Dr. Kim is a university-trained obstetrician/gynecologist with 15 years’ experience in solo private practice in a suburban Midwestern community. Dr. Kim graduated as “Outstanding Student in Obstetrics and Gynecology” with Honors in Obstetrics and Gynecology, Rural Obstetrics and Gynecology, and Pediatrics.
Below is a first-hand account of experiences Dr. Kim faced throughout her career.
A Day in The Life of Dr. Kim
Just for the heck of it, I bought a pedometer to measure the amount of walking I did while on call as an obstetrics and gynecology resident. Being ‘on call’ meant that I had to be in the hospital from 5 PM until 7 or 8 AM the following day. This would be after I had already spent 10 hours in the clinic. On call meant that I was responsible for all the patients on every obstetrics and gynecology unit (labor and delivery, high risk obstetrics, postpartum, gynecology, the cancer unit, and any emergency room patients).
One night, my journey ended after I walked 11 miles in less than 12 hours. The following is my account of what I accomplished during those 12 hours.
Delivered 14 babies
Five of the deliveries were by cesarean section. Cesarean sections take way more time than vaginal deliveries because they are done in the operating room with anesthesiologists, scrub nurses, pediatricians, and a whole slew of support personnel. Waiting for everyone to come together and finish their duties can be agonizingly slow. This can stress doctors out thinking about all the pages and calls that go unanswered while operating.
Sometimes with complications a cesarean could take up to 3 hours. The physical pain and exhaustion coupled with decision-making uncertainty and worry really messed with my confidence. This day the first delivery started at 8 PM, and the last finished at 4:30 AM.
Emergency Room Consults
In between the C-section surgeries, I did the vaginal deliveries and then went to the emergency room for 4 consults. Three of the 4 patients were admitted to the hospital. One of those patients needed me to stick a needle near her lung to drain out excess fluid, and another needed emergency surgery for a ruptured tubal pregnancy.
Tubal pregnancies are the result of the fertilized egg landing in the tube instead of the womb. When the tiny fetus grows too big, the tube bursts and the mother could die within minutes if surgery is not performed right away. Due to the delicate and severe nature of this surgery, it lasted 3 hours.
The last emergency room consult was a non-English speaking woman who needed a translator to communicate with me and the nurses. This took another hour to make sure she was properly cared for.
I was then called by a maternity ward nurse to evaluate a 25-year-old woman who had chest pain after delivering her premature baby. The pain turned out to be heartburn caused by intense anxiety from the delivery. But every cardiac test was performed primarily because my senior resident did not want to get out of bed to confirm that the young woman did not have a heart problem.
Paged Over 30 Times
Throughout the night, I was repeatedly paged for routine questions from nurses. It is shocking how unempowered the nurses are to make simple clinical decisions. If the instructions were not in the ‘Order Book’, the nurses would not make any decisions out of their scope of practice. We often joked that it was really a ‘Suggestion Book’ since half the time, the orders were ignored or second guessed by a more senior doctor.
In the back of my mind, I thought they paged me because they just wanted to talk, gain reassurance, or see if I really knew what I was doing. First year residents, like I was, are constantly scrutinized by nurses, second and third year residents, chief residents, and attendings. I was always on edge and fearful that I had not thought of absolutely everything.
Starving, I finally had a minute to eat my only meal: six tiny chocolate donuts from the vending machine. Then came morning rounds. Rounds are when the whole team of residents, medical students, and attendings visit each patient room, review test results, do an exam, review vital signs, write progress notes, and talk about the long-term management. But before rounds, I had to explain to my colleagues any changes concerning their patients whom I had seen throughout the night.
Then, I trekked to the operating department to talk to the three patients that I would be doing surgeries on that day. The surgeries started at 8 am so I had to move fast. Surgeries lasted anywhere from a half hour to 2 hours if they were “easy” surgeries, but cancer cases or more intensive surgeries often exceeded 6 hours.
After the last surgery, afternoon rounds began at 5:30 pm and lasted until 7:30 pm. Exhausted, frazzled, hungry, and desperate to go home, I still had to review and explain all my patients’ conditions to the next resident coming ‘on call’ to relieve me.
This was my life for four years as a resident. I loved surgeries, delivering babies, and solving medical problems for women. But I had no idea that the physical and emotional pain of long hours and surgeries and the mental strain from worrying about my patients would ultimately break me. After 15 years of private practice, missing every important moment in my own children’s lives, arguing with insurance companies for declining payments, sleep deprived, divorced, sad, burned out, and alone, I quit.
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