*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. :-)