Life Begins

I have recently had the privilege of being present at the birth of a beautiful baby boy, delivered by C-section. What struck me most about the whole process was how medicalised pregnancy and birth is, how it seems to be treated like a disease with teams of doctors and nurses and midwives discussing induction and dilatation and cardiotocographs, deciding when these women should go into labour depending on whether there is a bed available and enough staff.

It is difficult to write about a C-section in a romantic way, as the sheer brutality of it harks back to an era of medieval medical practices. The way in which the baby was yanked from the bulging abdomen of the supine woman, her face and view obscured by a large green screen from the mess and blood where previously a beautiful smooth baby bump had proudly stood. The speed at which the motionless tiny baby was retrieved and bundled into blankets then finally a glimpse shown to the mother. A high-pitched plaintive cry from the shocked newborn. Exhausted and emotional sobs of relief from the new mother in response to the cry. Then began the long process of repair, stitching up the multiple layers of damaged tissue and muscle.

At this point I feel I should confess a few minutes of the repair process escape me, due to temporarily passing out. I am almost certain that this is not comforting to the poor patient who is unaware of what is happening from her waist down, and is something I really need to work on!

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A Matter of Class

I ran into one of my new ‘house mates’ in the shared kitchen of my hospital accommodation earlier. And being the slightly neurotic, introspective character I am, have re-hashed the meeting over and over again in my head, and come to the conclusion that I don’t think I like her much. For whatever reason, despite being a fellow but senior Cantab, she assumed that I was a student from the local polytechnic (which also sends medical students to this hospital). That by itself is a relatively harmless comment that I usually take as a complement that I don’t conform to the common perception of Cambridge students as being stuck-up, posh, a***holes. However, once I corrected her, her tone of voice segued into friendlier chummy notes, and she began to reminisce about the course.

Now this by itself may not seem like a big deal… someone being friendly, oh dear! But it’s exactly this kind of hypocrisy and judgement that I meet all too frequently studying medicine, when I sometimes feel I have been mistakenly identified as a member of a privileged boys’ club. There may not be the gender barrier amongst most medical professionals now that there once was (at least if you exclude surgery), but there still very much exists a divide between doctors and patients, and even between Oxbridge-trained doctors and other doctors, which is ultimately due to perceived class and snobbery. This riles me because I come not from a privileged background like so many of my colleagues, but instead a hard-working ‘salt of the earth’ family in which I was the first to go to university after attending a relatively rough comprehensive school. This is just one of the reasons why I often feel like the mole hiding amongst the elite, hoping that no-one will notice that I hold my cutlery incorrectly, don’t own a pony, and would never EVER vote Tory.

Slow Progress

As much as I would love to be able to describe my day working in the hospital, the interesting new things I’ve learnt as a medical student or inspiring people I’ve met, I’m unable to. At around 2am this morning, still fully awake in bed, I gave in to my anxiety. We agreed that I could fall asleep on the condition that I didn’t go in today again, thus relieving the anxiety immediately. With this great weight lifted, I soon fell into a deep slumber until late morning.

So what I can comment on instead is the beauty of the autumnal trees I passed on my walk into town. The afternoon sun low in the sky, casting a beautiful warm glow over the ochre, russet and persimmon trees and leaf-strewn fields. The grey squirrels and small flittering birds dancing amongst the branches and in the undergrowth.

I can probably count on one hand the number of times I made eye contact or otherwise engaged with people today. Losing myself amongst the crowds in town did little to relieve my loneliness, merely emphasising the divide between the happy groups of friends light-heartedly chatting, and me. The disconnect from reality and others felt more palpable today than previously, and combined with a feeling of dizziness when I turn or tilt my head I’m suspicious that these changes are due to recently switching brands of my antidepressant medication.

Tomorrow I must go to theatre, even if I can’t sleep a wink tonight. I need to perform and have signed off by a senior doctor five bimanual examinations. This by itself wouldn’t worry me except for my fear of fainting in theatres, which I have done so on several occasions meaning I now expect to faint and therefore try to avoid the situation.

It’s amazing and somewhat humbling how fear conditioning transcends species, from deliberately conditioned lab rats to normal functioning humans. Whilst originally a practical and essential survival tool, for some like myself with anxiety or those with phobias, the primitive brain circuitry that triggers off a fear reaction to a conditioned stimulus or situation can be counter-productive even to the point of disabling in today’s world. It sometimes feels there is a battle between ‘me’ (my conscious thinking brain which is deciding on which of these words to type) and ‘my brain’ (the anatomical grey cauliflower shaped mass I see in dissection class or the mortuary). Having tried unsuccessfully to  explain this concept to several people, and being looked at as if I should be diagnosed with further mental health disorders, I have recently been keeping my theories quiet!