Doctor Stuff

For those of you who don't like medical terms and find procedures gross this is not the blog post for you. consider yourself warned.

Hi Family and friends,
Today was my first day in clinic (Because yesterday didn't work out the way that it was supposed to). I went to my last spanish class this morning and then at 12:30 headed over to the maternidad hospital. This is a public hospital that provides ob and gyn services. I was a bit nervous because my friend from the program passed out yesterday while watching the exams (not even births) so I made sure I had a big lunch and was hydrated...and then did some praying that I could keep it together.

I went up to the second floor and changed into green scrubs, a cap and was given a face mask and booties. I noticed that there were women on gurneys lining the hallways. There must have been at least thirty women in various stages of labor all crowded into a single hospital wing. I was first shocked by the sheer number of patients. When I looked around I also noticed that the oldest patient was no older than 25. I was introduced to Dr. Medina, the doctor who I will be shadowing this week. He told me that he had been delivering babies for almost 30 years so I knew I would learn a lot. He led me into a room where there were eight women who were further along in their labor. The room was kept at over 75 degrees and the doctor warned me that people tend to faint so if I needed to sit down I should do so. I watched as he went from bed to bed and checked to see how dialated the women's cervix was and then checked the heartbeat of the mother ant the baby. The process of checking the cervix was more barbaric that I ever would have imagined and I did start to feel a bit light headed. I decided to distract myself by talking with some of the residents and interns-all of whom were very nice and more than willing to answer my questions. I grabbed some water and then returned to the room feeling much better. Just in time to watch a doctor burst a patients water. Holy bajesus they do not prepare you for that in health class. The woman's labor progressed rapidly and when the baby's head was visible they took her to an individual room where I was able to watch the birth. It was a boy. I went back to the larger room and eventually watched a second birth-felicitations a second boy, The first mother was 18 or 19 and the second was 23. Both women were so small that some cutting was required to allow the baby to pass through the opening. I couldn't believe a woman's body can endure so much. I actually use the term woman loosely here because while 18+ is a woman, I saw a 13 year old in labor today. That was pretty hard for me. I couldnt help but to think about what my life was like at 13. My biggest problem was worrying about memorizing my torah and haftorah portions for my bat mitzvah and here is this girl who is about to be a mother. Unfortunately, this is not uncommon in ecuador. There is a lack of sex education in schools and the use of contraceptives is uncommon.
Some other things I noticed:
1. No men in the delivery room (or even on the hospital floor..they wait outside and women give birth alone).
2. No anesthesia. I found out this is because anesthesiologists are few and far between in ecuador (sometimes 2 for more than 40 patients) and also at these public hospitals they try to speed up the delivery process (for example by rupturing the water) and epidurals can extend the duration of a birth.

Things that I learned today:
1. You must be 10 centimeters to push. Doctors use their index and middle finger to measure
2. Women give birth twice. once to the baby and once to the placenta
3. Doctors check the placenta. It should not bleed when it is wiped off. If it bleeds it means that it has not fully detatched from the uterus and the woman is internally bleeding. I was also shown what it looks like when the placenta bleeds (the doctor stabbed it to demonstrate)

It is likely that tomorrow I will get to watch a cesarian section- I opted to watch natural births today so I could get used to the normal thing before I start seeing the different procedures. Let's hope my stomach is ready for round two.

Also- my friends have gotten to do cool things in their clinics. Noah and Beth are in surgery in the military hospital and today they got to scrub in on a spinal surgery (beth got to cut sutures and Noah got to dab blood with cotton) and a surgery to clean an infected hip surgery. They said the latter was really gross with lots of fluids and very little finesse. Oh well, orthopedics does have that reputation.

All in all it was a great day with a lot of learning and a lot of firsts. AND at the dinner table people were talking about how difficult spanish is and Rosita said "well hope is progressing very well and seems to be learning a lot". It was a really nice complement and I was appreciative that she has noticed the hard work I have been putting in to speak in spanish as often as possible.

hasta luego,
Hope (aka Esperanza...the doctors love calling me that)