Labor and delivery can be crazy in any country. At least from my perspective, the craziness here in the DR is a bit different than what I am used to. At home, when there are sick patients or stressful situations you can tell because everyone is revved up. Here, no matter how crazy things seem to be from my perspective, residents are still laughing, making jokes, planning the weekend, etc. Sometimes it's hard for me to realize that there is a critically ill patient because no one seems to be acting any differently- I guess they must all be so used to seeing this acuity of illness. I'm impressed with how darn calm they all are and how much fun they make work to be!
Today I worked again on L&D. Today, I ended up repairing at least 6 episiotomies (I lost count!). For non OBs, this can be tricky because there are often many different layers of suturing that have to be done depending on how far the episiotomy extended. I feel like I'm getting pretty good at it! I even have fun chatting with the patients (of course in Spanish) during it. I'm excited that I think my surgical skills are getting more confident but I'm also really proud that I'm able to start being more like the clinician I feel I am at home- consoling patients, chatting away, etc. After some awesome encouragement from Nina, I realized that I could still be the clinician I wanted to be even though it's in another language/culture and even though no one else I was working with was being supportive to these patients. It felt great to hold a laboring woman's hand, acknowledge her suffering, and tell her to relax nicely. I felt like the OBGYN I like to think I will become one day. So thanks Nina!!
Sometimes the labor room is especially busy and there isn't any room for more women to deliver. I saw a resident deliver two separate babies on a regular hospital bed today in the laboring room. I felt so bad for these women- they were laying in a pool of their own blood, stool, and amniotic fluid and were covered in it! The other women in the laboring room (about 20 or so) were strangely respectful- they all kind of stopped screaming during these deliveries and looked away to give these women some amount of respect for what she just went through. These are some super tough women that I'm working with!!
A crazy thing happened today- the power went out in the hospital twice! One time, while I was delivering a baby! Since the delivery rooms have no windows it was completely dark. No one around me seemed to care that it was dark so I waited a few seconds and then just tried to continue working. Luckily, the lights came back on before I completed the delivery of the baby's shoulders! Power outages still happen here in the DR often- not as much as in the past- but it probably still happens a few times a week. Looking back at the power outage today, it's really cool how I didn't even think to get stressed about it being completely dark- I just kind of kept working. I doubt that I will ever have to deliver a baby in the dark back home in residency, but it definitely is something that has boosted the confidence I have in my clinical skills!
One of my favorite things that happened today is related to the title of this entry which translates to "now you are a Dominican!" I forgot to mention earlier that since deliveries happen so fast and supplies are minimal, the only protection I have from the patient and her body fluids are my glasses (thanks Mom!), scrubs, and a single layer of gloves. For anyone who has seen a delivery before, you can recognize how difficult it is to deliver an infant and only get your gloves dirty. Anyway, after getting splashed today by various body fluids, I picked up a habit that I had seen the other residents doing- I now tie large black garbage bags around my waste so that when I do get splashed my scrubs are less likely to get drenched. I spent the rest of the day walking around in scrubs and garbage bags. One of the attendings saw me and told me that I finally was becoming a Dominican. She then encouraged me to show off my new attire so I did a nice catwalk down the laboring room and everyone stopped to applaud and cheer me on. It was super fun but I guess a little strange if you weren't there! Who would have known that something as gross as getting soaked by body fluids would turn into something that helps me become more accepted by colleagues?! :) That said, I really look forward to practicing back home where I don't really have to worry about getting covered in someone's body fluids.
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