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The Pictures

Posted Apr 23 2010 7:55am
It's because I'm in the pictures.

She came into Labor and Delivery at a reasonable enough hour--9:30am. She seemed to be in good hard labor with her cervix at 3cm and contracting every two to three minutes, but it was her first. I estimated I had time to run out to the office and at least see patients for a couple of hours as I filled in for my partner on my usual day off. After wrapping up an even dozen or so patients I headed up to the hospital some forty minutes away and was mildly discouraged to examine my patient and find she had only progressed one centimeter. Breaking her water I gave her a couple of more hours--no progress.

As afternoon turned into evening a little pitocin was added to the mix to strengthen the contractions even more. The labor nurse, who helped my wife labor and who I have tremendous respect for, frankly, really didn't push the pitocin terribly hard and she remained stuck at 4cm another two hours later. Was C-section written on the wall? Next came the internal monitors so the pitocin could be more accurately titrated and perhaps helping just as much came shift change at 7pm. Now we were contracting. Now there was pain.

After the epidural was placed patient was examined at 6cm. Okay, maybe she'll do this after all? With the increased contractions the baby's heart tones showed some signs of stress--nothing to get too alarmed about, but nothing to take your eye too far off of either. Slowly she made it to 7 and then 8cm as I tried to take a brief nap in the hospital's medical staff lounge until 11pm when my pager went off to tell me the patient was feeling "pushy."

False alarm, still only 9cm, but a good 9cm. An hour later the remaining centimeter had disappeared and the patient felt really "pushy" this time. The initial excitement went away after a half hour yielded apparently little progress. We reminded ourselves this is normal for a first pregnancy, and especially a first pregnancy with an epidural.

A half hour turned into an hour and then an hour an a half. Finally at 1:30 she delivered a 9lb 13 oz baby boy. Everyone, including the doctor, was as pleased as could be.

So what of the pictures? After the delivery the new proud papa took what must have been several hundred photos of everything and everyone in the delivery room including dozens of me with the baby and mother.

And why do I do it for the pictures? I generally never see them again, although occasionally someone will give me one, but I'd like to think at least through the picture I have become in some small way part of this family's history. Somehow this very human connection with the most basic of human constructs, the family, makes the frustrating long days and nights somehow worth it. I guess that's why they call it Family Medicine.

The Country Doctor

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