You want me to what? In labor and delivery?

I’m an emergency physician. In common parlance, an ER Doc. Which means, like a little kid who will eat dirt on a dare, there’s not much I won’t try in the practice of my profession. Many of my colleagues have had far more challenging careers than mine, I assure you. But I have some stories to tell. Cyanide overdose while moonlighting as a resident. Patient nearly dying from bite by pet rattlesnake. Escharotomies (cutting through burnt skin to allow breathing and blood-flow) on adult and child. Arriving by helicopter, then lying in the mud intubating a self-inflicted gun-shot wound. (While losing my temper with first responders and using bad words…not a shining moment.) Procedures of all sorts, tubes, lines, foreign bodies, abscesses, assorted bites, cracked chests, the list goes on.

But one thing I make eminently clear to everyone is that I do not, under any circumstance, enjoy delivering babies. I know, I know, the joy of new life, happy parents, first breath, blah, blah, blah. I get it. My wife and I have four of our own and it’s all wonderful.

Unfortunately, however, I never delivered many babies in medical school or residency. There just wasn’t much obstetric volume, and generally the nurses ran us out of the rooms in favor of well, obstetricians or obstetricians in training. I probably haven’t delivered twenty of the slimy little messes since I went to medical school.

As such, I have a kind of innate terror of things going wrong. Mind you, I’ll shove a tube in your collapsed lung and go right back to my lunch. I’ll put a tube in your trachea through partially digested cheeseburger and smile. I’ll manage your heart-attack, stroke, pelvic fracture, stab wound, etc. with relative glee. But new humans? No thanks.

So it was with some irony today that I was beset by frantic nurses who were called by other nurses upstairs in our small hospital, who said, ‘a baby is about to be born and we don’t have a doctor.’

‘Well get one,’ thinks I.

‘They need you.’ I looked around. ‘Me? Oh, no, the nurses are better at that than I am!’

‘Come on!’ I was all but dragged down dark hallways, up deserted stairwells on the edge of the sixth circle of hell, down the long passages of my own personal anxieties and into a room where a young woman (which goes without saying) was lying and rocking back and forth as a freshly minted citizen attempted to exit her nether regions.

‘Ok, ladies,’ I said, ‘it’s been a long time. What do you want me to do?’ And gently, patiently and firmly the labor and delivery nurses guided me to the bedside, and to the table with assorted shiny instruments and drapes.

And then it came back to me. Oddly, calmly, it was there. Put on the gloves, put on the gown, put your hand over the crowning baby’s head to slow it’s descent. (I was prepared to rupture the amniotic sac but nature did that.) Deliver head. Suction nose (just a bit, the nurse told me). Check for cord around neck. Shoulder down, shoulder up (I think…fog of war and all) and voila! A person emerged where previously there were clean sheets.

A beautiful baby was lain upon his mother’s warm body as she smiled to stifle what had to be really, really a 10/10 pain. (Not the kind of 10/10 I see when people have bad boo-boos.) A father nervous, uncertain. A grandmother beaming. There may have been a cheering section. It seemed crowded to me. Baby to warmer with nurse.

Clamped the cord. Father cut it. Cord blood drawn by nurses. I waited with the nurses for the placenta, holding the umbillical cord with a curved clamp, gentle traction only.

At which point I said, ‘not to be a bother, but I really have an ER full of patients.’

The nurses graciously allowed my exit. I congratulated all involved and the new little family was very kind to me. Maybe they knew I was only slightly less freaked out than they were.

Walking downstairs I practiced my best growl. I told the incoming night nurses, ‘do you know what they made me do? Deliver a baby!’ But I thought back to an important moment in medical school. The time I delivered one for the very first-ever time. I was beaming. I was exhausted. I was poetic and nearly tearful. I stuck a huge needle through the cord and into my hand. I called my wife, then girlfriend, Jan. ‘I just delivered a baby!’ I probably sounded like Will Ferrell screaming ‘Santa’s coming!’ I toyed with obstetrics as a career. For the next two or three weeks of my rotation when I said, ‘no way…’ But it was pretty magical back then.

In fact, I was glad the nurses dragged me up to that delivery. So much of what I do involves people who don’t want to be sick. Or want to be ‘sick’ for the wrong reasons. This was an ’emergency’ for a good reason. And with an amazing ending.

A new baby, a new mom and dad? A skill refreshed? Not a bad way to end a shift at Tiny Memorial Hospital.

But note to nursing staff: don’t get any ideas. That’s enough for ten years.

Edwin

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