Today was my day in labor & delivery and I just got home feeling frustrated, helpless and somewhat angry.  I guess maybe I need to get over this shit, but it’s not going to happen today, and when — god willing — I make it to being a midwife I’ll at least be able to do something about it.

The nurse I followed today was taking care of a primiparous woman who came in yesterday.  They ruptured her membranes for her (gotta speed things up, after all) and started pitocin (everybody gets pitocin at this hospital, gotta get those babies out quick, after all).  So she labored all night and this morning was at 9 cm/100% effaced when I got there around 8am.  She had an epidural and they gave her a bolus around that time because she was in pain from the pitocin, which was causing extremely strong & frequent contractions.  They were every 1-2 minutes and lasting up to 90 seconds, and the baby’s heart rate was going up to compensate for no recovery period between contractions.

She was 9.5cm at 10am, the baby was -1, she had a tiny little lip of cervix left, and she had a fever of 100.5 degrees.

Approximately 50% of women who get epidurals run a low-grade fever.  The doctors –actually, med students mostly — came in, diagnosed her with chorioamnionitis (infection of the uterus), told her she needed to have a stat c-section.

An hour before that, they had told her that she’d be pushing soon.  She was SO CLOSE.  She spoke no English.  She did not want a c-section.

She cried.  She was scared.

I don’t know, it was awful.  It was like this big cycle of poorly managed medical interventions that caused other problems that caused her to be forced (basically) into major abdominal surgery.  It infuriates me that people who go to this hospital all get pitocin.  I find it sick.  Without that drug, maybe it would have taken a little longer, but she could have pushed that baby out.  The heart rate most likely would have stayed within the normal range.  Or what if they’d given her something to eat?  That might have helped.  No muscle that doesn’t get food for over 24 hours is going to work very well, and that INCLUDES THE UTERUS.

It infuriates me that this doctor has a c-section rate of over 80%.  It’s creepy.  It’s all fear-based, fear of being sued and blah blah blah blah but it’s just fucked.  When we went into that OR, the nurse had to go under the table and push the baby’s head back up so the doctors could grab it.  She was totally down in the pelvis.

UGHHH.  I find myself feeling very militantly midwife-ish.  I’m sure this will probably just increase over time.

I just felt really bad for her.

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I wrote a bunch of these last week, but then I didn’t post and now I can’t find them. So here we go again. Sophie … a bunch of ours will overlap. Obvy.

1. Wandering the Stanford campus with Katie, singing choir songs … especially in the parking garage, where the echoes made our harmonies sound freakin’ awesome. “The water is wide …”

2. Helping Soren practice walking on a Spring day in 2005, at Mac.

3. Eating, drinking, smoking & laughing hysterically with Mark, Luis, Nick & Sophie in May, 2007.

4. Playing “guess the Beatle” with certain someones.

5. Floating for hours in the lukewarm ocean at Hermosa Beach with my brother.

6. Shabbat at haKotel, summer 2006, joining a ring of joyous dancing women as the sun set, and feeling something I hadn’t felt before … and haven’t felt since.

7. Water-sliding & rope-swinging with Grace & Sovigne at the Y in Minneapolis.

8. Sitting on a balcony in Amsterdam with Miranda.

9. Summer days on the roof, playing the guitar badly and singing (quite well).

10. Taking a walking tour through a historic neighborhood on a sunny day in beautiful Jerusalem, and being able to understand the (very basic) Hebrew.

11. Playing that Brahms clarinet sonata with Andy in his recital and really nailing it.

12. Driving four hours to Atlanta to see Bob Dylan, the size of a caterpillar on the stage. Awesome.

13. Watching Help! for the first time in ten years with another Beatlemaniac.

14. Drinking wine in Florence and tipsily finding our way back to the hotel.

15. Playing in a ragtime festival in Boulder, 2001, in between two professional pianists, both of whom told me how much they enjoyed my music.

16. Coming up out of the train station in Paris into the most beautiful city EVER.

17. Smoking with my dad … Coffeeshop Rockland.

18. Driving Sarah home every day junior year and playing Mario Kart until our thumbs hurt.

19. Sitting in the backyard of our house, with a good book & enjoying the sun, surrounded by our animals: cat, dog, bird, bunny.

20. Grieg songs in our apartment, and Sophie cursing at the obnoxious people outside who didn’t appreciate the music we were making.

21.  Climbing up Masada and standing at the top.

22.  Whiskey and easy, four-chord songs, Marshall Ave, St. Paul.

23.  Decorating our favorite teapot.

24.  Kirk + music + hysterics x almost every day of junior & senior years.

25.  Webcam pictures with a variety of people, children and adults alike.

That’s it for now. I was up at 5:30 and I must sleeeeeeeep soon.

Yesterday my clinical group oriented to our OB “rotation” over at the general hospital here.

Let me say this: I think we got damn lucky.  Our instructor is a super-cool, young, groovy midwife, and her brain is like a freaking computer.  There is so much information in there, I wish I could just import it all into my own head.  The relief I felt this week was pretty intense.  Listening to her tell us passionately about the amazing human body and all the miraculous things it does, and what we can do to help it without intervening medically, made me feel so much better.   I am going to learn so much from this woman.  The next five weeks are going to be like a little tide-me-over until next year.  I still have to get through a shit-ton of stuff that won’t be too fun, but I can see the light at the end of the tunnel, and this rotation … it’s already like a breath of fresh air, and I haven’t even met one patient yet.  (Well, we met one very tiny brand-new patient, in the normal nursery.  CUTE.)
I struggled some during our last rotation, and I am incredibly happy to be done with the cardiac step-down unit.  Taking care of people who have had open heart surgery and are very very sick is just not what I want to do.  A lot of people say that even after you become a nurse practitioner, you should work as an RN first to gain experience, but I just don’t know if I want to do that.  I guess it’s possible, but I have been worrying about it because I just did not enjoy being in that hospital.  Taking care of moms and babies is totally different because, for the most part, they are healthy.  They aren’t sick.  Woohoo!  I can’t wait to be a midwife!

That being said, I still have plenty of anxiety about whether or not I can do it … whether or not I can be a good midwife, if my brain is even capable of absorbing all this information, but I’m going to do my damndest.  It helps when it’s so fascinating and wonderful.  And babies.  I love babies.

I think the good weather has lifted my mood.  Thank you for coming, Spring.

happy

March 6, 2008

i need to focus on things that make me happy, so i’m gonna do that meme … or whatever … just list some things that make me happy.

1. naps.  i just had (another one), and since i am on spring break it was a guilt-free nap and it was awesome. i also had one yesterday, equally great.

2. my apartment.  it was nicer right after my mom came to visit and cleaned it, but it’s still in decent shape and i love it.  the light in this place in the afternoon — any time the sun is up, really — is beautiful.  it’s that really sort of clean, yellow light coming in all the windows and it feels so peaceful.

3. coffee from fido.  yesterday i brought my book over there and sat and drank a delicious latte and it was sooo good.  fuck, i love spring break.

4. visits from old friends.  elizabeth came last weekend and it was fabulous, and miranda is coming next weekend, and it will be fabulous.

5. hanging out with new friends.

6. writing and receiving mail. i have gotten 3 letters from costa rica so far and a few from the twin cities since i was there in january.  oh how i love mail.

7. umm … whenever i overhear anyone say anything about the beatles (except if it’s something bad, but really, how often does THAT happen).  when elizabeth was here, we went to a show where i heard some guy say, “there are probably DOZENS of beatles kids out there … and they just don’t know it.”  true, true.

8. showers.  hot showers.

yeah, those are some great things i just listed.  🙂

eleven hours later …

February 15, 2008

yesterday i was at the hospital from 6:30 am, and i got home around 5:30. oh lord. i was so tired. they do not have chairs in the halls at the hospital where i have my current “rotation” (it’s a cardiac telemetry unit), so i think i sat down for about 1 hour yesterday. during lunch. OW.

i feel so incredibly, totally incompetent and retarded at being a nurse. i know i’m just beginning, but my brain just doesn’t seem wired the right way. it’s totally different from anything i’ve ever done and it scares me. it doesn’t come naturally. i know i’m not the only one who feels like this, but it seems like some people just get it really quickly … it’s not like i’ve done anything really unsafe (well, except for getting this old dude out of bed when, oops, it turns out he couldn’t really stand) … but i just miss things. it’s like all these little balls you have to have up in the air all at once, and not only do you have to catch them, but you also have to put them together so you know exactly how they fit. like a puzzle. i’m not very good at puzzles.  i’m especially not good at puzzles when someone is watching over my shoulder.

i’m hoping it will become less puzzling as time goes on. i’m going to try to have faith that i am reasonably intelligent, nice, and able to work hard, and that if all those other people can do it, so can i. yesterday was only my 4th day back in the hospital since november, after all. so it IS understandable that my brain was farting all over the place. right? RIGHT?

i have a classmate who has a brave and good heart. he let me give him an injection yesterday, and then, THEN he let me start an IV in his arm. not once, but twice. because the first time i totally missed the vein. oops, sorry, jon. he was so nice, though, i was grateful. scary shit, sticking needles into other people.

sigh.

January 21, 2008

Soren: HERE I AM!  How about we play with my train. (we work on it)Soren: I NEED SOME MORE STRAIGHT PIECES.Me: There aren’t any more, though … here, here are some curved ones.  They might work.Soren: (takes curved piece) I can use this, but it won’t be as splendid. 

1/21/2008

January 21, 2008

Today was a really fucking hard day.  I don’t know why.  I didn’t have to do anything except sit through many hours of lecture (several of which were incredibly boring and pointless, but it’s not like it was a high-pressure or anxiety-causing situation).  Sometime during the early morning hours (we were learning about schizophrenia at the time) I was just hit by this wave of depression, loneliness and powerful feelings of being completely overwhelmed.  Ugh, it was awful.  I just wanted to get up and run out of the room and not come back.  I don’t want to be doing this right now.  I KNEW this semester would kick my ass as soon as it started, and I was right.  I’m tired.  There are so many little things piling up and stupid hoops we have to jump through and I just DON’T WANT TO.  I want a vacation.  I want to be with my friends, my friends who live thousands of miles away from me, the ones who make me feel better when I’m sad and keep me company no matter what.  I do not want to be here trying to study and feeling guilty when I don’t and trying to get to the gym and feeling shitty when I don’t and feeling shitty at 6:30 in the morning when I have to get up and being tired all the time. I believe I’ll be utilizing a negative & unhealthy coping strategy tonight and drinking most of a bottle of wine.  I’ll let y’all know how that goes.(I won’t be drinking alone.  There are many, many people in my class who are equally frustrated, tired & overwhelmed, and one of them will be bringing her boyfriend over here in a few hours to partake in the unhealthy coping activities I have described). 

A new year

January 12, 2008

I had such a lovely, relaxing three weeks off, and now I am back, and it’s pretty good. The weather is good, especially after visiting St. Paul, where the familiar freezing was … familiar … but not exactly pleasant. It’s just so much easier to live in a place where you don’t have to battle the temperature every time you go outside for five months.

So our first week was decent. This weekend is the time to get organized, though, because I can feel all the projects and papers and tests sort of floating around in the imminent future, and it’s overwhelming already. We also started clinicals this week, so I spent two days at the state mental institution. Psych is my first rotation this semester. I have some great people in my group, and a great supervisor, and woah does talking to people in a mental health institute change my perspective on my life. And the entire world.

Ok, I just can’t even think another thought until I get some coffee. This must be one of the lamest blogs ever.

fa la la la la

December 23, 2007

I love love LOVE our dog. How could I not? He’s a mini Australian shepherd, and our affection has turned him into a giant stuffed animal who gazes at us intelligently, smiles oftenjavascript:void(0) and sleeps in funny positions with his paws and head facing opposite directions. Occasionally with his head on its very own pillow.

Seriously … how could I not love this dog.
photo-441.jpg

It’s just that I sometimes feel awkard because he is deaf. He is far more brilliant than the average dog, but he also has special needs. So this means that when I am with him at the park, I can’t shout at him, or whistle, or call. I have to wave my arms in the hopes that I will catch his eye and he will choose to obey my sign language telling him to come to me. Yesterday I wanted to tell the kid at the park, yes I really WOULD rather my dog did not dance in circles right in the middle of the area that you are playing with your whirly flying toys, but I can’t tell him that because he’s deaf.

It wasn’t bad at all. This dog is so good. And he really does dance in circles, aided by the tennis ball, which doesn’t need to be thrown to provide many minutes of exciting entertainment. For a while I thought what he really needed is some kind of robotic ball that moves on its own, but he doesn’t, because a regular ball will do just fine. He kicks it and then pounces in glee.

AW.

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so close!

December 12, 2007

It’s 8am and in approximately 3 hours, maximum, I’ll be done with the semester and oh so very fucking happy. The only reason I’m up now is because I was going to study, but I can’t … I just cannot. And it’s not because I have already studied, no. It’s because I just can’t study. I think this is what they call BURNOUT.

Ok, on another topic. I like to read some blogs, blogs much better written than this one, and about much more interesting things like, say, pregnancy. So there’s one blog I read that is written by a woman who is pregnant with twins and has been on bedrest for a very long time, having contractions etc, monitoring herself constantly, and YAY! She’s maybe 35 weeks now. So things are looking good. But I read one comment she got from someone, I have no idea who, that said, well, it’s all good because you made it to 34 weeks without having the babies, that means that they won’t stay in the NICU hardly at all, everything’s gravy, congrats! And obviously I have no problem with her being congratulated, she deserves it. But I wanted to post and show this person a picture someone showed us in one of my classes … I don’t remember which class, or who the person was, that information has been deleted from my brain … of the brain of a 34-weeker and the brain of a 38-weeker baby. Oh, I think it was actually someone at the OB conference we went to a couple of weeks ago.

Anyway, the point is this: 34 weeks – large, but with very few wrinkles. 38 weeks – looks like a scan of an adult brain, all wrinkly and generally MUCH more developed.

That is not to say that babies born at 34 weeks do not end up perfectly healthy and fine. BUT. The longer they stay in, the better!!! Those last few weeks make a huge difference.

So that is what I wanted to tell that person, minus the exclamation points and capital letters. It doesn’t matter really, though, because the point is this blogger’s twins are most likely going to be healthy … prematurity is so dangerous, and I’m very happy for her, and excited to read about them when they arrive.

Emily, I’ve been meaning to write to you and I will. I hope that you haven’t totally given up on midwifery. I just wanted to tell you that when we started here, we met in our specialty groups with the directors of each program, and the midwife in charge told us: just get through this year. Next year you will be so much happier, so much more excited, you will be learning things you actually want to learn, but first you have to get through this basic nursing stuff, and it’s hard. That’s what we’re all struggling with right now, the fact that before we can even learn about babies we have to learn how to do 12-hr shifts on the floor taking care of dying people. Of course, I think we also struggle with whether or not this thing is right for us, if we can do it without going crazy, all that stuff. Anyway, more later … I have to get dressed and take a test.