Saturday, February 03, 2007

OB: The ongoing saga

OB is slowly growing on me, though I still would not consider it a career option. Last week I saw a couple more deliveries, though was not able to help much as they were somewhat complicated. One was going to be delivered by forceps but at the last minute things started going smoothly and the forceps were not necessary.

The patient population at this hospital is mostly inner city black, most of the mothers are younger than I am and either have no man in the picture or have an immature adolescent who laughs and makes jokes as the baby is being delivered. There have been a couple 24 year old G10P6046s (pregnant ten times, 4 miscarriages/abortions, 6 living children). It can be very discouraging at times. On Thursday I saw a married couple who were having their first child, and the husband stood and held his wife’s hand the whole time—it was a very nice change.

This rotation has brought up the subject of contraceptives. Obviously, anything that causes the death of an embryo I would consider wrong, but I have very mixed feelings about contraceptives that just stop ovulation. I have no problem with their being used by married couples, but at the beginning of the rotation I would have tended to not be comfortable with giving them to unmarried people because I felt like it would be facilitating a sinful and dangerous lifestyle. Now, I am not quite so sure—I am tending to think that they are going to live that lifestyle regardless of whether or not I give them contraceptives, but by giving them contraceptives I can at least stop them from conceiving a baby then having it aborted. I was talking about it to some of my Christian friends last night (one of who interestingly had no problem with contraceptives before, but now after being on Ob/Gyn does) and we came to the conclusion that if we were to give contraceptives out when we were doctors it would not be at all for the patient’s benefit because the only way the patient would be benefited would be to stop living a lifestyle of harmful and broken relationships. The only benefit is for society. Temporarily sterilizing these women prevents them from having babies for whom they do not have the resources (monetary and nurture-wise) to care for, and prevents the single mother/no family structure environment in which the children will inevitably be raised from being perpetuated. Having said that, isn’t the job of a doctor to care for the patient, not for society in general? And, I’m not sure that I will ever be able to comfortably sit down with an unmarried sixteen year old who has more sexual partners than she has fingers and discuss how she can continue this life but not get pregnant.

Mildly funny story: I had dinner at a hamburger joint with some classmates a couple weeks ago—our waiter who was very gay in the modern sense of the word but definitely not in the old gave us one bill, so the seven of us had to calculate out exactly how much each of us owed, write down the amounts with our names, then give him the list with five credit cards and a handful of cash—this is the conversation that ensued:

Gay waiter (annoyed at the prospect of 30 extra seconds of work): I need to know how much to charge each card.
Friend #1: We calculated the amounts and wrote down our names next to the amounts on this slip of paper. (and I'm deducting the time we spent on it from your tip)
GW (exasperated at the idiot medical student): That doesn’t help me, I need to know which card to use for each amount.
Friend #1 (wondering if he's serious): Our names are on the cards…
GW: Silence
Friend #2: grinding teeth shut and looking straight ahead to prevent herself from falling out of her chair laughing


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