Wednesday, October 24, 2012

Dear Surgeon, Would You Like to be ON THAT Table?


I am 3 weeks into Obstetrics and Gynaecology posting and I am already dreading it.
I come home everyday with shivers down my spine, recalling how the surgery went and imagining how it will feel like being in the patient's shoes.
I don't hate Obs and Gynae, I am just not interested in it, at all.
In contrast with Paediatrics posting I have just finished with, the patients in Obs and Gynae are all very do I describe it, "not cute"?

Birth Suite
Thank God I kicked off my O&G posting with one week in the Birth Suite. And when I say suite, I meant SUITE. The Birth Suite is a Consultant-led unit where there are 12 en-suite rooms with bath tub in the toilet in each room and the privilege of getting an epidural anaesthesia to cope with childbirth pain in contrast with Birth Centre where the unit is wholly midwife-led and no epidural can be performed. Midwives are allowed to prescribe limited dosage of diamorphine though. So my first week in O&G was filled with cute babies popping out of their mothers, painfully. But I can't help to notice the "bloodiness" of O&G. I helped with the delivery of the placenta and my hands were literally full of blood. Even my white plastic apron were blood stained.

And I witnessed one emergency Caesarean section where the mother was wheeled off to the theatre within 40 minutes of her arrival and recognition of fetal distress (because we can't feel the baby's moving and heart rate was bad). And it was bloody as well.

Gynaecology Theatre
After the one Birth Suite week, I started going into theatres and wards and clinics. And my my my, I can't stand the Gynae theatre. Most of the procedures were either laparoscopy or hysterescopy. When any procedure ends with -copy, it means we are viewing the structure, and most of the time it is via a camera rather than the naked eye.
So the camera will either be put into the patient's abdomen or through the women's vagina, cervix and into the womb to visualise the inside of the womb.

Both camera procedure will need clamping of the cervix. Yes, clamping.
I do not know if there is any specific medical term for it but a clamp (imagine a clothes clip) will be put onto the cervix and the cervix will be pulled up so that the womb will be pulled down so that the surgeon will not puncture the womb when she cuts through the lower abdomen to insert her camera and instruments.

And the sorts of clamps and theatre instruments used in the procedure are just freakingly traumatic! Traumatic to the cervix and vagina, I'd say.
They were merciless and vicious. Maybe because the surgeons did it so many times that they are doing it in an autopilot mode.
The surgeon need to clean the vagina before she starts any procedure to ensure the area she's working on is fairly sterile to reduce the risk of infection. And guess what, she shoved the instrument that was wrapped with cotton pads into the vagina just like that, mercilessly. Patient is asleep, of course. Patients are all under general anaesthesia. They can't even breath on their own, what more feel the clamps and pliers and needles. I'm sure the patient would have kicked the surgeon flying across the room if she was awake and knew what the surgeon did.

I know my description sounded very grim and horrible and cruel and I do not know if all surgeons do that or it's just this one but I doubt other surgeons take their time to clean the vagina gently, or clamping the cervix gently (if it can ever be done) when there are many patient waiting outside to be wheeled into the theatre.

And I doubt male doctors are any gentler, the one my friend was with certainly wasn't. He sounded even more vicious!

Whenever I see the surgeons clamping and shoving things inside there (which is almost 5 times a day), the question that was burning inside me will always be "Doctor, would you want THAT to be done to you?"
I can almost bet with my life that none of them will willingly want that to be done on them.

And I hope, I truly truly hope that none of my friends, family members, wives of friends and myself will ever get any kind of Gynaecology diseases that will need us to undergo these procedures. These procedures are not done for nothing, they have to be done. But they are unbelievably terrifying. And even though I know that our body has a remarkable ability to repair itself, the cervix can even dilate and thin out and the vagina stretch enough to let a 3kg baby out, a clamp and camera for 30 minutes are almost nothing but still, it's just......cruel.

I hope I won't get into trouble by writing this. I am always afraid my writing will one day drive me into some kind of trouble, revealing unnecessary things and this time, it might make some potential patient scared to death of a procedure she's about to go through. I am sure the doctors do not explain or show the instruments going to be used when they asked for her consent. Because if the patient knew, she will never give her consent unless she's too desperate to get sorted out.

And yesterday, I saw a baby being crushed and vacuumed out of her/his mother's womb. I might talk more about that later. I need to rest, and keep my mind clear of the traumatic look of the cervix (I had the chance to examine the patient while the surgeon was suturing). Bloody!

-Because life is a test-

[Image Credit]



  1. scary. btw, are u a doctor? or just medical student?

  2. so scary, i think u better edit ur post well, in case senior MO read this too....hahaha
    what year r u now as medical student?

  3. I'm in 4th year.
    Hmm... What can the senior MO do/think if he/she read this post?
    Even if a consultant read this, I think they have to agree to some bits of the post, maybe not my opinions but the facts that I provided are true. Haha...

  4. Assalamualaikum Akmar, it has been quite a long time. :) Hope you still remember me. hehe

    Hope you are doing fine in UK. You seem to enjoy your paeds moment a lot there..!! Goodluck with your O&G posting, it must be very very challenging aite? Dont worry, I believe you can ace it well.

    Love your post btw! Thrilling and oh-so dramatic, I wonder where did you get that amazing skillful story-telling-through-writing talent, it's truly awesome! ><

  5. Waalaikumsalam Farrah Star!
    Of course yes I still remember you.

    I am doing fine, Paeds is fun but no so for O&G... Haha..

    Thanks for the compliment re my writing. Didn't notice that it's vry dramatic.. Haha..
    Maybe I myself am dramatic so it somehow got reflected onto my writings...

    Hope you're well!
    And oh, since you disabled your google profile, I cant view your blog. Maybe you can leave ur blog url nxt time so I can read abt ur adventures :)