At my medical school, students do 1-2 half-days a week during their OB/GYN rotation at the county health department. I had OB as my first rotation of third year, so I was at the health department the very first week. My first few exams were supervised by attendings or residents, but once they were sure I could do it, they let me do them on my own (with a nurse chaperone, of course).
So I go in the room for my very first unsupervised pelvic exam. It was on a young girl who was 11 weeks pregnant with her first child, and she didn’t speak any English. She was very nervous.
As soon as I inserted the speculum (before I even opened it), she started bleeding. I’m not talking a spot or a little blood on the pap smear brush. I’m talking flowing. Remember, this is the first or second week of my third year. Alls I know is: bleeding pregnant lady = bad. So I calmly turn to the nurse and said, “could you please go get me a resident? Like RIGHT NOW?”
As I waited, my thoughts raced. Did I cause this? Was I not supposed to do a pelvic exam? What if I just killed this baby? No, it’s not my fault. The attending gave me this chart. He told me to come do this. Oh crap. Jesus, please let this baby be ok.
The resident came in very quickly and helped me with the exam. As I had so intelligently deduced, bleeding was indeed a bad thing, so she sent the girl to the emergency room with only a basic explanation via phone translator that she could be losing her baby.
An hour or two later I was back at the hospital on OB floor call, and we got called to the ER to do a transvaginal ultrasound on my health department patient because the ER docs hadn’t been able to find a heartbeat using the doppler (because she was so early along). By then her husband (who did speak decent English) was with her, but they were both looking nervous as ever. He told us that she actually had been spotting a little all day (thank goodness I didn’t cause it!), which we had missed earlier due to the language barrier.
The resident inserted the transvaginal probe and the baby came into view almost immediately. The husband and I tentatively smiled at the same time. Yes, the baby was still there, but was it still alive? As if it knew we were watching, the baby did a little wiggle for us. The dad’s face lit up and he started crying. He told his wife what he saw and they both just beamed. I blogged a little blurb about it that day.
I was extremely relieved to see that baby jump. Forget codes and fast paced traumas. That was my scariest experience in the hospital yet.