Ob-Gyn

I started OB/Gyn last week. It is quite a unique rotation. I start on Gyn-onc, dealing with all the cancers that can affect women, move on to outpatient gyn clinic, performing pap smears and breast exams until I can do it in my sleep, and then spend a month in Stockton, delivering babies.

Right now, I'm on gyn-onc, which is actually a surgical rotation. We admit women with 'pelvic masses', cut them open, remove their tumors and find out if they are cancerous or not. That part in itself makes it a pretty powerful experience. Additionally, it is a predominantly female speciality, in a generally male-dominated profession, and it is a rather inspiring experience.

That complicated mix was very present today when we operated on a relatively young woman who was recently found to have some sort of abdominal cancer with possible metastasis. She is young, a mom of a teenager, and had been healthy until 2 weeks ago when her tumors began to cause symptoms. Except for the young male anesthesiologist, everyone in the room -from the nurses to the attending- was female. Our attending is a young mom and a remarkably good surgeon. The assistant surgeon, a fourth year resident, just turned 29. We had a scrub nurse and a running nurse, both probably in their 40s, and then me and another medical student.

It was a very solemn surgery, from the very start. Unlike many surgeries I've been in, it was quiet in the room and everyone worked very efficiently. The resident and attending would clip, cut and tie, and we (the med students) would be ready to cut ties, take instruments, suction blood. No one talked beyond necessary communication. Everyone was expecting the worse, not daring to even hope for an unlikely happy ending. The fact that we were all women, possibly giving a chance at life to another woman who could have easily been one of us (in a profession that very recently was restricted only to men) added symbolism to the whole process.

We pulled three very large tumors out of her, all of them cancerous, two of them from completely separate processes, which is very rare. We pulled out lymph nodes and samples of tissue in her pelvis to assess for metastasis. She will need many courses of chemotherapy; she has a long road ahead of her with an unkown prognosis. It was a sad day...but also empowering. It was one of those days that happens remarkably frequently in medicine: that kicks you in the gut and reminds you about the amazing complexity of this experience we call life.