All In A Day's Work

108F.  That was the real-feel temperature this afternoon in Iowa City!  When I walked out of the highly air conditioned lab, I felt as if I had walked into a solid wall of heat.  My sunglasses steamed up and my hands felt clammy due to the sudden increase in humidity.  But when I complained about the heat, native Iowans told me, “just wait until the end of July, it gets worse!”  Luckily, I won’t have to find out, as the last day of my internship here is July 16th.

It took me awhile to decide what to write about in this post because for the last few weeks I have been doing more or less the same things in lab, but then I thought of something I haven’t told you guys about yet.  C-sections!  So far I have been to three C-sections and in doing so I have witnessed the birth of four babies.  These have been some of my favorite experiences of the summer so far.

Throughout rounds in the NICU it is not uncommon for one of the residents’ pagers to go off; usually it is another department calling to answer a consult or to ask a question.  Sometimes, though, all four pagers go off loudly at once.  In my experience, this means one thing: more hands are needed in the operating room!  Usually two residents and a nurse respond to the call, and since I’ve started wearing scrubs in place of professional clothes, I’m allowed to tag along!  The whole thing is very efficient because the OR is directly next door to the NICU.

We hurry down the hall to a big cabinet where we dress for the operating room: blue shoe covers, yellow long-sleeve smock, gloves, mask, and hair-covering.  By the time we are all suited up, our eyes and ears are the only skin showing and it’s nearly impossible to tell us apart (this makes me feel better going into the OR, because at least I look like I know what I’m doing).  Then we head through a pair of huge double doors.  By the time we arrive, the surgeons are already well on their way to opening the uterus.  In subsequent conversations with my housemates, I’ve learned that C-sections are well known to be some of the “goriest” surgeries simply due to the volume of blood and fluid that is involved.  I didn’t know this my first time observing though, and I was glad my mask covered me as I stared open mouthed at the outpouring of blood.  When the surgeons finally punctured the amniotic sac, my first thought was of a volcano; suddenly I understood why the surgeons had plastic shields covering their faces from mouth to forehead.

Once the incision is made, the surgeons pull the baby out - a task which turns out to be very laborious.  They pull and push and strain until finally the infant slips out and is handed immediately to the baby team (in this case, the NICU residents).  It is the baby team’s job to rub and suction the baby until it cries, then clean and swaddle it.  One of the babies I saw delivered weighed over 10 lbs!  She looked HUGE compared to the tiny infants I’m used to seeing in the NICU.  The delivering surgeon was petite, and clearly had to struggle to pull the baby out.  As another surgeon, observing next to me, said into my ear, “poor thing, that baby is bigger than she is!”

During each baby’s first few minutes of life, I like to watch the family members who are present in the operating room; sometimes the father has come, other times it is a sister or grandmother.  But without fail, they all tear up and watch in joyous disbelief as the newest member of their family turns pink and wails.  It reminds me of how wonderful life is, and of all the amazing potential ahead of every newborn.  Meanwhile, the baby team takes the new baby to “Transition” where it will prepare to go home, and heads back to finish rounds in the NICU.  They treat the whole thing as if it is a perfectly normal occurrence.  It’s not quite normal to me yet though, and I count myself lucky to work with people for whom bringing  new life into this world is all in a day’s work.