Location: Labor and Delivery Floor
Attire: Scrubs and Danskos
Occassion: First day on OB/GYN Rotation
“Do you know how to scrub in?” asked the second-year resident, Dr. B, as we speed-walked through endless sets of double doors to the Delivery ORs. “We’ll do it together.”
We stood side-by-side at the huge silver sink basins, already wearing masks and hairnets, and began the ritual of scrubbing. First, we cleaned beneath each of our fingernails with a plastic pick. Then we opened packages of special scrub sponges filled with special soap. When we turned on the water by hitting a huge panel with our hips, a large clock above the faucets turned on, counting down from five minutes. 5:00. 4:59. 4:58. 4.57… Scrubbing is required to take the full five minutes. Scrubbing takes a directed sort of focus, the same feeling I get when I am running; the mind feels at once still and directed, and the rest of the world fades away. I focused on my fingers, imagining each of them as a box with four sides, and proceeded to scrub each side of each finger-box ten times. I did the same to the palm, the back of the hand, the wrist, and the arm all the way up to my elbow, then started on the other hand…
In a hospital world where everything always feels rushed, standing at the sink for a five full minutes, hearing only the water hitting the steel basin, is at once strange and calming. The trickiest part is rinsing: the water must not drip onto any part that you’ve already rinsed. Once you’ve rinsed, NOTHING can touch your skin. As I was finishing up, the clock reaching 0:00, my pinky brushed the string of a mask sitting on the shelf above the sink. I froze. Dr. B chuckled ruefully, “I’ll meet you in there,” she said, heading towards the OR as I reset the clock and began the entire scrubbing procedure again.
The second time I scrubbed successfully and backed into the OR, opening the huge doors with my back to protect my newly clean arms. The scrub nurse (in charge of all the logistics in the operating room) handed me a sterile towel, and then held up a sterile green gown for me to plunge my arms into, like a bathrobe going on backwards. The efficiency of the OR staff took me by surprise; the moment my arms entered my gown, a second nurse was at my back, tying the strings. Next, the scrub nurse helped me into my gloves. First the white pair, then the green pair over the top. This way, if the top glove broke, I’d notice the lighter color glove showing through.
I was ready.
The patient was already in the room, lying on the table with her huge belly sticking into the air. Dr. B stood on the patient’s right. The attending physician, Dr. V, stood directly opposite on the patient’s left, directing the show. I stood at Dr. B’s left elbow, my hips resting against the surgical table and my hands on the patient’s leg (protected under a sterile drape). Across from me, the scrub nurse positioned a huge tray of instruments – scissors, scalpels, forceps and towels. Dr. V positioned the huge lights overhead. Anesthesiologists stood by the patient’s head, busy with IVs. The atmosphere was calm, purposeful, and efficient. I stood stock still, afraid to get in the way, unable to diffuse the thought that I was close enough to mess things up badly if I bumped against Dr. B or knocked over the instrument tray.
Everyone’s focus honed in on the square of brightly lit, pregnant belly. With Dr. V’s guidance, Dr. B made the incision and exposed the surface of the uterus. Then Dr. V turned to me. “Kate, put your hand on the uterus and slide it up until you find the top.” I reached, heart beating faster. The dark red uterus was warm and smooth, stretched tight because of the baby inside. I slid my hand up into the abdomen between the skin and uterus, my eyes widening: the uterus was so big! And my hand was inside the body of a LIVING PATIENT! It was a surreal but wonderful feeling.
Dr. B continued the procedure, opening the uterus and breaking the amniotic fluid sac. Dr. V reached inside for the baby. Time stood still as she calmly pulled, spun, and wriggled the baby into the world, exposing a little bottom, two feet, two flexing arms, and finally a tiny face to the air for the first time. The baby scrunched up her face and started to cry, at that moment the most beautiful sound in the world because it meant that she was healthy and safe. As Dr. V carried the baby over to her mother’s arms (free to move behind the surgical drape), she cooed, “Happy birthday, we all love you, welcome, oh happy day! Born at 7:46am on a Monday.”
With a start, I realized that in my first hour on OB/GYN, I had scrubbed into a c-section delivery, touched the inside of a living, breathing woman, and seen a new life come into the world. Hundreds of thousands of babies are born every day – for mother nature birth is routine. But for me it was completely incredible. I scrubbed several more times that day, each time before another c-section, spending the five minutes of calm reflecting on what I was seeing. I might just become an OB/GYN. Oh happy day indeed.
Kate is a third-year medical student at University of Michigan Medical School. She is passionate about women’s health, reproductive justice, and finding the humanities in medicine. When not in the hospital, you’ll probably find her running along the Huron River or puzzling over the NYTimes Sunday crossword.