This was the third day of my gynecology rotation and before this all my clinical work had been in medicine. This was my first experience in a surgical ward. Until now we had only taken histories from patients for two days. Today I had my night shift. Our clinical group has 15 students and each week, one subgroup has the night shift. Each subgroup has five students and this week, my group had the night shift.
We report for duty from 10:00 AM to 1:00 PM, and those with night shifts return at 3:00 PM. Typically, the night shift ends around 10:00 to 12:00 AM but we have a relatively lighter ward, so we are usually dismissed by 8:00 PM.
Our group of five students was ready by 3:00 PM, and we headed to the operation theater (OT). In our group, there were two girls and three boys. The boys weren’t allowed in the labor room so we could only observe C-sections in the OT, while the girls helped in the labor room.
When I reached the OT, the surgeon there was quite junior, but in Pakistan doctors gain a lot of experience quickly due to the heavy patient load. Junior doctors handle so many cases that they become very capable quickly. This is why Pakistani and Indian doctors are in high demand in the U.S, as they encounter a wide variety of cases and gain experience with many diseases that they might not see anywhere else.
Anyway I liked this doctor because she kept engaging us, and she also had a great sense of humor. As we were entering the OT she joked with me, and I thought that one can learn a lot in a friendly environment.
She told me to quickly put on my scrubs and join her in the OT. I went to the changing room, put on my scrubs, and returned to the OT, where two women were about to have C-sections. Since this is a government hospital, the facilities are minimal. The building is old, with an emergency and theater room, as elective C-sections are done in the morning, and the theater closes by afternoon. However, emergencies are handled 24/7 so we were performing the surgery at night.
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I followed the doctor, who kept me engaged. The anesthesiologist administered anesthesia via a lumbar puncture. A lumbar puncture involves inserting a needle between the third and fourth or fourth and fifth intercostal spaces through the skin and ligaments into the intrathecal or subarachnoid space, where anesthesia is delivered. This causes the patient to lose sensation from the umbilicus down to the toes. The patient remains awake but cannot feel anything below the umbilicus.
The first operation that I observed was both, very shocking and interesting for meee because it was my the first time witnessing any surgery live and above sll it was a C-section where you bring a new life into the world. The moment the baby was brought into the world was one of the most satisfying and wholesome experiences of my life. I now wish I could tell the baby in future how youu were born right before my eyes, we struggled a lot for you. Seeing new life enter this world in the midst of a challenging surgical procedure was incredibly rewarding and filled my heart with an overwhelming sense of joy and accomplishment
The surgeon made the incision and cut through the subcutaneous fat and then the muscles and then reached the uterus where a fluid came out and suddenly they pulled out the baby within the game of seconds. The process was challenging to watch but since I'm very interested in surgery, I stayed firm and reminded myself that there’s a lot more to see and experience. However, the female colleagues with me were really shocked and went outside to catch their breath.
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The entire process, from the first incision to delivering the baby, took the surgeons a maximum of 5 to 10 minutes because they are so experienced in this procedure. However, the time-consuming part is closing up the incision and stitching everything back, which can take 20 minutes to half an hour.
After this surgery, the doctor rested and I asked when the next operation was. She told me to come back in an hour as her patient was scheduled then.
The doctor said that since I answered all her questions correctly during the previous surgery, she wanted me to assist her hands-on in the next one. She told me to get scrubbed, wear gloves, and get ready. But just as I was about to, my friend requested me with such urgency, saying, “You always get the opportunity, please let me do this one. You’re a male doctor, and this is a gynecology ward.” I thought it was strange and replied, "So what if I'm a male doctor? I can still understand and perform in a gynecology ward." Nevertheless, I don’t know why, but I gave her the chance. I told the doctor that my friend would assist with the suction during the operation as she was very emotional and eager to participate. We quickly got her scrubbed and ready, and the operation began.
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This patient had a slight complication, as she still had some sensation after receiving the intrathecal anesthesia, so we had to administer general anesthesia. Fortunately, the rest of the operation went smoothly, and the baby was healthy. I really wanted to hold the baby, but they quickly cleaned the baby, removed the vernix caseosa, and applied oil or whatever massage they usually do. They handed the baby to the attendant, but I insisted on holding the baby, so I finally got the chance to hold the baby when the father allowed me to. He thanked me afterward.
My friend was very nervous initially, but I reassured her that we have to perform many surgeries in our future careers and we must be confident from the start. Not everyone can do it, but those who have the courage and belief that they can succeed. By the end of the surgery, she was almost assisting more than the primary surgeon, all thanks to the encouragement and adrenaline boost I gave her. Inshallah, I will also be performing many surgeries soon and will share those experiences with you. If you enjoyed reading about my experience today, please let me know in the comments. I’m very happy today as we brought four new lives into this world, and all of them were healthy babies, Mashallah.
regards,
Dr @abdu.navi03
Indeed bringing a new life into this world has to be the most heartwarming feeling. Specially for a mother who has to bear hardships and pain for 9 months and then during the delivery. Even after a baby is born the responsibilities only increase.
This is indeed a miracle of God to create a living being out of a seed. One of the most beautiful things. Congratulations to you for experiencing this for the first time. Many more to come.
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Felicidades por tan hermoso trabajo. Dios Bendiga tus manos
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