Trust

I delivered my first baby this week. Not MY first baby, that is, but it was my first time on the other end of the table. It was 3am (the time the labor and delivery floor gets really busy) and it was my patient’s second vaginal delivery, making her a relative pro. Baby was a little bit early at 36 weeks, but everything was looking good. The resident had asked me I’m advance if I wanted to help, and when the time came the attending told me to gown and glove. The patient looked down at me between pushes and said, “Wait, you changed clothes,” referring to the surgical gown.

“Are you the medical student that I met earlier?”

“Yes, ma’am. I am.”

“How many of these have you done?”

“I have done two of them in the simulator, but this will be my first real-life delivery.”

“Ok.”

And then the next contraction started and we all got to work. Just like that! Yes, there was a whole team there. The patient saw the resident and the attending. She knew that I wasn’t alone. She heard these women, each with hundreds of deliveries under their belts, giving me tips as I delivered her baby.

Protect mom, control the head, allow baby to turn, deliver the anterior shoulder, deliver the posterior shoulder, and deliver the body. For style points, show mom her beautiful baby girl before handing her off to the waiting pediatrician.

I knew the steps, but when the time actually came I was a little bit hesitant. The attending looked over my shoulder and encouraged me, and a healthy baby girl came into the world.

The delivery of the placenta was a little anticlimactic. Mom is tired, and it’s mostly a matter of waiting for the placenta to release from the uterus. It came out intact as expected, and we started to clean up. The pediatricians were looking baby over, and mom was relieved to be done. As we were tidying up, she looked down at me, smiled, and said “You know, you looked like you were more scared than I was!” We both laughed, and the pediatrician brought over her healthy newborn. I congratulated mom and thanked her for allowing me to be a part of her delivery, before leaving her to bond with her new baby girl.

Looking back, it amazes me how she trusted me. Knowing that it was my first time, that I was only a student, she let me deliver her baby. We all have to start somewhere and without these patients there would be no way for me to learn, to develop the skills of a physician.

But no one ever wants “the new guy” working on them. People tell me all the time how they refused to let a phlebotomy student draw their blood, because it might require an extra “stick.” Rarely, a patient tells me that they don’t want to see a student. They don’t want the sweet young (female) student to hear about their erectile dysfunction or their STD.

I’m not offended, though I do often chuckle at the thought that, after months of taking sexual histories and asking patients about their bowel movements, patients think anything they say will surprise me.

Every so often, though, it is time for me to of a procedure for the first time. Sometimes the patient asks, sometimes they don’t. At moments like this, I am struck by the trust that my patients place in me, their willingness to allow me to learn from them and their experiences, to use their bodies as a training ground in a very real sense. I try to return the favor when I’m on the other end of things, but I know that not every patient feels the same way.

So thank you, to every single patient in every teaching hospital around the world. Without you, there wouldn’t be any doctors.

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