Freckledog

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According to Student Doctor Network, Most Medical Students Attend Harvard

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Kansas City, MO – In a recent Census of US Medical Students report, published in JAMA last week, researchers wanted to see which medical school students were attending. Researches used the very popular forum website: Student Doctor Network, where many prospective medical students and active me…

Read more on http://gomerblog.com/2016/01/tudent-doctor-network/?utm_source=TR&utm_campaign=DIRECT

… and 8 other feminist resolutions for 2016 - NYmag.com (via annfriedman)

The first time I cried, it was during clinicals. Ironic really, considering it was perceived a non threatening environment. Except I was completely threatened. The instructor was evaluating sterile wound care at the patient bedside, and after about three sterile fields that were ripped from the bedside table with a curt, “do it again,” I felt tears flooding my eyes. The patient, alert, looked at me with pity, fellow students surrounded the bed, silently writing notes - likely what they will do differently to avoid this catastrophic fail. Tears fell, as I finally met expectation, but there was no victory. “You shouldn’t cry in front of patients,” commented the Instructor. I vowed I would never show emotion again.

The second time I cried, it was during orientation in Med Surg, the fear of making a mistake, the pressure to take more patients, the demands of the preceptor, patients, and forgetfulness began to build up. The struggle to keep up with charts, meds, assessments, and the overwhelming impossibility of it all. Tears threatened at the nurse’s station, and before I knew it, I was whisked away by a nurse educator into a patient’s bathroom.. “Never let them see you cry.” She said, and left the room. I looked around, through the tears. At least she had the good sense to ensure it was a confused patient’s room. I wiped the tears that betrayed me again, and carried on.

The next time I cried, it was my first code. The patient was a DNR, but the family wasn’t sure. When he stopped breathing, they panicked. And so did I. But still, we coded him, and he survived. I held it together, as we tended to him, post cardiac arrest. I held it together while I thought about his broken ribs, hypoxia, and quality of life. I held it together while the family held hands in a prayer circle and reinstated the DNR. I lost it when I watched the heart rate on the monitor slowly go down, and I slipped out of the room silently to cry in the supply room.

I trembled, the first trauma patient I received in Pacu, a 90 y/o female, broken pelvis, s/p ped struck, after being dragged by a bus for five blocks. I trembled, as I fought to keep up with her rapidly depleting blood volume. I trembled each time she coded on that shift. I fought back the tears when she gave up the fight. “Don’t let anyone see you weak.” Said the charge nurse. And I cried the tears silently.

I felt a void the day I took care of a 17 y/o female who overdosed on energy drinks. I felt a void as we ran a marathon attempting to save her young life. I didn’t feel anything while we maxed out on pressors, pumped her with fluids, and she continued to decline. I felt detached while we invaded her body with a catheter to drain the toxins from her blood in emergent dialysis. I felt removed from the scene when she died, her family destroyed, and my fellow nurses wept at the climax of a heart wrenching day that resulted in defeat. I was her nurse, and I had failed her, but my eyes remained dry. Every so often there’s a patient that affects the unit, one that unifies the team, I looked around as though I was viewing it all from the gallery of an OR, and understood there was no shame in crying, and there was no shame in feeling empty - I remained silent, realizing a nurse didn’t have to justify being one or the other. Sometimes you needed to grieve to move on, and others you need to detach to survive it all.

More TMI - I passed a MASSIVE clot after my fourth birth. At this point I already knew this could happen - it’s normal. What I DIDN’T know, was that I had caused it.

My post birth contractions were so bad after the birth that it felt like full transition labor. And they don’t give you anything for the pain. So I used a hot water bottle, without the nurses knowing, and it caused me to bleed even more. I lost so much blood that by the first time they sat me up to go to the bathroom, I fainted. It took three more tries until I could sit up.

Anyway, that’s not the point. The point is, the next morning I passed a clot the SIZE OF ANOTHER PLACENTA I KID YOU NOT, and I know what is and is not normal. So I called for the nurse and through the door told her I had passed a huge clot, and her response was - “It’s not big. I know what big is.” She hadn’t even looked. So I rolled my eyes and said, “Yeah, no. It’s big, I’m telling you.”

So, sounding extremely put upon, she asked me to open the door. I did, and after a long pause she goes, “Okay, yeah, that’s a little big.”

YOU DON’T SAY.

The point I’m trying to get across is that this shit is so common - women not knowing this stuff is so expected, and it keeps getting reinforced. People don’t expect you to know anything, don’t teach you anything, and then make you feel like you’re totally ignorant and a burden for your lack of knowledge when THEY WON’T SHARE.

Fucking learn EVERYTHING you can when it comes to childbirth, girls. It is the single most empowering thing you can do for yourself. And if you missed something, that’s okay. But the more knowledge you arm yourself with, the more in control of your situation you’ll be.

A few post partum tips:

DON’T use a hot water bottle - lol.

ONLY pads - NO tampons. Tampons can cause severe infection, not to mention, you probably don’t want to be shoving anything up there any time soon.

If you’ve had stitches, sitz baths DO help relieve the pain. Another great pain reliever? Dampen some pads and freeze them. Let one thaw slightly and use it on top of another pad. This will help with the pain as well as reduce swelling. Change the pad out as soon as it’s thawed completely. This REALLY helps on the first couple days after giving birth.

If you pass a clot, don’t sweat it. Even the one I passed, which was fucking massive, just required that we keep an eye out to make sure it didn’t happen again. If it does, talk to your doctor.

Take a pain killer half an hour before nursing. Because YES - your uterus is contracting after you give birth, to get back to its original size, and nursing causes much stronger contractions. Taking nursing-safe painkillers won’t prevent the pain, but it will reduce it. 

Buy disposable underwear for the first few days after birth. They will get VERY dirty. Or use your ratty old pairs that you’re ready to get rid of. Double up on pads - line them all the way up your ass-crack. I am so serious. And wear dark pants.

Pee in the shower. You do NOT want to wipe down there right after birth because ow. Peeing in the shower lets you just rinse afterwards. Especially if you’ve had stitches, peeing in the shower, with the shower-head rinsing AS you go, keeps stinging to a minimum. And fuck everyone else - keep on peeing in the shower until you feel ready to move back to toilet paper. Middle of the night and need to pee? Get your pants off - get in the shower and just go.

IME bags of frozen peas in your underwear with proper covering (you don’t want to get frostbite) are the best sort of cold compress.

Those contractions during nursing?  They are v v important.  They shrink your uterus, helping your body get back to normal faster (and helping you pass blood quicker).  They hurt.  Keep drinking red raspberry leaf tea (which hopefully you drank during your third trimester).  It should help not only with the contractions, but with your milk supply as well.  Take a nursing-safe NSAID if you can.

REST.  I know this is especially hard for people who are already parents, for poor folk, for people with a ton of responsibilities in general.   This is when you call in the cavalry, if you’re lucky enough to have support.  FRIENDS AND FAM of birthing persons, leave the parent alone with their baby.  Do a load of dishes.  Pick up.  Check to make sure the parent has their baby supplies handy (as in, within reach).  Bring them food.  The more they rest, the faster their body heals, and the shorter the bleeding period will be.  If it tapers off and then ramps back up, YOU’RE DOING TOO MUCH.  Slow down.  This is the perfect time to learn that, as a parent, you can’t do it all.  Always prioritise your kid.  If there’s one time you’re allowed to just let shit go, it’s during your babymoon.  (Google is telling me babymoon now means a trip you take with your partner before you have your baby.  What.  No.  “Babymoon” means the first week after your birth.  When the hell did that switch happen?)   REST.  REST.  HOLD YOUR BABY.  SLEEP.  NURSE.  EAT.  This bonding time is imperative.  You and your baby deserve this time.

1. We need better sex education.

2. We need nurses to perform postpartum follow-up calls. Home health and well baby home check ups should be the standard of care for all new first time moms.

3. Don’t assume people who work in healthcare know things from nursing school/med school. I’m a telemetry nurse I don’t know shit about OB. Additionally we all know that when you are sick you forget everything.

4. Not sure if your patient knows the discharge teaching? TEACH BACK. Nursing teaching 101 make the patient teach you to ensure they know what to expect.

If I wasn’t so depleted and exhausted from labor and from trying to start breastfeeding, I would have figured out sooner that it wasn’t normal to have intermittent shaking chills, fevers, night sweats, nausea/vomiting, and contraction-level cramps. When I finally dragged myself back to the OB at 3 weeks postpartum (after lying in the fetal position unable to move during a weight check at the pediatrician's office) turns out I had endometritis from retained placenta. Oops! Once I was on antibiotics I felt SLIGHTLY more human and was able to realize how truly sick I had been. Even my med school friends who had come by to see the baby remembered me ashen gray, lying under a blanket on the couch, not wanting to eat anything, and just thought I was tired. 

Uh, nothing big, just your average stuff all women in medicine get:

patients assuming I’m a nurse because I’m female

being called honey / darlin / sweetheart / my first name / “lady doctor” when my male colleagues are called Sir or Doctor

getting frowns from my patients when I tell them I’m not married and don’t have children

being told I should smile more

Notice it’s all from patients who likely don’t know better. I don’t remember ever experiencing any sexism from colleagues or attendings. I know it happens though, because I’ve heard other peoples’ experiences. 

Being asked when I’m going to manage to have and raise kids.

Being told I don’t look like a lady in my white coat.

Being asked if I’m going into Obgyn.

Being called a nurse when being spoken about to the rest of the team.

People assuming I’m good with kids- that’s a personal trait, not a girl thing.

Getting inappropriate comments from male patients of all ages after puberty.

While on medical school telling someone I was in medical school and being told not to call nursing school medical school.

Walking out of a room after doing a splint and being stopped by a tech asking if I knew when the doctor would be done and then staring me in disbelief when I said I was the doctor and I was done.

Walking into a room and introducing myself, shaking a mother’s hand and hearing her say into the phone “no I can keep talking, its just some nurse.” (Bonus points for being offensive to both female doctors and all nurses everywhere).

Parents who say “no offense, but do you have children?” As if my status as a parent affects my ability to practice medicine when my male colleagues never get asked.

And once people see women having careers and caring for their families and women who don’t want families living fulfilled lives.

And once people see men prioritizing family the way women have traditionally been expected to.

And once maternity/paternity leave becomes valued in our workplace.

And once men speak up for and support their female colleagues who are subjected to sexist comments and attitudes.

And once people’s eyes are opened to their own individual sexist attitudes and actions.

And once women understand and reject internalized misogyny.

And

And

-being called nurse despite having a BRIGHT RED ID ON MY CHEST that says DOCTOR in capital letters. Our nurses have BRIGHT BLUE IDs that say NURSE in capital letters so there is legitimately no excuse if they are literate and have no eye problems.

-being interrupted, cut-off, or ignored far more often than my male colleagues

-having to call in my male seniors when nurses or other personnel refuse to follow my recommendations or written orders 

-being told I’m “sacrificing a lot” “not being family-oriented” “when will you start a family?” “don’t you feel sad?” when my fellow single male colleagues are applauded for being “career-minded” “going for their dreams” “hustling like a boss”

-having to hide the fact that I’m an MD when I go out on dates because I’ve had SO many experiences of men immediately saying something negative such as “oh you must be a hardass” or “damn you didn’t sound that intimidating when we were texting” or some stupid sexy-doctor joke

-frequently being asked “so how does your husband feel about you being a doctor?” even though I am SINGLE and any husband of mine will be proud of me

-being told I was ‘over-reacting’ when I reported a sleazy attending when tried to grab my butt and made suggestive comments when I was a first year med student

-being hit on DURING an interview by the interviewee

-always having to refer to myself as “Dr. md-a” to get equal respect as my male colleagues who get away by being called their first names

-didn’t happen to me but here’s some other fun things that have happened to my female colleagues: having their boobs grabbed, butts slapped, called “honey”, “baby” “babe” “sweetie” “girl”, being called “Doctor Barbie” because she was tall and blonde, being told “you’re too pretty to be a doctor” having an interest in ortho surgery questioned because “you’re just kind of small to go into ortho, aren’t you?” 

Sexism is real and it exists in medicine, too. I have seen people I had the highest regard for say or do something which was outright ignorant. It doesn’t matter if they’re male of female, med student or a professor or a PhD, just doesn’t matter.

Being a pregnant med student has been…. An experience.

My favorite is when I say I’m a medical student and people assume that I’m going to be a nurse.

The number of times I’ve been confused about what city I’m in are too high to count. I’ve also forgotten what day it is – and even what time zone I’m currently in. 

Or when you would look at the notes on a friends posts and notice that someone else had said something really funny in the replies? So you went and looked at their tumblr and decided to follow them?

These things are dead and it’s sad.

To white coat, or not to white coat?