Early afternoon. Fan turned on high to combat the Chicago summer heat. Lounging in a pair of shorts and a tank top, nursing a cup of high-octane coffee while I work up the motivation to do something other than NAP. You'd think it was the weekend for me, but no; it's MONDAY. The patient load is extraordinarily light on this service (at least today), and at 9AM (after about four hours of rounding, lecture, ect.) our residents told us to go 'study', that they'd page us if anything happened worthwhile, and if we DIDN'T hear from them, to go home at 4. I'm telling you, it felt like fucking CHRISTMAS. I had to stifle the impulse to SKIP outta there.

I promise you, despite the way it might sound, I'm not miserable. I'm about half-way through my Ob-Gyn rotation, and it's organized in such a way that we spend two weeks each on three different 'services', or flavors of Ob-Gyn practice. I was on labor and delivery the first two weeks and LOVED it; I could work a 16 hour day and not bat an eye-lash, be back bright eyed and bushy tailed at 5AM the next morning. (P.S. where the hell does that expression come from? Whenever I hear/ say it I conjure up images of the cartoon squirrels from Sleeping Beauty.) My second two weeks are being spent on Gynecology-Oncology, which deals with cancers of the female genital tract and is essentially a surgical specialty. If I've learned anything in the last couple weeks, it's that I have zero interest an surgery; even if I DID, my personality is not 'surgical' in the least. I'm not suffering by any means; the medicine is still cool, and I've followed some interesting patients. But at the same time, when they set me free from a day in the OR, I'm certainly not HEARTBROKEN. Next up is Uro-Gyn, which is more of the same, but I have some lectures and whatnot that fall on those days, so it won't end up being a full two weeks. Lord have mercy. :-)

All in all, although I've enjoyed this rotation, I'm pretty sure my future doesn't lie in OB-Gyn. It's just too darn surgical. Scratch it off the list of career possibilities. Next up is Peds, and what a freaking cliche I would be, peppy blond pediatrician, but Peds is definitely in my top three possibilities for a future career. I suspect I'm going to like it a lot.

In OTHER news, and much much happier news, I just got back from a surprise visit to Shane in Maryland! He had NO idea. I pretty much got a bug up my ass on Thursday morning that I wanted to see him, bought a surprisingly cheap last minute flight, and flew into BWI on Friday evening. Bekah, wonderful woman that she is, picked me up from the airport and dropped me off on base, where Shane was bowling. He had his back to me when I walked in, so I went up and grabbed his ass. Like full palm squeeze action, NOT something he could miss or ignore. God bless the man, he's so loyal to me, he turned around looking ready to slug someone, male or female, only to be confronted with my smiling face. HIS face was PRICELESS. He says "I'm imagining things," then, "WHAT THE HELL ARE YOU DOING HERE?!?" and hugs me. It was a great start to a great weekend, which I think did worlds of good for our relationship. Long distance sucks; you really have to find things to hold on to, to carry you through when things get hard. This weekend was one of those things I'll hold on to.

He comes and visits again on August 14th. CanNOT wait. :-)

Aaaaaannnddd it's time for my nap. Being a third year is f'ing awesome. :-)

*i-love-sitting-down-sigh*

I've always liked hanging out in the hospital around 2AM. Even now, when I'm not getting paid for it, I enjoy it. There's something soothing about the sounds, the hum of computers and SCD machines, the rhythmic hissing of the vents, the frequent beeps of alarms and the clack-clack-clacking of keyboards as people try to catch up on charting, juxtaposed over the peaceful quiet of sleeping patients. The hospital is an entirely different animal at night, and if not for the severe effects a shift like this would have on my social life, I might consider committing to shifts like this in my career to come.

Aw, who am I kidding... I'm a medical student... I have no social life. :-)

Last week I started my third year of medical school, and essentially kicked off the clinical years of my medical education with a "bang"; on night float on labor and delivery, a notoriously difficult week for third year students. The shift is essentially 4:30pm- 7:30 pm, 15 hours through the night, and I'll tell you what, although you CAN adjust relatively quickly to working at night/ sleeping through the day, the adjustment period BLOWS. The benefits, however, WAY outweigh anything negative I can say about it. It's SO much more chill on the floor at night, so it's a very friendly, laid back atmosphere for third year med students who are COMPLETELY clueless about their role and responsibilities. Because it's a bit lighter and there aren't so many distractions (rounding attendings, confused pharmacy technicians, ect.), there's more opportunity for learning and DOING. I've seen some fantastic stuff in the week I've been here.I've scrubbed in to a few c-sections, assisted in the delivery of a few babies, done a few dozen admissions/ exams, and even performed a pelvic exam or two. Some of these experiences have been especially memorable...

Unfortunately (or fortunately, depending), Loyola tends to get a lot of high-risk pregnant women, the moms with blood pressure through the roof due to preeclampsia or whose water broke at 22 weeks. Often, the outcome isn't very good. I wheeled one such Mom up to the NICU yesterday who, after a c-section at 22 1/2 weeks, was forced to say goodbye to her infant. He was so little, and the neonatologist said that his lungs were so poorly formed that it was impossible to ventilate him, even with a tube down his windpipe. It was so sad; he kicked his feet and waved his arms like an infant three times his size, he LOOKED like he was a little fighter, but it was all but a certainty he would die in the days that followed. Mom was seriously in denial, and that made the situation all the more heartbreaking. It's not ALWAYS sad, though. A few days ago, we had a woman at around 23 weeks whose membranes (the sac that holds the 'water' in place) ruptured while she was in the shower, and most often, when your membranes rupture you go into labor. The rule of thumb for premature babies is at 24 weeks, only 50% of babies survive outside the uterus. Of that 50%, half will be developmentally delayed. So, at 23 weeks and in labor, the chances were pretty slim for this patient. Attempts to stop the contractions failed, and she got an infection in her uterus, which is an indication for an immediate c-section. So we sectioned her, and out pops this baby thats just HUGE for its gestational age, crying like a little champ! I had TEARS in my eyes; I wanted to CHEER!

The few 'normal' births I've seen have been memorable, as well. If the birth is low-risk, and Mom has an epidural, often the residents let the med student themselves deliver the baby (with heavy supervision, of course). I was all set to deliver this one woman this evening, when on a cervix check being performed by the resident, the baby practically FELL OUT of the woman's vagina. We didn't even have time to get her into the stirrups or scrub in... this baby FELL OUT into our barely gloved hands. Mom is in an epidural-induced coma, baby's wailing away like she's proud of herself, and the resident and I are standing there covered in blood and amniotic fluid. Bizarrely, I didn't mind at all. Honestly, there was a very big part of me that even ENJOYED being covered in labor goo...... I know it sounds odd, but there's nothing that makes you feel more like a medical professional than being covered head to toe in someone elses secretions LOL. I just laughed. It was awesome.

So it's been hard, and humbling, and half the time I feel like an idiot, but its been straight, unequivocally, unbeleivably AWESOME. Pretty sure I don't want to go into OB-Gyn, but I'm really, really enjoying my time here.

It's almost four. We've had about an hour of downtime, and now I need to go do a few quick exams and write some notes. Have a good day, kids. :-)