Today Is The First Day...

December 2001, Audrey’s Unexpected universe.

Kel heard the lock turn from his position on the couch. He’d been biding his time watching TVLand. Some of those shows from the 70s, he thought, still held up, but the clothes, what were they thinking? Then again, he hadn’t purchased anything unassisted since the late 70’s himself.

It was Jake at the door.

“Hey Dad, Mom invited me for dinner.” Jake staggered in the door, shedding coat and books like rain. “Liz is on duty. Sorry I’m late.”

“Long day?” Kel asked, remembering Jake had started a new rotation that day.

“Well…sorta.” Jake volunteered, following his father into the small dining room just as Dixie came out from the kitchen.

“Perfect timing,” she said, hugging him. “Hungry?”

“Starving. It’s been a long day. I didn’t mean to make you wait.”

“Nonsense, sit down,” Kel motioned him into a chair. “Wanna beer?” he asked, heading into the kitchen.

Twenty-five years old and I’m still not used to my Dad offering me a beer. “Yeah, that’d be great. Sophie coming?” he asked.

“No,” Dixie said, sliding a plate of pasta in front of him, everything else was already on the table. Obviously, they’d waited dinner for him. “She had a deadline.” 

“Thanks for having me over.”

“Our pleasure,” she beamed at him. 

“So,” Kel said sitting down and sliding Jake his drink, “you started a new rotation today, what was it, Ob/Gyn?”

Caught unaware with a mouthful of pasta, Jake tried to respond, “Yeah. First day of Ob/Gyn at St. Francis. I have two weeks on the surgical floor, and week in the clinic and a week of basic Gyn. But my assigned preceptor had an emergency C-section, so first thing they had to scramble to put me with someone else.”

“Who?” Kel asked.

“Elaine Curry.”

“I don’t know her,” Kel said, spearing a forkful of salad.

“She knows you,” Jake grudgingly admitted, “…by reputation.”

Kel looked confused.

“She recognized the name when I introduced myself.”

Here we go again, Dixie thought.

Before she could intervene, Jake continued, “First patient was a 32 year-old female, first pregnancy, history of polyhydramnios but they’d been watching that. Labor was progressing normally until her water broke. It looked like someone blew up the Hoover dam!”

“Jacob!” his mother scolded.

“Sorry, but it did.” He grinned at her; he’d always been able to charm his way out of things with Dixie, much the same as Sophie’s shameless manipulation of their father.

“Anyway, so Dr. Curry’s checking the fetal monitor and, of course, she asks me what I see. I’ve had four lecture hours of fetal monitoring, been on the floor, what, 20 minutes and this lady is shoving a strip under my nose. Good thing I reviewed my notes last night.”

“You know what it was?” Kel asked.

“Yup. Classic pure variable decelerations. Probable cord compression.”

Kel nodded his approval. That’s my boy.

“So off she goes to check the patient,” Jake gestured with his fork, “and all of a sudden she says ‘Jake, go check for the resident, see if you can see him’. I poke my head out the door, no resident in sight. Then she’s like…’okay, you’ll do…get on a glove…get on a glove’…and I’m looking around for gloves and manage to get one on and she says ‘Okay, we’ve got a prolapsed cord, what I need you to do is hold the baby’s head up off the cord while we get her to the OR’.”

Jake paused for dramatic effect and helped himself to another mouthful of pasta. “I’m thinking, eight weeks of Ob/Gyn and all I can remember is ‘prolapsed cord, very bad’.”

“So? What did you do?” Dixie asked.

“I put my hand in” …Jake stopped, blushing furiously. The topic was just not the sort of thing a guy normally discussed with his mother.

Kel, of course, was focused only on the case and thus totally oblivious to Jake’s discomfort. “And…” he prompted.

Grateful for an out, Jake continued his recap. “Dr. Curry asks, ‘Can you feel the baby's head?’ Yeah. ‘Can you feel the cord, is there a pulse?’ Yeah. ‘Okay, it’s your job to keep the head off that cord.’ By this time two nurses arrive and one’s telling me that in 17 years she’s never gotten to feel a prolapsed cord – which is nice but it’s still embarrassing to have your hand in a rather intimate part of a woman’s body – especially since you’ve never been formally introduced.”

“You’ll get used to it,” Kel encouraged, which elicited an arched eyebrow from his wife. Really, we’ll discuss that later. 

In between bites, Jake continued, “So we’re off to the OR and Dr. Curry tells me to ‘get on the bed’. So I sit down and this is not what she wants because they’re trying to wheel the bed out of the room and she yells – ‘No Jake – On the bed!’ So there I am, sort of scrunched up and kneeling on this bed and these two nurses are pushing the bed down the hall to the OR and Dr. Curry is running along in the front shouting orders. And all I can imagine as these faces go whizzing past is are these people thinking ‘who’s that fellow bunched up there between that woman’s legs?’ ‘Him, that’s the new third year’.”

Jake was now so caught up in retelling his story that he failed to notice the expressions on his parent’s faces. Both were assiduously studying their plates – or their son – anything but look at one another to keep from laughing hysterically.

“So we turn the corner to the OR and someone’s putting the mask over my face – cause I can’t,” Jake waved only one arm in explanation, “and I get a surgical cap jammed on my head and we go flying in to the room.”

He passed for a couple of bites while his parents attempted, valiantly, to regain their composure. He’s so sensitive, Dixie thought, about how he’s perceived, especially in comparison to Kel, that we can’t laugh at him. Keeping her voice steady, she asked, “What happened next?”

“It was bedlam. The anesthesiologist was trying to get room to work and scrub nurses and techs are running back and forth and Dr. Curry keeps asking me if I can still feel the pulse. Then some tech goes to drape the patient and the next thing I know I’m under the drape. Sterile field – not a problem, the med student covered in all manner of goo is under the drape.”

That did it, the mental image was too much and Dix collapsed in laughter. Kel followed immediately.

Far from being offended, Jake seemed to be delighted. “Wait! It gets better,” he said. “Then one of the nurses tried to wheel the surgical table over the patient and keeps whacking me in the butt with it. I can hear her asking what-” he smacked table for effect, “-is this (whack) and someone says ‘oh that’s just the med student’. Dr. Curry says ‘you still with me Jake’ – what does she think, I’ve popped down to Starbucks for a latte, though it is dark and cramped and getting really warm under there…and it doesn’t smell…well, you know.” He paused to polish off the last of his pasta.

“Well?” his parents asked in unison.

“Dr. Curry makes the incision and I feel the head jiggle a little and the whoosh, she’s outta there.”

“Was the baby okay?”

“Yeah, they had to intubate her, but she’s gonna be fine. They get her cleaned up and everyone’s ohhing and ahhing and so finally Dr. Curry says, ‘Jake… you can come out now’.”

“You were still under the drape?” Dixie asked in disbelief.

“Well no one told me to come out yet. I’m a med student; I’m trained to follow orders.” Jake explained. “I did feel a little awkward, you know, with my hand still…after they got the baby out.”

Dixie couldn’t look at him. She stared at her plate instead. “Trust me son, she didn’t notice.”

“How long were you under there?” Kel asked.

“Nineteen minutes, felt like two hours. They finally pulled the drape up enough for me to slide off the end of the table. I stagger to my feet and there they are, an entire room full of women. I’m the only man in the room and what a lovely impression I made. Surgical cap pushed down on my forehead so it’s resting on my eyebrows, drenched in sweat, mask on so that all you could see were my eyes and covered in amniotic fluid and blood and betadine”

“Tough first day,” Dixie observed. “I’m sorry sweetheart; I’m sure it will get better.”

“Are you kidding? It was great! They let me get cleaned up and loaned me some clean scrubs and a coat, I don’t think I’ll ever get mine clean, and off we went. We did another C-section and vaginal delivery.  It was amazing. Miraculous. They let me hold the last one. A little boy...he was so tiny. I got to help the nurses take his footprints,” he sounded awed. “I don’t want to do Ob/Gyn, but I loved it.”

Despite the excitement, he’d managed to clean his plate. “Mom, is there more?”

Dix nodded and reached for plate.

“No, I can get it.” He got up and headed into the kitchen.

As Jake left the table, Dix turned and caught Kel watching him with a wistful expression. “Remembering your first day?” she asked solicitously.

He looked down at the table, remembering Jake’s words but a different newborn…a little boy…so tiny…then up at her. “No,” he said with a warm smile, “Not mine, his.”

Acknowledgements: I am stunned but happy to report that the basic details recounted here are true and fairly accurately describe the first day of an Ob/Gyn rotation for one of my students. It was just too good to pass up. Thanks Darci!!!