Parcho, MD

Many months ago–when I was a mere “third year” student, I stumbled into a horrible, no good, very bad place: the labor and delivery ward.

But you don’t just stumble in for a few minutes–they make you stay. In our case, students spend two weeks on the floor doing the nastiest of nasty–delivering babies.

Say what you want about the “beauty of childbirth”, it just isn’t pretty. Things get ripped and people pull and there’s screaming and pushing and suction and ugh. Disturbing to say the least.

So for a guy like me taking the internal medicine route, labor and delivery can be one of the worst rotations–unless you master the art of the “medicine delivery”.

The medicine delivery is so simple in its execution, that students will be talking about it for years.

The key to the medicine delivery is patient selection. If you have a choice you want the patient that is already carrying her baby in her arms. A delivery outside of the hospital without your assistance is a flawless medicine delivery. Unfortunately, two weeks on the service and I never encountered such a patient. The next best thing is the patient who comes waddling down the hallway with wet pants. Bingo–no waiting for their water to break. Even better would be the patient whose significant other exclaims, “I think I saw the baby’s head as we got out of the car”. Double bingo–even less work.

The next step is really more of a nursing step. The staff gets the patient situated in the room, gowned, IVed up, etc. But don’t run away too far, because the best medicine deliveries happen fast.

Usually, the resident will then begin a quick exam–visual and physical. This is the worst part, I assure you. As a student you’ll undoubtedly have to repeat the resident exam. But, if you have carefully selected the patient you’re going to follow–then the exam should be simple. Visual exam of the reproductive region reveals baby’s nose, ears, and a clump of hair all coming out of the…ouch!

At this point, the resident will undoubtedly be bouncing around like a juiced Super Ball. This is okay. OB residents are just like that.

Now, if your medicine delivery has been going as scheduled, the patient has probably been on the floor for about 10 minutes. Perfect.

It’s time to gown up for the delivery. Paper boots? Check. Hat? Check. Gown……………

::sound of baby crying::

By this time the baby’s been pushed out onto the bed and delivered by the nurse without so much as a single scream or difficult push by the patient.

Outstanding.

And that, my friends, is the perfect medicine delivery.

*For the record this happened twice to me while on L&D.*