The "big house"

In medical school, when I decided to pursue a career in obstetrics and gynecology, I was amazed all the practicing obstetricians were under the age of forty. At that time I did not appreciate the grueling nature of the profession. Women, calling their physicians at all hours of the day and night, usually with complaints better reserved for their mothers. More about this later.

Anyway, in interviewing for residency training programs, I met an obstetrician who was the son of an obstetrician, who loved delivering babies so much he was determined never to give it up. He could be found at 3 o'clock in the morning, long after his patient was delivered, quizzing the residents about the other patients on the labor board, asking why nothing was being done to get those babies delivered. The answer to this question was usually that their obstetrician was asleep and had instructed the residents to do nothing with would interrupt that sleep. Even the most naive of us know medicine is a twenty-four hour a day proposition and especially when obstetrics is involved.

Lucky enough to be chosen by this particular residency program, I was also privileged enough to practice with this obstetrician for many years. I learned a great deal about obstetrics and about life from this brilliant, compassionate human being. When my kids ask me who the best doctor or smartest person I have ever known is, this man always comes to mind.

He grew up around doctors and hospitals. He father was a physician, chairman of the Ob-gyn department at two hospitals, chief of the medical staff at one, and dean of a medical school for a time. My mentor was also a philosopher with an undergraduate degree in the subject. I am sure most of his life was surrounded by the practice of medicine. He called the hospital, "the big house." I believe to him, and many of his generation, who actually lived in the hospital for the year of their internship (first year of training after medical school), the hospital was a kind of home.

I find it kind of a home too. This is especially true now that much of my time is spent there rather than in a clinic or office setting. About ninety percent of the patients I see each week are in the emergency room, labor and delivery, or as hospital in-patients. On a busy day or even a sort of busy day, I feel much like Jonah must have felt when he was thrown overboard while sailing to Tarshish and was swallowed by a big fish. In my case, I feel swallowed by the hospital or the big house. Frequently I wonder if I will ever see the light of day again.

In the past two years, unlike Jonah, I have learned to take events as they come, deal with the problem at hand, and be thankful for victories when they are achieved. I am always in search of ways to do it better but I have also realized that there are many more people involved in each scenario than just me. If we all work together much can be accomplished. All I am responsible for is my part. The patient, the residents, the nurses, hospital administration and yes, probably even God (who I believe is probably a hospital administrator), are involved in the outcome.

All this said, I have chosen to keep blogging but under a different title. I am, after all, no longer a local MD. It has changed me and mostly for the better. I will be telling the stories I have experience in this "belly of the big house." The names are changed, the situations are disguised but yes, all this stuff really happened.