to ask one of the junior doctors in a whisper what her name was. He looked back at me incredulously, "that is Prof Mirembe!" She certainly had a presence in the room, admonishing the interns and registrars to higher standards
1. Allan Ronald - In all honestly I didn't fully realize who was coming over for dinner, over the past two weeks we had innumerable meetings with a variety of phenomenal individuals and names were all starting to blend into each other. So Allan Ronald took me off guard. He is humble to a fault, down-playing his involvement in a massive HIV trial currently taking place. He is somehow able to connect personally with everyone in the room, he leans forward engaging me in conversation, interested in what my plans are. Then, looking me straight in the eye puts the entire responsibility of saving the world squarely on my shoulders. "You need to change how CIDA works, you need to transform the way health research and development are done, its up to driven young people to do it."
As it turns out Allan Ronald has not only received the Order of Canada and been inducted in to the Medical Hall of Fame, but he is the foremost infectious disease physician and microbiologist in Canada and was at the forefront of developing the infrastructure for the hundreds of thousands of Ugandan's who have received antiretroviral medication. He is a leading HIV researcher who spent 30 years involved in research in Africa. Sadly, I heard he has been diagnosed with advanced stage cancer, something you would not have know by the hope and inspiration oozing out of his every word as we sat and discussed international development over dinner. Everyone was a bit starry-eyed as he left that night.
The Top Five have left me humbled, inspired and unapologetic about what drives me. As the slog of residency continues, the day to day of baby-catching, sleepless nights, coffee-jittered days. The endless learning of surgical techniques and the challenges of clinical decision-making threatens to convince me that all there is to my vocation is getting babies born safely and hysterectomies done properly. Not to sound cliche, but these individuals, all in different ways, have been a thundering waterfall on a parched and disillusioned soul, overwhelmed by hope in the face of a much greater need than someone with painful periods wanting a hysterectomy.
OB/GYN Residency
You see, they would come and knock on my door, I would spend the day working and then come home to a line-up of patients. It started in my office at home... I simply could not ignore the need. So we started St. Stephens.His young protege gives us a tour of the small but clean and organized hospital, we all agree we'd rather deliver here than as part of the mass of humanity at Mulago. Sam's hair is now mostly white, his smile gentle and his laugh genuine. His clerical collar (since he has also trained as an Anglican priest) seems to make him even more approachable instead of unattainable and intimidating. He has 'adopted' over a dozen children, mostly from his siblings who have passed away, from AIDS and other life circumstances. I have no doubt he has made more of an impact on this community than the most well-published of academic general surgeons could ever hope to.
4. Jean Chaimberlain - They told me she was a spit-fire but I must say seeing is believing, (I briefly may have even mistaken her passion for hypomania at one point). An obstetrician originally from Ontario, she has dedicated her life to developing a Masters of Public Health in Maternal Mortality at Uganda Christian University where currently professionals from across East Africa are being trained. I felt privileged to meet some of her students and was blown away by their dedication and passion, some were government health officials, nurses, social workers and business people who all work full time in addition to taking the course. She makes no excuses. Not for her faith, nor for the relentless drive she has to affect change in a world where a woman dies needlessly every minute of everyday from a pregnancy related cause.
3. Veronica Najjuma - She must be nearly 60 but to me her wrinkled face seems ageless. Rarely without a smile, always some type of floppy hat on her head as she sets out into her community of Kisenyi with a message. Whether related to cervical cancer or a town meeting, she spreads the word with determination. She's a village chairperson and one of the research assistants that I've written about previously. In January of this year, I visited Kisenyi again, but this time with an entourage from UBC. Among them, the head of gyne oncology, the Canadian infectious disease in pregnancy guru and of course my fearless research supervisor herself! I have worked with these attendings in a very different context than the dust and garbage that surrounded us in the slum.
Veronica had been charged with a tour of Kisenyi which she took seriously. First to the houses that had been burned down just three days before, two children had died. The wooden shacks are crowded so close together that the fire had destroyed a dozen houses within only a few square meters. Next she lead us to the brothels. We sat in a tiny courtyard, crowded on tiny wooden stools as Veronica chatted with these women about HPV self-collection. To be there, having my attendings, a group of driven women who are leaders in their fields, sit and witness the stories of a group of women so different from themselves, some of the most marginalized, was a powerful and moving experience. They had recently been involved in an HIV microbicide trial and were wary of pelvic exams, saying speculums had caused HIV in some of their friends. Veronica engaged them in conversation, her openness drawing them in.
2. Florence Mirembe - aka The Queen of Africa. Previously the head of the department of Obstetrics and Gynecology. She may have done more than any other woman in Uganda to forward women's health. She is a trained obstetrician-gynecologist and a long-standing professor at Mulago Hospital. I remember going to morning rounds before I had met her and leaning over to ask one of the junior doctors in a whisper what her name was. He looked back at me incredulously, "that is Prof Mirembe!" She certainly had a presence in the room, admonishing the interns and registrars to higher standards
"you knew she had a previous Ceasar when she came in in labour, and now you have risked her life and taken her baby's life from her because you waited for her uterus to rupture before going to theater!"No apologies, just pure passion, decrying the injustices of a system without resources. How can a woman who has not only lived through the dark times of Idi Amin but also witnesses unspeakable tragedy at the loss of women's lives not have become jaded? Not have come to lower her standards of care? How does she maintain that fiery compassion in the twilight years of her career when she could be relaxing a bit more? I have trouble not getting jaded and I'm only partway through residency!
1. Allan Ronald - In all honestly I didn't fully realize who was coming over for dinner, over the past two weeks we had innumerable meetings with a variety of phenomenal individuals and names were all starting to blend into each other. So Allan Ronald took me off guard. He is humble to a fault, down-playing his involvement in a massive HIV trial currently taking place. He is somehow able to connect personally with everyone in the room, he leans forward engaging me in conversation, interested in what my plans are. Then, looking me straight in the eye puts the entire responsibility of saving the world squarely on my shoulders. "You need to change how CIDA works, you need to transform the way health research and development are done, its up to driven young people to do it."
As it turns out Allan Ronald has not only received the Order of Canada and been inducted in to the Medical Hall of Fame, but he is the foremost infectious disease physician and microbiologist in Canada and was at the forefront of developing the infrastructure for the hundreds of thousands of Ugandan's who have received antiretroviral medication. He is a leading HIV researcher who spent 30 years involved in research in Africa. Sadly, I heard he has been diagnosed with advanced stage cancer, something you would not have know by the hope and inspiration oozing out of his every word as we sat and discussed international development over dinner. Everyone was a bit starry-eyed as he left that night.
The Top Five have left me humbled, inspired and unapologetic about what drives me. As the slog of residency continues, the day to day of baby-catching, sleepless nights, coffee-jittered days. The endless learning of surgical techniques and the challenges of clinical decision-making threatens to convince me that all there is to my vocation is getting babies born safely and hysterectomies done properly. Not to sound cliche, but these individuals, all in different ways, have been a thundering waterfall on a parched and disillusioned soul, overwhelmed by hope in the face of a much greater need than someone with painful periods wanting a hysterectomy.
OB/GYN Residency
Monday, December 13, 2010
Family Feuds and Cancer Survivors
I make no claim to have battled the Emperor of All Maladies, I have merely doggedly walked under the feet of the insurgents who attempt to stand in the way of the Emperor's tank as it rolls into the square. I loved and resented the experience, captured by their vision and passion, I may even make a career of anti-tank mines myself.
Its a fascinating family dynamic. At its head is the Matriarch, simultaneously commanding, inspiring and terrifying, all the while deeply proud of her brood and how far they've come. The fatherly and jovial Uncle at the height of his career, confident in his inside knowledge of how the whole machinery works, with only occasional sexually inappropriate jokes. Then there's Diva, the sometimes moody and generally demanding teenager. The Adopted Child, sweetly cerebral but easily the brunt of the family's jokes. The Distracted Godfather, now moved on to faster moving races, still an efficient and skilled surgeon but detached from family functions. Last comes the Runt, once dotted upon but now pressured to prove that she can play with the big kids. As a family they can be inspiring, compassionate, blood-thirsty, passionate, and heartless all at once. If you succeed they applaud you loudly, taking credit for having painstakingly formed your skill. If you fail, they step back disgusted at your weakness, sure it is no fault of theirs.
It is one of those rotations in residency that seems like an initiation, a gauntlet designed to prove your worth at every turn. Having survived you now breath easier, knowing comrades have fallen before you, switched to other specialties, left without mental health intact.
Despite the incredibly melodramatic picture I've painted, I'm grateful to the Emperor and the Insurgents for lessons learned...I can say that from the other side.
Its a fascinating family dynamic. At its head is the Matriarch, simultaneously commanding, inspiring and terrifying, all the while deeply proud of her brood and how far they've come. The fatherly and jovial Uncle at the height of his career, confident in his inside knowledge of how the whole machinery works, with only occasional sexually inappropriate jokes. Then there's Diva, the sometimes moody and generally demanding teenager. The Adopted Child, sweetly cerebral but easily the brunt of the family's jokes. The Distracted Godfather, now moved on to faster moving races, still an efficient and skilled surgeon but detached from family functions. Last comes the Runt, once dotted upon but now pressured to prove that she can play with the big kids. As a family they can be inspiring, compassionate, blood-thirsty, passionate, and heartless all at once. If you succeed they applaud you loudly, taking credit for having painstakingly formed your skill. If you fail, they step back disgusted at your weakness, sure it is no fault of theirs.
It is one of those rotations in residency that seems like an initiation, a gauntlet designed to prove your worth at every turn. Having survived you now breath easier, knowing comrades have fallen before you, switched to other specialties, left without mental health intact.
Despite the incredibly melodramatic picture I've painted, I'm grateful to the Emperor and the Insurgents for lessons learned...I can say that from the other side.
Saturday, October 30, 2010
Good news! You have lymphoma!
Well, I have some good news and some bad news... The bad news: you cancer, but the good news is that its lymphoma!
I recall standing next to my attending at the gyne oncology clinic as an elective medical student in complete disbelief at the words that had just come out of her mouth. The poor patient dissolved into tears. She had been pacing back and forth with too much back pain to sit in the chair next to her husband, a result of massive lymph nodes pressing on her psoas muscles.
A hideously awkward discussion ensued where the attending (sickeningly upbeat and logically) explained that lymphoma had a drastically better prognosis than ovarian cancer, so it was a better cancer to have really. The whole time the poor patient's husband tried to refrain himself from punching said attending in the face. Or maybe that's just the fly-on-the-wall little medical student's interpretation of what happened. My attending then did a smooth punt and turf to medical oncology despite the sobbing patients request for answers.
I remember feelings of helplessness washing over me, overcome with empathy for this hurting woman and anger towards a frankly ridiculous attending. It was in the midst of a frigidly cold elective in Ontario during which I was supposed to be impressing people but felt achingly lonely and completely incompetent for the entirety of the rotation.
Last night I had a vivid flashback on call at the Death Star. The emergency physician called me to see a woman with "new onset metastatic ovarian cancer" who had recent growth of parotid (jaw), neck and axillary lymph nodes (and of course, a mass in her pelvis). It felt like a case of: "patient has vagina, please see in consult." She was young, and as I spoke with her and her husband the fear was palpable. A single tear slipped down her cheek as she answered my questions. The truth was, the chance of her having ovarian cancer was slim to none as further investigations confirmed, gyne oncology was not the service that could help her. Unfortunately Dr. DoucheBag McEgo was the internal medicine Sr resident and it took three heated discussion, four hours and a (useless) consult with hematology for him to admit the patient. My blood was boiling with Dr. McEgo's passion and determination to turf this lovely patient to anyone but his team.
Hours passed, internal med finally saw her but as I walked by to see another patient, her husband grabbed my arm, looking for answers. What's going on? Does she have cancer? Is she going to die?
Leaving the post-partum lady with a fever and the palliative patient with metastatic uterine cancer who now had a lung full of fluid, I sat on her stretcher and laid it all out for them. Yes, right now it looks like lymphoma, but there's treatment for this. The husband curled up in fetal position crying. My heart broke a little...maybe a lot, but it felt like I was actually doing something useful. Not turfing, not fighting to get rid of patients, but being present in the pain, messy as it is. I'm not scared of tears anymore and I'm no longer just a witness to it all.
I recall standing next to my attending at the gyne oncology clinic as an elective medical student in complete disbelief at the words that had just come out of her mouth. The poor patient dissolved into tears. She had been pacing back and forth with too much back pain to sit in the chair next to her husband, a result of massive lymph nodes pressing on her psoas muscles.
A hideously awkward discussion ensued where the attending (sickeningly upbeat and logically) explained that lymphoma had a drastically better prognosis than ovarian cancer, so it was a better cancer to have really. The whole time the poor patient's husband tried to refrain himself from punching said attending in the face. Or maybe that's just the fly-on-the-wall little medical student's interpretation of what happened. My attending then did a smooth punt and turf to medical oncology despite the sobbing patients request for answers.
I remember feelings of helplessness washing over me, overcome with empathy for this hurting woman and anger towards a frankly ridiculous attending. It was in the midst of a frigidly cold elective in Ontario during which I was supposed to be impressing people but felt achingly lonely and completely incompetent for the entirety of the rotation.
Last night I had a vivid flashback on call at the Death Star. The emergency physician called me to see a woman with "new onset metastatic ovarian cancer" who had recent growth of parotid (jaw), neck and axillary lymph nodes (and of course, a mass in her pelvis). It felt like a case of: "patient has vagina, please see in consult." She was young, and as I spoke with her and her husband the fear was palpable. A single tear slipped down her cheek as she answered my questions. The truth was, the chance of her having ovarian cancer was slim to none as further investigations confirmed, gyne oncology was not the service that could help her. Unfortunately Dr. DoucheBag McEgo was the internal medicine Sr resident and it took three heated discussion, four hours and a (useless) consult with hematology for him to admit the patient. My blood was boiling with Dr. McEgo's passion and determination to turf this lovely patient to anyone but his team.
Hours passed, internal med finally saw her but as I walked by to see another patient, her husband grabbed my arm, looking for answers. What's going on? Does she have cancer? Is she going to die?
Leaving the post-partum lady with a fever and the palliative patient with metastatic uterine cancer who now had a lung full of fluid, I sat on her stretcher and laid it all out for them. Yes, right now it looks like lymphoma, but there's treatment for this. The husband curled up in fetal position crying. My heart broke a little...maybe a lot, but it felt like I was actually doing something useful. Not turfing, not fighting to get rid of patients, but being present in the pain, messy as it is. I'm not scared of tears anymore and I'm no longer just a witness to it all.
Friday, October 1, 2010
Full Circle
February 14th, 2008 Vancouver was enveloped in its standard winter cloak of gray clouds and cold rain. Although, even that I was only aware of cycling in the drizzle to work in the dark mornings for 6:30am rounds, leaving as light left the sky in the evenings. Exhausted and drained from another day at the Death Star. There was a haze in my eyes and my head ached, I was on call that night and groaned inwardly when the oncology fellow paged me to go to Emergency to see a patient.
She was a woman in her early 50s, who after a long post-operative recovery from ovarian cancer debulking surgery had now developed an abscess. She was febrile and in significant pain, accompanied by her husband. She was also a physician, as was her husband a fact I knew from her lengthy admission to the service.
The most amazing thing happened that night. Though her own pain and fear, she focused on me as a person. How is residency going? What type of practice are you considering? What are you struggling with? What do you love about the specialty? I stood next to her stretcher in the emergency department, examining her, explaining the CT scan she would get and the antibiotics she would be on, all the while completely floored. Here was my patient, a physician no less, taking the time to recognize my humanity, something no one else had taken the time to do that whole year. I remember the night vividly.
September, 2010 Why don't you see the next patient? She's a doc so make sure she's okay seeing residents first. And there she is as I walk in the room. A warm smile on her face, her arms tanned from the sun, positively glowing despite a recent recurrence and chemotherapy. Hey! I know you, February 14th. Were her first words to me. You saw me on the night I was readmitted to hospital!
I couldn't help but recount to her how she had recognized the person-hood of a junior resident in the middle of the night in the emergency department and in doing so had renewed my faith in a healing vocation. We can't cure her cancer, but nothing about her suggests a dying woman, she is living and vibrant, full of hope and laughter. And so I come full circle.
She was a woman in her early 50s, who after a long post-operative recovery from ovarian cancer debulking surgery had now developed an abscess. She was febrile and in significant pain, accompanied by her husband. She was also a physician, as was her husband a fact I knew from her lengthy admission to the service.
The most amazing thing happened that night. Though her own pain and fear, she focused on me as a person. How is residency going? What type of practice are you considering? What are you struggling with? What do you love about the specialty? I stood next to her stretcher in the emergency department, examining her, explaining the CT scan she would get and the antibiotics she would be on, all the while completely floored. Here was my patient, a physician no less, taking the time to recognize my humanity, something no one else had taken the time to do that whole year. I remember the night vividly.
September, 2010 Why don't you see the next patient? She's a doc so make sure she's okay seeing residents first. And there she is as I walk in the room. A warm smile on her face, her arms tanned from the sun, positively glowing despite a recent recurrence and chemotherapy. Hey! I know you, February 14th. Were her first words to me. You saw me on the night I was readmitted to hospital!
I couldn't help but recount to her how she had recognized the person-hood of a junior resident in the middle of the night in the emergency department and in doing so had renewed my faith in a healing vocation. We can't cure her cancer, but nothing about her suggests a dying woman, she is living and vibrant, full of hope and laughter. And so I come full circle.
Monday, September 13, 2010
Doctor in Denial
There comes a time in every kid's life when they realize something about themselves that has become too obvious to deny. This has happened on many levels for me, and now, there's no denying it, its been four years, lets face it, I'm a doctor. No more denial.
The challenge comes when trying to find a new blog title though, something that portrays a journeyer, some humility, faith, a learner, open-mindedness, and yes, something related to obstetrics and gynecology. A list of hilarity ensued:
Hippocratic Acrobatics
Chicken Soup for the Vagina [lets get all spiritual]
Vaginal Soup for the Soul [that's going too far]
Vaginal Surrender: Gynecology on its Knees [an attempt at the humble part gone oh so wrong...]
Vagina Smagina [not quite profound enough]
Confessions of a Passionate Nomad [sounds like a travel blog, although a friend once told me she could see me 'saving the world, one vagina at a time'...]
Confessions of an Aspiring Mid-wife [might get doula-wacked, better watch out]
Dr. Mister the Gynecologist [insert inside joke here]
God, Boob-juice and Hysterectomies [stop while you were ahead]
Eventually, after several episodes of gut wrenching, eye-watering laughter, here's the new title, comments welcome.
The challenge comes when trying to find a new blog title though, something that portrays a journeyer, some humility, faith, a learner, open-mindedness, and yes, something related to obstetrics and gynecology. A list of hilarity ensued:
Hippocratic Acrobatics
Chicken Soup for the Vagina [lets get all spiritual]
Vaginal Soup for the Soul [that's going too far]
Vaginal Surrender: Gynecology on its Knees [an attempt at the humble part gone oh so wrong...]
Vagina Smagina [not quite profound enough]
Confessions of a Passionate Nomad [sounds like a travel blog, although a friend once told me she could see me 'saving the world, one vagina at a time'...]
Confessions of an Aspiring Mid-wife [might get doula-wacked, better watch out]
Dr. Mister the Gynecologist [insert inside joke here]
God, Boob-juice and Hysterectomies [stop while you were ahead]
Eventually, after several episodes of gut wrenching, eye-watering laughter, here's the new title, comments welcome.
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