Monday, March 3, 2008

A Night of Obstetrics Call

PHOTO: Remember the "first day of school" photos that you usually had taken? Well, this is my very nervous, I-think-I'm-going-to-vomit, "first day of being a doctor" photo.
Again, I'm post call and thought that I'd write. I'm currently on obstetrics and had an interesting night.

My first patient came in and we began Iraq! The woman's husband was stationed in Iraq and could not be here for the delivery, so the hospital helped set up a webcast to his station in Iraq for him to watch and participate in the birth "real time." She did an amazing job, going "all natural," and he did an amazing job coaching her from afar. When the baby was finally born, you could hear the dad's sobs of joy mingle with the new mother's tears. Then he announced the name of the baby to everyone. It was a very special moment (as all births are) and I felt blessed to be a part of their experience by delivering their baby girl.

My next patient was a Thai woman, a culture that tends to labor very stoically and quietly. The Thai culture views things in terms of temperatures. Labor is a "cold experience," whereas post-partum recovery is a "warm experience." She had a bulging bag of waters, so we decided to rupture them to increase her contractions. At the same time, she asked for ice to bring on labor (part of the Thai "cold experience" of labor). I'm not sure which worked (the ice or the rupturing of membranes); but VERY suddenly the baby was crowning and I wasn't quite ready. I had to throw on gloves and climb onto the foot of the bed to deliver the baby, just barely making it and getting covered with all the messiness of delivery in the process! Afterwards, she was continuing to bleed too much for my comfort. So, medically trained, I gave her a few medications to firm up her uterus and stop the bleeding. However, she calmly asked for hot tea (part of the "warm experience" of Thai healing). Shortly after, her bleeding decreased. So, I'm not sure if it was the ice or the rupture of membranes that brought on her labor. And I'm not sure whether it was the medications or the tea that stopped her postpartum bleeding. It could really be either, and who am I to say. There is much mystery to medicine and health.
My third delivery the dad wanted to be involved - not just "cut the cord" involved, but "get in there and help deliver the baby" involved! I was excited about helping him have the experience of joining with his wife to deliver their baby together. He was a very "tough" Marines guy, but when she started pushing and he saw the head coming down the birth canal, I thought I was going to lose him to the floor. We were standing side-by-side and I took his hand and placed it on the baby's head, at which point he relaxed but also started to tear up at the wonder of it all. I placed his hands on the baby and guided him as he delivered their baby immediately up to mom's chest. They both dissolved into tears of joy and I couldn't help but water up. I quietly delivered the placenta, cleaned up, and left the room; leaving mom and dad alone with baby. A while later, the dad approached me at the desk and was profusely thankful for the experience. It has motivated me to try and get the dads as involved as they want to be in the birthing of their child.
During the final delivery of the night, after the head and shoulders of the baby were delivered, I took the mom's hands and placed them on the baby's body. She then pulled the baby out from herself onto her chest, delivering the baby herself. I talk to the moms beforehand and offer this option (if all is going well with the delivery and the baby) - many get excited about the idea.
Ultimately, it is always the mom that "delivers" the baby. I just feel lucky to share in the moment by facilitating the process.

Saturday, March 1, 2008


PHOTO: Jen & Chris in the Chena Hot Springs Ice Hotel near Fairbanks, Alaska. This is a year round ice structure that has an ice bar, ice rooms with ice beds, etc. Notice that I am drinking an appletini out of a glass made of ice! The weather outside was -40 degrees. We also went into the outdoor hotsprings under the Northern Lights.
This is the first entry of our new blog. I've been wanting to create a place to post stories, pics, etc since moving up to Anchorage, Alaska.

I'm currently post-call after a 30 hour sleepless shift at the hospital...which somehow seemed to me the perfect time to take on a new project! Chris says that I always tend to do new projects at the most inconvenient times, such as when I brought home 20 plants and decided to pot them all the same night that I was flying out for a conference. Hmmmm....

We purchased our first house (that is our first LAND house, as our first home is our sailboat High Endeavours) this year. It is a simple ranch on a court off a side street that is nestled in the foothills of the Chugach Mountains. We have ski trails out our backyard and moose in our front yard. The house needs some serious up-dating and it is keeping Chris quite busy. I'm not sure quite where he learned how to do house projects, but he has been doing a great job and I just smile when he tells me that he's "punching a hole through the wall" or "going into the ceiling to do some wiring." I have ZERO skills in this area and am baffled by it all. But it is coming along great and we have a guest room ready for guests - but make your "reservations" early, as this summer is already filling up!

Our Anchorage address is: 8620 Kushtaka Circle, Anchorage, AK 99504
Our home phone: 907-929-1189
Our cell phone: 907-242-7868

Our "real home" - our sailboat, High Endeavours - is in Seward, Alaska. This is about a 2-3 hour drive south from Anchorage on the Kenai Peninsula. Even though a city named Anchorage should only is used for large ships. So, our boat has found a home in a mountain surrounded harbour in Seward, noted by Sailing USA to be one of the "top 10" sailing destinations in the US. We try to get down to see her on a monthly basis, as the snow and ice builds up and creates horrible weight on her. In April, we have a 10 day vacation where we plan on sailing over to Prince William Sound for some exploration.
I have been BUSY with residency, which has been difficult as I have not been able to "keep up" with family and friends as much as I'd like to. I am working 80 hour workweeks with a few 30 hour shifts in there. I'm learning a ton and am very happy that I chose this program and the speciality of family medicine; but I am also beginning to get a bit worn out. This first year is the most brutal. The second and third year have fewer long call shifts in the hospital. I work between two hospitals (Providence Hospital and the Alaska Native Medical Center), our clinic (where I have my own patients), and various locations throughout the state (Bethel, Soldotna, Dutch Harbor, Nome, etc). The program's focus is to train "frontier family docs," which goes one step beyond "rural."
Chris has been busy with house projects, boat projects, and working at REI; where he was recently promoted.

That's all for now. Will write more soon,
Much love,