Wednesday, January 22, 2014

The Pregnant Resident

      First, I will say I am extremely lucky. I have the most beautiful, delightful baby girl on the planet and I would not change her for the world. I will say, however, that it was extremely difficult to be pregnant during my surgical intern year, and I had the easiest pregnancy ever (and I am 100% positive that I will have every symptom in the book during my next one to make up for it).
     I had decided early on, that I was not going to be the type that used pregnancy as an excuse to get out of doing anything. I would do everything I could do to be a great intern. This was a good attitude, in my opinion, because excuses are not tolerated in surgery. I was fifteen weeks pregnant when I started. Being a surgical intern takes a lot of endurance. It requires a lot of running around (at least in NYC, where putting an order in the computer is not enough to get a job done. You actually have to chase someone down to make sure they saw the order, and make sure that if, in fact, they did see it, they are not choosing to ignore it), lifting, little sleep, and frequent periods of starvation. I was okay, because I had an easy pregnancy, but if I hadn't I would have been (excuse my language) screwed. I wouldn't have been able to keep up. Even at the end, at almost 9 months pregnant, I scrubbed into a surgery and retracted for 4 hours straight. If you have never retracted before, I can only compare it to playing a game of tug of war for hours. I thought collapsing and falling onto the patient was in the realm of possibilities, but debated saying anything throughout the surgery because I did not want to be THAT GIRL. Luckily, I made it through.
      The no excuses mentality worked extremely well, because, as I mentioned, nobody, especially in surgery CARED that I was pregnant. They were not going to hold it against me, as long as I did not expect any special considerations or treatment, which I didn't, but they also didn't care. I will never forget an incident during my first month of my intern year when I was the intern covering trauma nights. I came on at 6pm, and the chief on my team was irritated because one of the patient's x-rays were repeatedly unclear because she was unable to turn her neck enough to get a good picture of her injury. It was decided that someone would have to go into the x-ray room with her and literally hold her neck at a certain angle so a good picture could be obtained. She said to me "I do not care what goes on tonight, but make sure the x-ray is done by morning." The night was crazy (typical of trauma surgery in July), and by the time I was able to take the patient to get the x-ray, it was 2 am, and I could not find anyone who would go into the x-ray room and hold the patient's neck in the proper place. I begged, I cried, and the x-ray techs as well as the nurses all said "We don't care if you are pregnant, we are exposed to radiation all of the time, so if you want these pictures taken, you will go in yourself." I will not go into what transpired, but the x-ray was done that night.
      There was also an instance in the SICU, where the transporter yelled at me for not walking fast enough while I was pushing the hospital bed of a 300 pound patient up to radiology. I explained that I was pregnant, and that I was going the fastest I possibly could, but she didn't care. She said " I don't care, I had to transport patients when I was pregnant, and if you don't speed up, we will go back down to the SICU, and the patient won't get their CT." I was speechless, but too afraid to say anything back to her. If my patient did not get their CT, I would be the one in trouble with my chief and attending.
      I also had issues going to the doctor. My obgyn only scheduled patients until 7 pm, with no weekend appointments available. I tried to get my glucose tolerance test done (which is supposed to happen at 24 weeks) when I was on night float (meaning I left work in the morning and had to be back at night), but I accidentally drank too much of the sugar water, and they would not let me do the test because I could get a false positive. I had a very hard time trying to find a time to reschedule the test, and ended up doing it much later than I should have. Even my doctor did not understand that I could not just leave work as an intern to get a medical exam without getting in trouble (and he is a doctor). I typically did not get off of work early enough to make it to the doctor without leaving work early, and I hated that I had to do that. Everyone at work was fine with it as long as I found someone to sign out for me, which was not always easy. Personally, if I were going to be the type of doctor that had an office, I would make sure that I had late hours at least once a week to cater to people who work late (like surgery residents). By late, I mean 9 pm, not 7. Future doctors of America, take a hint.
      Maternity leave was also an issue. If I had been pregnant during my anesthesia years, I could have taken a maternity leave of at least 6 weeks, and made up the time by extending my residency by 6 weeks. However, this is my preliminary surgical year, and I have to complete it and be ready to start the anesthesia portion of my residency by July 1st. Therefore, I have no extra time to extend the year to make up for time on maternity leave, so I did not get one. My original due date was December 26th, and I was scheduled to work through January 1st. I had my one month vacation for the year scheduled for January. I was sure that I would make it through the month, because most first babies are late, and the average first mother delivers at 41 weeks and 1 day. Charlotte, however, had other plans, and decided to make an early debut into the world. This created a lot of drama with my schedule. She was born on my day off for the week (conveniently), after I worked 14 hours the day before, but I was scheduled to work the next day. So, directly after I delivered, I had to call my program director and the administrative surgery chief to arrange for someone to cover me the next day. Instead of enjoying my baby and the moment, I was in a panic until coverage was sorted out. Since she did come early, and I still had 2.5 weeks left before my vacation was supposed to begin, they gave me 7 days of medical leave, and then I had to come back to finish out the month at work before my vacation. It was torture going back that quickly, but I had to do it.
      My baby is an angel, and I love her more than anything, but I have had an extremely difficult year. I do believe being pregnant would be easier as a resident in other specialties, but it was very difficult as a surgery intern. That is why I wanted to share my experience of what it was like, and how although it was hard to be a pregnant resident, it can be done. You can't control what kind of pregnancy you have, or other's perceptions and attitudes towards your pregnancy, but you can control your own attitude and behavior, and do what you have to do as long as you are physically able.
      Of course I have to include some pictures of Charlotte:






      

Monday, January 6, 2014

Welcome Baby Charlotte

      Sorry for the LONG period between posts, but I have had a VERY busy month. I know I never mentioned this on the blog before, but I had a baby girl, Charlotte Elizabeth on 12/14/13. I never mentioned it on the blog, or internet in general for that matter ( ie facebook), because I have seen (and studied) way too many bad outcomes in pregnancies and during childbirth, and was kind of superstitious about it. However, now that she is here and healthy and perfect, I will definitely be talking about her a LOT. I will also definitely go back and talk about what it was like to be pregnant during my intern year- in SURGERY. As you all know, surgery is probably the LEAST family-friendly residency that exists. I want to talk about it primarily because when I found out that I was pregnant and about to do a surgical intern year, I tried to do a google search to find advice from people who have been in similar situations, or to simply just read about their experiences. Unfortunately, very few hits came up when I did the search. Meaning, a) most people do not get pregnant during their surgical intern year/intern year in general, and/or b) people have not written about their experiences (if they have been pregnant) very often. Anyway, I just wanted to give everyone a SHORT update, but I do not have time to do more than that right now, because I have a) newborn, and b) was back at work 7 days after giving birth, which is another topic I will discuss on this blog in the future too. I hope everyone had a happy holiday!!!!

Here is a picture of my angel (she is an absolute doll):



Charlotte Elizabeth, 12/14/13, 6 lbs, 20 inches.