This blog is named after the Ice Cube song, (which samples the classic Grandmaster Flash's "The Message", check out the link for some amazing costumes and dance routines) in that I need to check myself to not lose what is important. This process of medical education continually makes me re-evaluate what I formerly knew to be true, and I don't want to fall in lock-step with the prevailing notions that are strongly swirling around me. I want to come through this process with my essential self intact, my humanity and compassion strong, and with a feeling of positive growth and development from this time in my life. I want to sift and sort, keeping what is valuable from both old and new, to forge a new, better version of myself each day. I hope this can be a place where I can share my thoughts and experiences, and have you, my nearest(to my heart) and dearest, share the journey with me. So help me to check myself before I wreck myself! (Unless I can get wrecked with the Wrecked Crew, which would be a nice change these days!)
Currently I am in Milwaukee, in my 3rd year of training. It is so much better now that I get to interact with patients and participate in their care on a daily basis. Intrinsic rewards. This is a sharp contrast to the past 2 years which were based on lots of memorization of barely useful facts without any context to frame them. Though the process of medical education is changing, it is changing slowly. Many people have described it as a hazing process, or a culture of abuse that cycles from generation to generation, and so far that seems apt. Like all hazing, not everyone is a major contributor, but the ones that are are noticeable, and they have a lot of power and control, so navigating that is challenging, to say the least.
I am starting my 4th week on Ob/Gyn. So far I have been present at multiple people being told they have cancer, have examined many pelves (plural of pelvis), worked with doctors, nurses, midwives, and residents, (midwives are still by far the best), done lots of prenatal visits complete with pregnant bellies, kicks, and fetal ultrasounds, helped deliver 4 babies, and 1 case of fetal demise in the middle of the second trimester. I am about to go on a full week of nights in Labor and Delivery, which is 6pm, to 8 am, so I will get lots more time with laboring and birthing folks! So far, all the mom's have had epidurals, none are breast-feeding, and the process of delivery was less than optimal. However, mom's choice, and so far healthy mom, healthy baby, is the outcome. The fetal demise was sad, however the day before I had just gotten a wonderful talk on grief counseling and infant mortality. Milwaukee is shocking in its stats on infant mortality, they are double the rest of the state, and black women are triple the state average, on par with developing countries like Mexico, Nicaragua, and El Salvador. It is terrible, and mostly preventable. However this talk was amazing, and it really helped me to be sensitive and know what to say to the family that had lost this pregnancy. They were a young family, in their early 20's, with 3 young girls at home. They were going for a boy to round out their home, and unfortunately, this one didn't make it. After she delivered, there was a lot of crying, and both mom and dad, but they held the baby, and had friends come and see the baby. One thing that really helped was to notice how beautiful the hands and feet were (because fetuses at this stage are humanoid, but their bony structures aren't really solid yet, so they do look a bit alien), to talk about the names they had picked out, and to generally just be supportive. It was a really supportive environment for such a sad event. The nurse caring for them was amazing, she did and said all the right things, and was incredibly caring and kind. However, there was one exceptionally jarring time in this event, when another nurse came in and was dead set on 'filling out all the paperwork, there are so many forms...Fetal demise..." all in a very loud, scratchy, disruptive voice. I was literally making subtle hand motions trying to shoo her out the door, but there is always a fine balance being a student, especially since the resident was in the room, about contributing appropriately but not overstepping my bounds. About 5 minutes into it, the resident finally asked if we could have this conversation outside the room. The nurse didn't mean to be insensitive, and later took some lovely photos of the baby for the family. However it was a stark reminder to me of time and place. The delivery of the placenta had just happened, after some stress about it not coming down. It wasn't the right time for the paperwork to be the priority. It is easy to see how we can get lost in our routine, our job, and forget the people experiencing an intense moment right then.
On a happier note, part of my time here is to do a community project, and I am currently working with a free clinic that works hand-in-hand with an alternative clinic. They are housed in the same offices, and there is much referral back and forth. Currently I am gathering information to see how I can best be of service to the community. On friday, I interviewed 3 lovely people, both staff and patients. To hear how the existence of the alternative services, or integrated care has impacted people's lives in such dramatic ways was wonderful. I think I have somewhat forgotten about the power of these modalities, living in the cult of pharmaceuticals for so long. People have described how it has opened them up, allowed them to be positive, happy human beings, all while still dealing with the pressures of immigration, financial uncertainty, and illness from lack of ongoing care. I finally feel like I can re-access a part of myself that is locked away most of the time. I can't tell you how nice that is, both to be able to be more open myself, and to remember, as in re-member or reattach body parts, to myself.
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