27 yo 1979 Surgical internship, OBGyn

I delivered a lot more babies in my internship. I’d chosen a rotation in OBGyn in the summer time.  This was when the staff men and staff women were mostly on holidays.  If you wanted to deliver babies, which I did, you, picked a summer rotation.  So I was teaching nurses disco dancing and catching babies like they were coming off an automatic ball toss machine. It sounds crude but all our delivery rooms were full.  The nurses with nurse wisdom attributed it all to power failure 9 months before.

I had this complicated case where the baby heart disappeared and the staff OBGyn on call was called in for an Emergency C Section.  She was that amazing East Indian lady. I was wheeling the gurney with the nurse into the OR washing hands looking over my shoulder at the patient in labour having contractions. The East Indian goddess had arrived and had thrown a gown over her gown. Sparkling 24 k gold earrings. Hair up, booties over high heels she was magnificent.  I had been terrified at the thought of doing the C Section on my own. The baby had to come out and this glorious doctor may as well have ridden out of the skies on a white charger. 

“We’ve washed enough, “ she said. “Hurry up. Hurry up.’

A surgical tray was being wheeled in as we entered.

“Scalpel.’

No issue of pressure here. She just sliced that belly open like gutting a pig. With finesse.  The uterus just popped out like a dive balloon surfacing on the ocean.  The anaethestist was still trying to catch up with the gas. The mother was still alert.  Another cut and the uterus was open and the baby was coming out.  Just a little blue. Cord around the neck. If the vaginal delivery had continued the baby would have been dead.

“It’s a girl.”  She smiled.  She reached in for the placenta and scooped it up. She handed the baby to the nurse letting her snip the umbilical cord having pointed where she wanted the scissor cut to be.   The mother was whoozy.  The anesthetist was backing off having hardly turned the gas on..  

I was suturing up the uterus.  “Big stitches.  Big stitches”. She was coming from the other side .  Her hands like an automatic sewing machine to my 2 or 3 sutures.  

“Now close her up”.  She again started from one side like a human sewing machine while I plodded in from my side getting two or three sutures in before we were finished.”

The anesthetist had taken the face mask  off and the mother was coming around. She’d hardly been under.  She was awake.  Her eyes were fluttering. She was reaching up for her baby. Sleepy tired smile. 

The amazing OBGyn had picked up the baby and handed it to her having the nurse put her hand on the back of the baby to hold her close to the mother.  The mother was not just smiling but glowing. . The mother and child together.  No one else in the room. The duo staring at each other. The great waltz continued.

“Doctor, “ a head poked in through the door. “We’ve another delivery.’

“Can you handle it, Doctor.”  I was quite overwhelmed but the word doctor was affecting me. I was growing into it. It still sounded like somebody else was being called. “I’ll see.”

“Call me if you need me. I’ll be a few minutes before I leave.”  Sometime when I asked how she became so quick and so good, she told me that in India she’d delivered ten thousand babies and done hundreds of C/Sections. 

I went on to deliver the next baby with that staff lady ‘hanging around’. The baby was crowning  when I’d scrubbed and got in the room . With grace and apparent  practice the baby came out perfectly smoothly navigating the turn and twist like a seal.  A perfect exit by an Olympic baby.  I was only their to witness. Mother and baby were so happy with the performance. 

I looked at the window in the door, the OBGyn hair up , dangling gold earrings giving me a thumbs up and a wave. The masked female Zorro disappeared into the night. We all went back to waiting the next delivery. 

There was the chiropractor trying to reduce his wife’s pain with last minute manipulations.  There was the acupuncturist needling his wife.

There was the guy who barged onto the ward shouting

“Where is she?” 

“Where is she.” 

He was pulling aside the drapes and looking into the room until his bruised wife I was admitting stood up and he saw her. 

He literally charged at her and was lifting his foot to kick her in the swollen belly when I got in between. The nurse was beside me telling him to leave. His wife cowered behind us and I said “You have to leave” . We could see security coming. He was just staring at me with hate. Venomous hate. Then he turned and stomped off the ward evading the security. 

I never got the back story. I just remembered the effect of rage and fear on perception. The police interviewed us and asked me how tall he was. I said I was 6 feet so he must have been 6’2 or 6’4”. 

“Everyone else said he was only 5’6 inches or there about. »

I could have sworn he was taller and bigger than me, 

It was night after night excitement and deliveries. . Every night I was on call we had a half dozen deliveries and I’d get one or two because I was there.  Thankfully I didn’t have to do a C/Section on my own.  There were more c/sections but these were usually scheduled during the day and I’d assist. No more emergency c/sections.  When I wasn’t doing Obs that I was asssisting with cancer surgery in Gyne.

Today most of the cancers that I was doing surgery on back then have cures. Mostly we were end stage and doing what we could to relieve pain. The breakthroughs in research are amazing to any of us who have been around and have memories. Cervical cancer is all but prevented and cured in early stages. Uterine cancers are also detected early and surgically curable.  The ovarian cancers are caught early now on ultrasound. cTScan has revolutionized abdominal diagnosis but especially so with gyne.

We had this golden age  of female medical and surgical care after the dark ages of women being ashamed to complain of ‘female problems’.  Thanks to good public health and prevention women were getting pelvics and examinations and early detections meant people weren’t having what I faced back in those surgical intern days. We’d open abdomens and cancer was every where. 

The sad part is that today the Administration and Doctor Police are  bowing to feminist and sharia pressure are discouraging doctors from ‘touching’ women. All doctors male and female in the cultural communism gambit are being portrayed as perverts and enemies.  “Don’t even ask women about anything sexual unless they raise the issue,” Government  is telling doctors.  “Women are too sensitive to be asked about sexual matters.”  Meanwhile swaggering feminists are crying ‘sexual harrassment’ if any male or female doctor so much as looks at them.

“I don’t examine any woman now.” He told me. Just one of many gp’s saying the way it was.  He hadn’t even been falsely accused or had a complaint just didn’t want to take any risks. 

“I’d be ashamed if someone else found disease I’d misssed” said a College registrar to a doctor on examination.  The women beside me said, “she obviously doesn’t have to pay the rent.”  She was an administrator so far removed from reality as to be deemed psychotic. Doctors weren’t worried about ‘looking good’. Clinicians were good and smart but they didn’t want to take any risks with their licenses. 

In practice I’d ask women routinely when they had their last PAP or pelvic examination and most would say years. These were women with drug and alcohol problems, high risk, some prostitutes, their principle resource walk in clinics. No doctor  ‘dared’ to do a ‘physical’ or a ‘pelvic’ or ask about their ‘sexual’ health or even ‘periods’. As a psychiatrist  I made dozens of Gynecological diagnosis a year confirming my history with referral to the incredible OBGyn Crossroads service atttached to women’s and UBC.  The gynaecologists were the best but the administration were back in the medieval age with their political correctness and not wanting to offend. GP’s and walk in clinics were responding to the message they were giving loudly, ‘let the women die. Better a million women die than one woman complain. » So the light went out on women’s medicine. I was there to watch it fade

I was so thankful I was there when the days were lightand the profession wasn’t dominated by increasing darkness.

One of my favourite deliveries was with this great blond beautiful family physician.  She arrived in to deliver this Portuguese lady who was screaming her head off.  The family physician was bigger than the patient in labour. 9 months herself.  

“I don’t know why she’s screaming. She seems perfectly okay. Every thing is normal. The anesthetist and nurse can’t see anything unusual either.” I told the very pregnant staff lady.

“That explains the young man and his father I passed in the hallway.” She said.

“What?”  I asked 

“Two men are wringing their hands and consoling each other outside the door. It’s cultural. The louder and longer the Portuguese women scream the longer their husbands and fathers care for them in the first year.  This girls going to have a year or two of loving care the way she’s going. She might even get her meals in bed! » she laughed as another loud keening wail erupted.

We went ahead with a normal delivery. The men’s guilty fearful faces looking through the window at the great mystery of creation.

The healthy  baby boy was delivered . A new gurney with ecstatic mother was pushed out in the hall by the nurse. 

The beautiful family physician  asked the anesthetist for help getting up on the bed.

“I’m afraid I’m going to have to deliver, John” she said to the anesthetist.  “My waters broke during the last  delivery.  I think I’m crowning. It feels that way. » She said puffing Lamaze breathing.

«  Would you mind taking over. I’d rather you do the delivery than put the intern out. I suspect it woud be more difficult for him.  Could you call the staff lady, Doctor”  she said to me as the anesthetist moved to end of the bed.

Thankfully the East Indian staff lady  was on the ward. I called her. 

‘She’s delivering, isn’t she?  I told her, she would . But she wouldn’t listen. Her other three babies didn’t like to wait either.” 

 I was thankful as she carried on, passing me as she entered the holy of holy  sanctuaries..  The adults were gathering and caring for one of their own. The head nurse passed me.  The saints were gathering. I sat at the desk waiting, to making notes..

There were no screams.  A handsome harried professional man arrived anon. I pointed him to the delivery room. He rushed in. Moments  later  the happy cry of another new born baby rang through the ward like cathedral bells.  

Pregnant Doctor Delivers

Now that I’m older I have the true luxury of remembering. Those who died young didn’t know this.  As a physician I’ve been blessed to be present at so many pivotal, and one might well say ,sacred times.  I’ve heard countless stories and felt the lives of those who have come to me to share.

This morning, for no reason, these memories seem to rise up like that, I don’t even know of a trigger. Yet this one came to mind and I smiled as I so often do remembering work, the colleagues I knew and the patients who brought us together.

This occurred in a busy teaching hospital.  An obstetrics ward in the wee hours of the morning.  We were all gowned and masked.  We had these little paper booties that covered our shoes.  I remember them most.  The white walls and bloody red sheets. The laundry piling in the corner as all were needed for the work at hand. Later there’d be time but at that moment it wasn’t something we could think about.

“There must have been a power outage over the whole city 9 months ago,” the nurse joked.  

I was at the foot of the bed watching as the cervix dilated and the woman pushed. She’d been screaming for an hour before between contractions when the pain should be least. In addition the anesthetist had just given her a spinal block and begun to administer epidural analgesia.  She should be feeling less pain and be screaming less. If anything her screams had grown louder. 

 I’d asked the nurse about that, as an aside, concerned that something might be amiss.  She nodded to the door where a thoroughly terrified young man was there at the window peering in. He’d come to the little square glass then walk away with an older man comforting him.  I’d seen the older one put his arm around the younger man’s shoulder.

Then the father to be would pull back his shoulders, stand tall and return to peer in the little window.  There were tears in his eyes as he waited helplessly, overwrought I presumed with his inability to do anything but wait.   I’d been glancing out at him now and then while waiting, patiently, for the delivery to progress. 

While the anesthesist was speaking to the patient, the nurse was reviewing the continuous monitoring data strips.  In a low voice , beyond the hearing of the patient, who was either  listening to the anesthetist or screaming her lungs out, the nurse shared. 

‘That’s her husband and father,’ the nurse told me. “They’re old school Portuguese.  Our patient is okay but the more she screams the more the men will care for her and the baby after.  They’ll be helping her now for the whole of the coming year,’ she said smiling.  “It’s a good thing. It’s cultural. She’s going to be okay and she and her baby are going to get a lot of well deserved breakfasts in bed.’ She laughed.

I reflected on the aboriginal patients I’d delivered who’d been a different challenge. Their stoicism and silence had been the means to recognition in the family and  community.  As a doctor I had so much to learn about how people express themselves in sickness and in health.  I had to listen for the different cues that something which might be normal had changed to something that might be more concerning. The older nurses especially in Obstetrics were a wealth of experience and insight. Early days I felt like a hamster on a wheel forever playing catch up. 

I was brought back to the present, not by a fresh crescendo of screams but by the door bursting open and another gurney rolling in as it was pushed quickly  in place  by two sweating hurrying orderlies.   

“We’ve run out of anesthetists.” One said smiling as our anesthetist began to busy himself with the new arrival.  “All the delivery rooms are full and we’re  doubling up.”

I was suddenly very anxious. I was very new to this, only a few deliveries under my belt. My lady was almost fully dilated and here was this new lady well on her way by the rate of the her contractions.  

I think the older anesthetist could see I was concerned if not outright terrrifed.  He said, “Her doctor will be on the way. She was just delivering another lady before I came here.  If all else fails I’ll gladly help at your end.  I’ve been there many times before,” he laughed with the infectious confidence of maturity and experience.  My patient screamed. The other patient screamed.  The nurses eyes twinkled.  It was already a long night.

At that moment a very very large young female doctor burst into the delivery room and went to the side of the newest patient taking her hand, speaking kindly and calmly to her as she looked over the monitor.  

“You didn’t think I’d miss this for anything,” she quipped to her tired but smiling patient. “We’ve been planning this for 9 months.  Now we’re going to see that it was all worth it!:

The doctor was 10 months pregnant herself if she was a day.  Bigger than a house and nearly the size of a whale. She’d moved fast into the room but could hardly bend to speak to the patient.

Going to the foot of her patients bed she peered down and said to the nurse.  “Already crowning”.  To the patient, she said,   “ We’re doing very well.’ Not much longer now especially given how well your last delivery went. “

“Hi Charley’ she said to the Anesthetist. 

“Hi Annie,” he replied, in the tone of old friends.

“Good morning, Doctor, “ she acknowledged me kindly. 

Looking over my shoulder she saw that my patient was just beginning to crown too.. 

“Primip” she quearied,  smiling at my patient.

“Yes,” I replied

“This is Sarah’s second, could be a close match! ‘ she said looking at her patient and returning to where she could view her.  Turning to me she said, “I’m not going to say it’s a race but if this were Vegas they’re be laying close bets as to which child would come out first.‘ 

“Not much longer now , just a few more pushs Ladies.” She said to both.

It was clear that my patient was more relaxed now that this marvellous woman doctor had arrived, even if she was the size of a house and some at Vegas might be including her in the betting . 

The poor patient  was no longer dependent on me a young doctor obviously wet behind the ears. Her screams had changed  now to more like grunts as she pushed responding to the nurse who’d taken a position right beside her head , letting the patient  hold tight to her hand. 

“Here we go”  Dr. Annie said to her patient just as my patent  became fully dilated and the crown  began to appear.   There was no need for an episiotomy. Everything was going smoothly.  I reached forward as the baby came , cradled the  head, then the shoulders and the bum and finally the legs came too.. The nurse was there beside me taking up the baby in clean linen and, wiping off the amniotic fluid, then giving the beautiful little boy baby to the mother.  The placenta delivered. All the bits were there. The new mother was smiling beautifically, pleased with her little boy. I clamped and  cut  the umbilical cord.  

Normally the father would be invited into the room but with the two deliveries happening and the nurse being more aware than me she’d wheeled this bed out into the hall where the father and mother and family and in laws were all waiting to celebrate the new addition to their family. The nurse returned immediately to be there for the second delivery.  I stood by waiting to be of assistance, not knowing what else to do. 

Just as my lady was being wheeled out, with her baby clutched to her chest, the other baby was delivering.  I’d only glanced over to see the mountain of a pregnant woman doctor between the woman’s legs in stirrups.   She’d been leaning awkwardly forward , stretching out and over the mound in front of her  assisting the delivery.  Her arms had the vague resemblance to the Tyrannasaurus Rex but somehow she managed.   Lifting the baby into the air she exclaimed,  “It’s a girl!”  as she handed the baby to his mother.  

I was about to leave then when the lady doctor said, “I’d appreciate if you ‘d not go  just yet. “

“Sarah” , she said, “Congratulations, but if they don’t get me another bed I might have to ask  to share yours.  My waters broke in all the excitement of your delivery! “ She laughed. It was obvious thought she was  just a bit strained. 

The nurse with the strength of a Sumo wrestler and the speed of a jaguar  muscles  another bed into the room with my helping with the guidance.

 Sarah’s husband had joined her and the two were google gaga over the new baby as the two sweaty orderlies were moving the bed out of the room. I don’t even think they noticed us so caught up in love they were.

Dr. Annie was now  standing partially bent over grabbing hold of her thighs and Lamaze breathing as another contraction passed.  The anesthetist,Charley,  was right by her side. 

“I’m going to have to ask you to help me up on the bed,” she said, “ I don’t think I can stand much longer.”  Together with Charley I helped her onto the stool the nurse had brought forward.  Together we hefted her up onto the bed where she collapsed with a huge sigh.  Lying on her back she looked like an Anaconda who’d swallowed and elephant. I couldn’t believe how far along she’d been and delivered two babies that night before she was about to deliver her own. 

‘Could you tell me how far along I am?” she asked between panting.   Charley was establishing an IV.  The nurse  was spreading the jelly for the  ultrasound monitor.  The baby’s heart rate was suddenly visible and looking just  just fine on the screen.

I examined her then. She was fully dilated and just beginning to crown.    I said so.

“I thought as much, “ she said, between breaths and pants. “I called my own doctor before Sarah. If he doesn’t get here,  I’d appreciate you’d stay and assist. I’m rather occupied myself. “ She smiled and I could see Charley’s eyes twinkling as well.  I really was rather awkward and uncertain in those early years. I stayed of course. Never thought I’d do otherwise. 

“Of course,” I said. 

Her beautiful face was flushed and sweating profusely as another contraction took hold.  The nurse had given her her hand and she was squeezing tightly.

At that very moment,  another rather  tall doctor,  burst through the doors. He stopped abruptly beside the patient and said. 

 “I’m glad I’m not late, Annie. I hope you didn’t wait just for me. ” Another contraction came.

“Good to see you, Charley,” he said coming down to the end of the bed beside me. 

“All’s well?” He said, Charley, myself and the nurse nodding. 

I never was more happy to stand aside and let an older doctor take my place.

“I see a head Annie.  Shan’t be long.  Just another push or two if you don’t mind.”  Dr. Annie gave a powerful push and the baby’s face began to slowly appear, the obstetrician carefully guiding.

And sure enough, another baby girl was delivered that morning.  A lovely little girl.  Five fingers and five toes.  

Dr. Annie’s smile was as beautific as the other women’s.  Her husband came in as I began to make myself scarce.  Even as I was leaving, Dr. Annie, turned her beautiful eyes on me, and said,  “Thank you. ” Then her attention was all for her baby and her man.  I looked back over my shoulder at this wonderful family tableau knowing I had been blessed to be there this night. .  

I made my notes at the nursing stations surrounded by the doctors who’d been called in for this most productive night. 

 I will never forget that beautiful lady doctor 9 months pregnant delivering another woman’s baby before giving birth to her own.  That’s a memory I feel  blessed to have. Looking back I’m just thankful to have been there and thankful to have been of some service to all those amazing colleagues and patients and especially Dr. Annie.  Sacred times.