I’m currently on another surgical rotation where, again, everyone thinks I’m pretty much nuts for going into OB/GYN. Until, again, I mention that I’m considering doing a fellowship in REI (Reproductive Endocrinology and Infertility). Then it’s all “Ohhhhhhh, well that’s smart. (i.e. Okay, maybe you aren’t a total nutter.) You’ll have office hours if you do that. Nine to five that’s the way to go! (i.e. Okay, maybe you won’t turn out like that poor sap I told you about who crashed and burned out after two years of general OB/GYN and now does corporate physicals for a living.) Plus, you’ll probably make lots more money. (i.e. Okay, you probably won’t be sued into vagrancy.)”
It occurred to me recently that a lot of this negativity probably, actually stems from the fact that most people who don’t do OB/GYN, just don’t like it. As my current attending puts it, “You either like OB/GYN, or you don’t.” (Or, as one of the nurses in their office put it “They just hate OB/GYN.”)
And when I think about it, I can recall countless non-OB/GYN physicians grimacing painfully as I excitedly regaled them with tales of deliveries, sections, hysterectomies, pessaries, and pap smears before they (pointedly) changed the subject. I particularly remember one internal med doctor I worked with as a nurse who was so excited to be taking another job where they wouldn’t “have to be doing any of those pap smears anymore!” [pap smears, YUCK, written all over their face and inflection]
Frankly, if some doctors don’t like OB/GYN stuff (fine, that’s cool), instead of condemning me for liking it, I think they should be congratulating me. I mean, they have no desire whatsoever to deal with “crazy pregnant ladies” or “all those ER patients with vaginal discharge [shudder].” Well, I can’t wait to “deal” with them. Heck, that’s all I want to deal with. So make both our days, send them all to me, and instead of thinking I’m nuts for wanting (and totally loving) this work, think I’m doing you a big favor, and throw me a frickin’ party.
I’m just saying.
Which (sort of) brings me to Reason #456.
I read this article yesterday on NPR’s health blog about doctors talking to (or not talking to) patients about their sex lives. From experience, I have found that many physicians are not necessarily comfortable talking to patients about sexuality. For example in first year, before OB/GYN was even a twinkle in my eye, I watched a generalist complete a yearly physical on a young female college student. They did all the exams – heart, lungs, abdomen, pap, pelvic, wrote a script for birth control, and sent the patient on their way. They did not ask one question about sexual partners, sexual practices, STD testing, nothing. I was very surprised and a little dismayed. Last year I heard about a patient who had expressly been sent to an OB/GYN with persistant UTI’s for further investigation of sexual practices and a workup for STD’s. Later the patient presented with yet another UTI, and per the OB/GYN’s note, none of these things had been done. I completely understood the generalist’s frustration as they read the note and asked me “You’re going into OB/GYN, shouldn’t they address that stuff??”
Yes, yes they should.
Sexuality and associated health concerns are a fact of life, and an important part of a patient’s overall well-being that cannot be ignored. I am sure that patients have a hard time talking about such issues, and probably more often than not, the (sensitive, non-judgmental, well-educated, trustworthy) doctor is going to be the one who has to start the conversation so that any concerns can be properly addressed. We need to be better about this, and I for one, am very happy to be going into a field where I will be a (sensitive, non-judgmental, well-educated, trustworthy) resource doing my best to help patients with these important issues.
And, on a lighter note, Reason #457. (Or, a stolen, precious OB/GYN moment that was the highlight of my non-OB/GYN week.)
A few days ago I walked out of a patient room and one of the nurses beckoned me to the lobby where, to my absolute delight, I found one of the patients I’d delivered months ago waiting to say Hi with their baby. The patient had been a delight to work with, I’d spent all day on L&D with them and their family, and when the baby came I had been just as ferklempt as grandmabear.
The baby was spectacular, all decked out in their best baby duds, snoozing and drooling like a little angel. As I exclaimed and made a general fuss over them, the proud mamabear said she had heard I was in this particular clinic and they just wanted to stop by and show me the baby. And then they handed me a thank you card, and I got ferklempt all over again.
And that is my kind of Pediatrics. I love kids. I do not like having to poke, prod, or otherwise torture children in the name of medicine. And with OB/GYN I get the fun part of Peds, aka the exclaiming and general fuss-making, without all the Bad Guy stuff. (P. S. Pediatrics people you are my Absolute Heros for being willing and able to do the Bad Guy stuff. Seriously.)
Really, does it get any better?