C-Sections, Suturing and Circumcisions, Oh My!

One of the strengths of my residency program is the training in obstetrics, including regular deliveries and c-sections. I was told that I would get the chance to be the primary surgeon on c-sections from the get-go, and now I can say that is true. Thursday I got to do two c-sections - and I mean really DO them. Up to now, I have only assisted on c-sections, scrubbing in, but standing on the left side and helping to hold retractors, cut sutures, etc. So this week when it was my turn on the "floor" I was determined to overcome my fear and dive in. I watched the step-by-step video on c-section techniques, and I asked my upper level residents to walk me through the process. I wasn't sure the OB attendings would let me take the leading role, but I've learned that showing confidence and being assertive goes a long way.

When the time came I was SO nervous. I was afraid I would completely screw things up. But I have determined not to be ruled by fear. And in learning procedures, the best and only way to learn is to do - hands-on, down and dirty, physical learning. On my first case of the day, I told the OB attending that I would really love to have the chance to do the c-section myself with her guidance. Her response was, "we'll see." But once we were scrubbed in, she pointed to the patient's right side and nodded. The right side is where the main surgeon stands (not sure why, but I suppose it assumes the surgeon is right handed and it is easier to do most of the procedure from that side). Anyway, there I was. The scrub nurse handed me the scalpel and after a moment of panic and a strong desire to flee (oh my gosh, what the heck am I doing here?!!), I made the incision and off we went. Everything went smoothly. The attending guided me through each step, the baby came out just fine, we got mom sewn up, and all lived happily ever after!

Later that day I had the chance to do another c-section. It meant staying 3 hours late on my shift. But I knew the attending was really nice, liked to teach and was very patient with residents. I figured a second c-section the same day would reinforce my learning and solidify it, as well as boost my confidence level. It was great. The second doctor did things a little differently, but he was so good about explaining each step and encouraging me. What a wonderful and amazing experience! I have now actually cut into someone's uterus and extracted a baby! Wow!

I still have a long way to go before I'm proficient in doing c-sections. Suturing is one of the toughest skills to learn. Holding the needle right, manipulating the needle driver and instruments, tying knots - all of these require manual dexterity and practice. I will eventually be able to do this in my sleep, but right now it's awkward and I am slow at it. That's why it's so good to get the chance to practice whenever possible.

Friday I also got to do another circumcision. That makes #5. After I've done 10 with supervision, I will be able to do them by myself without an attending present. That's a little scary, but no, I will not let fear get the best of me. Circumcisions are actually pretty simple, short, and fun to do. And the babies are so cute! Don't worry, I'm not being sadistic or cruel. The babies get local anesthetic and sugar water and most of them don't even cry that much. Mostly I think they cry because they're just mad at being handled.

So my job is really cool. I can't believe I get to do all this stuff! Plus, as I get more confident, I have much better interaction with my patients. A little more experience and wisdom helps me to put them at ease, answer their questions and connect with them personally. Although they have their own OB doctor, I'm the one they see most throughout their labor, so I feel like their doctor for a while, which is nice.

Well, all for now. Have a great week.