On Idols and Not-So-Idle Thoughts (Part I)

Obstetrics and gynecology was my carrot throughout the first few years of medical school. It dangled in front of me, the reward for those years of grinding, crushing study; for giving up so much of what I loved in life along the way. Third-year rotations in general served as a general type of carrot – after all, seeing patients had to be better than hours hunched over textbooks – but as the first few rotations proved less than inspiring, ob/gyn hung promising on the horizon. I had scheduled it for January and February; I would start out 2011 on the right foot.

But by the second week of the rotation, I could no longer remember how it felt to live without a knot in my stomach.

Tay asked again and again for clarification of just what I was feeling. From what he could see, I had loved pediatrics and was just having a hard time adjusting to ob/gyn, likely due to a combination of: 1) residents who seemed to hate their lives and barely notice the students like myself who frantically followed them everywhere, trying to make sense of roles that were never explained to us; 2) my general aversion to change that reared up predictably at the start of every rotation; and 3) the fact that I was living in the free student housing, an hour away from my home with him, in an apartment that I would have shunned even when I was fresh out of college and scrounging to find a place that my embarrassingly small paycheck could cover.

(The best part of that housing was the skinny mirror in my bedroom. That and the bright pink striped shower curtain that had cost $8.99 at Target. Another plus was that the hot water didn’t always emit a scree like the sound the smoke detector would have made had it not been dismantled and disemboweled of its battery; sometimes a full five minutes could be spent in blissfully quiet pre-sunrise steam.)

I had met so many people – residents, attendings – who reminisced bitterly, “I thought I wanted to do ob/gyn... until I did my rotation!” This sentiment had frustrated me, with its negativity and with these individuals’ apparently easy dissuade-ability. I wanted to prove them wrong, to prove that ob/gyn could be liked, could fulfill what one hoped it would, could be a path charted at the start of med school (or even before) and followed without deviation. I didn’t want to be just another of the stereotypical women who had been all about women’s health until they realized how demanding the hours were or how catty the residents and then went running to something like psychiatry... family Medicine... pediatrics. I had been sure that one day I would look down my nose at them and announce that I, in fact, loved ob/gyn and found it to be nothing like the stereotype. So there.

Except here I was, hating every minute of every day spent at the hospital, and using up every minute spent outside of the hospital dreading my return to the wards the next day. I stayed up later than I should, lamenting my unhappiness to Tay over the phone, reading a few chapters of a book for pleasure and then feeling guilty about the indulgence; half fighting through the din of the ugly, noisy town in search of sleep with the other half always keeping an eye on the alarm clock, terrified I would sleep through my 5:30 wake-up. As a result, I was exhausted and cranky in addition to being frustrated and confused.

What was so bad about it? The residents, for starters. The younger ones – the interns – were all very sweet, but personalities seemed to go downhill as one climbed the ranks. I spent idle moments trying to pinpoint at what stage in their training the kindness was beat out of them. Teaching was rare; the few questions they asked ranged from those requiring magical mind-reading abilities and ones so ridiculously simple they made you wonder what you were missing. I once scrubbed in on a C-section and received only two questions: What is this? (pointing to the uterus) and Very good, now what about this? (holding up the fallopian tube). They were the only words spoken to me throughout a procedure in what is supposed to be a teaching hospital.

The lack of organization, for another thing. The rotation was ostensibly well-organized, with each student spending one week on each of seven services: Gynecology, Labor & Delivery, Nights (which was basically more labor & delivery but with horrible hours and less action… in other words, an atrocious week), Urogynecology, Reproductive Endrocrinology & Infertility, Maternal-Fetal Medicine (high-risk obstetrics) and Gynecologic Oncology. The problem was that the organization ended there. No one had any clue about appropriate roles for students, so they didn’t really give us any; we chased the residents all day, with no warning about when we might be able to eat lunch or use the bathroom or when we had to attend a meeting in a building several streets away. Multiple times, I nearly followed residents into the bathroom because they hadn’t told me where they were going – hadn’t told me anything at all – so I judged it safer to follow along than risk losing them. At other times, the residents would be busy and decline my offers to do anything to help, so I would be left literally holding up the wall, torn between trying to look available eager to help out and trying to look busy, like I wasn’t just standing there counting the seconds.

And then there was the actual medicine of it. Truth be told, I just wasn’t feeling as excited as I’d anticipated. Yes, I got teary-eyed at each birth (especially if the dad cried – that really got me), but that didn’t make me want to do it all the time. And the surgeries were interesting the first time I saw them, but with each repetition my interest dwindled. Once upon a time, I had been excited by the uterus and its neighboring organs, by the infections that could plague them, the tumors that could grow, the changes that took place monthly and throughout the arc of a woman's lifespan. But now that I was faced with them each day, I wasn't all that thrilled. I missed the heart and the kidneys.

Of course, as everyone reminded me, I had planned to subspecialize in oncology, so maybe it was ok that I wasn’t so excited about the general stuff. They suggested I wait to see how I felt during my week on Gyn Onc. So I tried to control my freaking out until then.