Obstetrics and Gynaecology (O&G) was one posting I did not look forward to in housemanship for varying reasons.
First, it was infamous for being the most stressful rotation in OAUTHC (with surgery contesting keenly) and as such, people would scare you with tales of it without meaning to.
I was excited, nonetheless, because it was my last posting in housemanship, which translated into three months until this phase of my life ended.
When I reached the six months mark, I could not muster a similar excitement, but this time? My excitement was irrepressible!
I shielded my fear in this excitement and reminded myself that O&G was my favourite rotation in medical school. I understood, however, that being a medical student and a medical doctor were similar but parallel experiences and braced myself for the task ahead beforehand.
If I could skip the posting and end at the third, I would, but I knew I had to – needed to, do it. And the sooner I started, the sooner I would get done with it (and housemanship as a whole).
So, even though I could extend my leave by a few extra days or even a week, as some of my colleagues did, I dug my heels in and presented myself to the department for resumption on the stipulated day.
I remember walking into the seminar room on my second day at 08:01 am and finding virtually everyone seated. I was impressed, to say the least, and decided that thriving in this department would require some measure of excellence.
I had a fair first day courtesy of the senior registrar I worked with. We had antenatal clinic and it went smoothly; he made me feel relaxed such that the anxiety that accompanied me to work stayed at bay.
I was placed on my first labour ward call two days into the posting, after taking a pilot call the day I resumed. We were two house officers who were manning the antenatal and postnatal wards, as well as the labour ward, alongside a registrar and a senior registrar. It did not feel so much as a first call, it felt like a continuation of my paediatrics posting.
The nurses station, Labour ward.
On and on went the busy labour ward calls, the not so busy gynaecology emergency calls, and the morning reviews.
Morning reviews are departmental meetings where the registrar who was on call the previous night lists the cases he saw and one of them is singled out for him to present – to discuss in details how the patient presented and what he did in terms of management, and questions regarding his management and knowledge of the case are asked him. It can be draining for the person presenting and stimulating for those seated.
A few times, the house officers get asked questions, but there is often no penalty for us not knowing, as we are considered mere passersby with no real commitment to the units we are rotating through at a given time.
Truly, the most non-committal phase, add blissful, in the life of a medical doctor is the housemanship phase. You constitute more of a workforce than anything else, even though it can be a sad reality when ‘workforce’ is converted into ‘professional slavery.’
When I first got to O&G, after overcoming the initial scare, the next thing I had to deal with was the constant threat of extra call at the slightest slip. It is hard enough that the labour ward calls are often busy, and one would need a night or more to fully recover from them depending on how spaced your calls are, which is dependent on the number of house officers per time. Now, imagine adding (undeserved) extra call duties to the mix. A sad tale.
Hence, the mantra I developed, ‘The fear of extra call is the beginning of wisdom.’ This informed my decision to be on time every day regardless. You never know the day you would get unfortunate for being late and this I did my best to avoid. Sometimes, of course, it was an uphill task but I also have a philosophy of not making excuses and this helped me a great deal.
On difficult days, the medical students added colour to my day. There was something relaxing about seeing them around. Maybe getting to teach them or learn from them or merely seeing them struggle to learn as much as they can to pass their exams. I am not sure which stands out the most. Also, the patients – the ones who make us leave our houses each day, deprive us of sleep at the oddest hours and refuse to take up admission sometimes after letting us take a full history from them and document – were another source of joy on gloomy days.
How some admit to you, ‘You guys are trying o!’ And inquire so lovingly, ‘Doctor, hope you have eaten.’ We live for these ones. God helping us, we will learn more, know more and do more to take your plights away. You never know how distressing being sick can be until you have. I get a glimpse when a patient keeps saying thank you to me for attending to her and relieving her of her acute ailment. At such times, I can only imagine how much relief she feels.
I like to say, Obstetrics and Gynaecology forced itself on me. It’s too practical to go through without learning the basics of managing both pregnant and non-pregnant women who need medical attention. I learnt a lot, shared in their joy even (the miracle of childbearing) and their hurt too (watching some persons consecutively lose their babies and almost their lives because of poor decisions).
I am still fixed on being a Paediatrician. Sometimes, I ask myself if I want to really go through with it. At those times I recognise fear for what it is: The fear of uncertainty, the fear of getting into residency in Paediatrics and discovering I am not enjoying it after all, and wonder if I would have the courage to make a U-turn if need be. But it is what it is – fear. You only know what lies beyond when you step over your fears. So, wish me luck and pray for me as I take the next steps toward the rest of my life.
I promise to make it count. For God, myself and everyone who believes in me.
Have you rotated through Obstetrics and Gynaecology as a medical student or medical doctor or know someone who has? What was their experience like? I would love you to share and for us to continue the conversation in the comments.