Reverence

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Photo and piece by Sarah Peters (c2020). 

The first delivery I ever saw was on YouTube. I was reclined on my bed—cup of tea in hand, and the familiar ‘ding’ of Facebook chats ringing from another Internet tab. I didn’t pay too much attention to the video, because I only meant to prime myself for the next day’s horizontal elective in Obstetrics & Gynecology. Many of my friends had already embarked on Labor & Delivery shifts, claiming the “magic” of delivery, explaining it was something that you simply must see to understand. I clicked back and forth to the YouTube tab throughout the video, making sure to catch the important parts—appearance of the head, clamping of the cord, delivery of the placenta. A few quick minutes later, I shut my laptop and went to bed, feeling a bit apprehensive about how I may react physically to the real thing in hospital (…maybe I should bring a paper bag).

Fresh in my scrubs the next morning, I eagerly awaited what the day had in store. My preceptor had one impending delivery: Nicole, a healthy woman pregnant with baby number 4, accompanied by her husband, and anticipating a quick and uncomplicated delivery. I was tasked with keeping tabs on mom and baby—I quickly learned how to read the printout of the fetal heart/uterine contraction monitor, and my preceptor patiently taught me about the basics of labor. To my delight, he took extra time to introduce me to “Fiona,” a plastic pelvic model used to demonstrate childbirth maneuvers, and “unnamed creepy black suitcase,” a large case full of rubber vaginas (yes, seriously) used to learn manual cervical examination.

After spending some time with my preceptor, Fiona, and the suitcase, I was surprised and excited to be given the opportunity to manually palpate Nicole’s cervix. It was a quick exam, and afterwards, I felt grateful to have earned the trust of both my preceptor and our patient—after all, it was a very invasive and sensitive exam. The afternoon continued with more teaching, observation, and exposure to new and interesting obstetrical cases. Eventually, during a brief break between patients, I found myself shooting the breeze with my preceptor and the team of nurses. It was casual conversation that ended with what felt like a bombshell: “Okay, Sarah, let’s go check in on Nicole. She’s almost ready, and you’ll be delivering the baby.”

I kept my cool, trying my best to exude professionalism, gratitude, and excitement. Internally, I looked and felt quite the opposite: my stomach churned anxiously as I mentally cycled through the delivery procedure that I had learned merely an hour before. Internal rotation, flexion, external rotation… was I missing something? Was flexion first? I didn’t have much time to think, because before I knew it, I was standing at the foot of Nicole’s bed, hands outstretched, eyes locked on the tiny human being who was making his first appearance into the world. My preceptor guided my hands as he talked through the birth, and in just a few minutes, Nicole’s son was calm, swaddled, and resting on her chest.

I could spend hundreds of words describing those few minutes: my sense of gratitude, the sharp awareness that I was the first human to touch Nicole’s son, the unexplainable reverence of witnessing the first moments of a new life. I felt an overwhelming and awe-inspiring sense of connection—I’m still not exactly sure to what, but I was completely present and aware of the moment’s intensity. Having the privilege of participating in this profound experience sparked a reflection on the intense trust that physicians receive from their patients. I realized that yesterday’s assessment of the ‘important parts’ of labor failed to take into account the patient’s whole story: the YouTube video didn’t capture dad’s teary smile and sense of relief, or Nicole’s admirable fortitude, or even the more ‘real’ components—smells, fluids, blood.

I want to be a physician who doesn’t forget about the whole story: the patient’s narrative. I’m coming to realize that these profound moments—a delivery, a death, a diagnosis—do not and cannot exist in a vacuum outside of real emotions and experiences. Physicians are somewhat akin to mechanics in that a job must be done, and they are under pressure to do it well: fix something, stitch something, put together pieces of a puzzle. Excellence in these skills contributes to the excellence of a physician, but I think that part of the ‘magic’ of medicine comes from the ability to remain mindful of what I’m doing, respect the immensely personal and intimate nature of the patient-physician relationship, and constantly reflect on my gratitude for the privilege of becoming part of this profession.

 

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