There are days that being a med student is really frustrating. Frustrating because you see need that you can't help (YET), and there's so much going on that you don't understand (YET), and you find things that you've learned aren't really true anymore but you have to know them (FOR NOW), and people around you would really benefit from a second pair of hands, but your hands aren't qualified (YET).Today was not one of those days.
We had mom with PET go into an APH at 27 weeks with a previa. For those of you that don't know, normal gestation for people is 40 weeks. In Ireland, the cut of for viability is 24 weeks (some places in the States use 20 weeks). So 27 weeks is really really early. Thankfully, it was 8am, the consultants were awake and some of them in hospital, the Regs and SHOs were on the ball, mom survived, baby survived. We had to call a transport for baby to get it down to Dublin (where they have the training and facilities to care for a baby this small). Let me tell you just how tiny this little guy was (and yes, it was a guy). He was <900g at birth, his head a bit smaller than a tennis ball. we had a miniature BP cuff on him and could only fit 3 leads of a neonatal ECG monitor on his chest. I got to see him in the SCBU (like a NICU in the States) as they were prepping for transport. As a result, I bagged while we intubated. I've never been worried about squeezing and AMBU too hard or really paid that much attention to the timing before. I did today. I thought intubating an adult, or hell, even a child was tough... this little guy's chest tube was only 7cm long. But he was very responsive, he opened his eyes, his vitals were solid enough for being 27weeks, and he peed on me. Go little man go. I think that's actually a good sign for the kidneys. After that, he was NGed, CXRed, and bundled for his first trip in an ambulance. All this before noon.
The best part about days like today is that it reminds me why I've been in school for so effing long. It makes the all nighters, the gray hair, the ulcers, the stress of exams... all totally worth it. It gives me a high (a good type of high). The worst part is that I leave a day like today and think, maybe I should be a neonatologist, maybe I should work in a NICU. (it's not that bad, but it makes me feel a little flippant about my intended specialty).
So it's 6pm now. I've been on a dinner break (we finished clinic early, woot! my consultant is awesome) since half four. I'm headed back to A&E in about 30 minutes to do another call. And I'm not tired. Really, 100% not tired at all. I love my job.
