I was going to go to a cultural festival in the village of Teller today (which I was super excited about!), but while rounding on my patients at the hospital, a pregnant patient that I saw in clinic yesterday came in active labor. Since I really love delivering babies, I elected to stay and help her rather than go to Teller…and I thought just maybe I could do both, if she delivered quickly! But that’s not the nature of labor and delivery. 🙂 So early in the morning she progressed to near complete, then stalled. She stalled long enough that we were preparing to MedEvac her in case she needed a cesarean section, but then she very courageously (and gracefully!!!) got up and walked around with super strong contractions, and the baby moved down and before we knew it, she was back in bed, pushing out a happy, healthy baby!
Her mom was helping her get through it like a very skilled Doula, speaking to her in Siberian Inupiaq, comforting her, breathing with her, massaging her back.
It was a great learning case from beginning to end, because she may have been preterm (as her due date was not certain), and that would have meant that I should have sent her to Anchorage yesterday. While I was suturing up the lacerations on my own, it re-dawned on me: “This is it. I am the doctor now.” It felt empowering and rewarding and heavily weighted with responsibility. Of course, I still have back up, but when I feel confident with something, I no longer report to anyone! Which feels a bit weird, and makes me feel less confident all of a sudden, because I just want to check and be sure. But then I remind myself of what I’ve done before and the cases I have had, and the literature I have read. And sometimes I double check with another doc, just to be sure. And then when I know I have made the right decision, I feel a little bit stronger and more sure of my legs under me. Like a baby learning how to walk on their own, I’m sure I will have times where I fall or sit back down, or catch myself, but the way to learn how to walk is to start walking on your own.
While in residency I worked with an amazing, humble, super intelligent Nephrologist who had this Jewish Physician’s Prayer hanging over his desk, and I had to hang it by mine:
Dear Lord, Thou Great Physician, I kneel before Thee. Since every good and perfect gift must come from Thee, I Pray that You give Skill to my hand, clear vision to my mind, Kindness and Sympathy to my heart and Strength to my body. Give me singleness of purpose, and the ability to lift at least a part of the burden of my suffering fellow man, and a true realization of the rare privilege that is mine. Take from my heart all guile and worldliness, so that with the simple faith of a child I may rely on Thee.
I love how humble and thoughtful it is, and how it refocuses me to the purpose of medicine.
This is the Fireweed wall on the East end of the hospital. Many walls of the hospital are painted with the colors of the tundra. This is from the tundra flower, fireweed (I have yet to see the flower!). In Alaska, they say when the flowers turn to cotton, it means there are 6 weeks till winter. I saw the cotton tufts when I arrived three weeks ago…I’m not sure when they first turned to cotton, but I guess that leaves less than three weeks till Winter. I think by all standards that I’ve ever lived in (ie freezing temperatures, snow, scraping cars), it’s already Winter. I wonder what Winter really means here?!
I ended up leaving rather late after discharging one patient, and having a long conversation with another, and finishing up more paperwork. I am on call tomorrow, and I am preparing myself for whatever may come! I’m sad to have missed out on the cultural events in Teller, but I am sure there will be more. I got to walk home on a beautiful evening, with the wandering sunset travelling lower and lower across the sky.