When all is messed up

I'm one day away from my last day on my first OB month, which, if you haven't already gotten the gist of my whining posts, has been really hard on me. It's mostly just hating constantly feeling not ontop of things-- that things are just on the verge of spinning out of control without you being able to do anything about it. You can only be in one place and do one thing at a time. I've been so frustrated because I'm realizing that hard work does not always guarantee success-- although I've never worked so hard or been worn so thin in my life, I still don't feel as though I'm doing things well. That makes the perfectionist in me mad and makes me feel utterly inadequate and hopeless. I know my expectations may be messed up, but still. I want to be good at what I do every day, and right now I'm not. Anyways.... other updates from this week include:

On Tuesday, I delivered a baby with gastroschesis, which is when bowels are herniated through the abdominal wall. I've only seen this one other time, which was at Mayo, when the mom delivered via scheduled C-Section-- I was actually surprised that these babies are actually more commonly delivered vaginally (Mayo may be more conservative, as it is in many other ways, too!). The shocking thing was that everyone was fine with me, the intern, doing the delivery! Weren't they afraid the bowel would somehow perf(orate) as I was pulling the infant out?! No worries. Baby came out fine, we slapped a warm saline towel right on those bowels when she came out, and off to the NICU team she went. She had surgery yesterday and is doing well.

Another shocker: yesterday, I was told that it was my job to to consent a woman for a post-partum tubal ligation as I would be doing the procedure today. THAT'S RIGHT!!! I had to fill out the scheduling request forms and things listing me, yes, ME, as the surgeon for the case. This really freaked me out. I was pretty distraught last night, and feeling really ill/nervous all through rounds and board signout this a.m. in antipication of the procedure. I hadn't been in any OR in over a year! But guess what-- it's done. It took a long time-- I know that the chief resident and attending, although patient-seeming, were probably groaning inside, as I timidly (and shakily) made the infraumbilical incision and required lots of hand-holding the entire time, from opening up the peritoneal cavity, hunting down and tracking the fallopian tubes, and then tying. I felt terrible also because the anesthesiologist, in there with us too, kept getting called b/c other women in labor wanted epidurals, but had to say "We're almost done in here." As crazy as it is, I somehow sterilized a woman this morning (permanently and successfully, let's hope). What's perhaps more messed up is that this woman, who already had 4 kids and had the pre-op diagnosis of "satisfied parity," as they say, was born in 1982!!!!!!!!!!!!!!!!!!!!!!!! Boy, does this make me feel old.

It is messed up when the chief asks you, "Doing okay? No breakdowns today?" while having casual conversation in the board room yesterday. "Not today," I answered. The day before? Check. Today? Double check. I completely lost it in triage just before lunchtime today. All the sleep deprivation has really gotten to me-- I am just so tired I can't even think straight or keep things together. Although everyone kindly tries to tell me that "It's ok. Everyone cries on OB. All the interns were crying last year, too," I still think that it is not normal to break down all the time while at work. I think patients tend to be a bit worried and unnerved when you walk into to see them with red,puffy eyes and a runny nose. I need to fix this, majorly, or at least find a way to hide it better.

This afternoon was my family practice clinic day, which feels like a vacation compared to being on the OB floor. It is messed up when, biking home at 5 p.m., after working for 12 hours, I was saying to myself, "Wow! I'm getting home so early today!"

I was able to join Kate, Amy, and Kate's friends Lindsay, Lisa, and Dave, for dinner at Centro (Cocina Mexicano) tonight for Kate's birthday. It feels like forever since I'd been "out" and done anything resembling a recreational activity/social event. It's messed up that the majority of any social interaction I've had over the past month has been because I've been at work. It's almost more lonely coming home; sometimes I wonder if I should just not pay rent and live in a call room instead :)

My apartment is horrendously messed up. I'm actually surprised how much mess one person can make, when I am never home and awake for more than 3 hours per night, but it apparently is possible to create mountains of papers and clothes in this time frame.

My sense of style is messed up. Having worn only scrubs for, really, the last 26 days or so, I'm finding that it is quite difficult to try to figure out what to put on for the day/evening and to think about coordinating shoes, earrings, etc. Sometimes life is just simpler when you exercise no choice and don't try to look snazzy :).

Today is Nicole's birthday. Happy birthday, Nicole! Life is so messed up that I accidentally called her yesterday on the wrong day. At least it wasn't a day (or more) late, eh?

It's messed up that there has not been one day, in the past 13 days (this will continue until Saturday morning), where I have not been in the hospital rounding. I worked (last week) Monday, Tuesday, Wednesday, Thursday, Friday, Saturday (+overnight), rounded Sunday and slept the rest of the day, then Monday, Tuesday, Wedesday, and Thursday, and am on tomorrow day and night until after rounds Saturday morning. I think I could manage to pick my head up if I just had a day off. It is really miserable to not ever have time to do anything at home. I know I'm whiny, but still. This is seriously messed up.

If I go to bed right this minute, I could get about 6 hours of sleep before I have to go in again for my 24 hour call again tomorrow. This, too, is seriously messed up.