It’s been a busy period trying to juggle multiple projects whilst slaloming around Covid-19. If I had a tragic backstory, I’d try out for Britain’s Got Talent.
I had the pleasure of experiencing my Maternal and Child health block. To be honest, I wasn’t too excited about this at the start of the year. It’s now been one of my favourite periods (hehe) of medical school as a whole.
I realised this around the moment I heard the thumping tempo of Baby Shark (doo doo doodoo doodoo) billowing as a backdrop whilst I examined a little toddler’s abdomen. The song was being played by the consultant. I’d suggest reading my blog post on sexism in the NHS to gauge my usual experience with consultants.
Both expectant mothers and children have this remarkable ability to make you positive (most of the time). I think it’s because, on the spectrum of life, you’re dealing with the early years. A lot of medicine can feel like you’re simply delaying an inevitable bad outcome, managing symptoms but accepting that the underlying condition (heart failure, lung disease, cancer, liver failure) will eventually win. There are certainly aspects of gynaecology and paediatrics that have this unfortunate flavour, but a lot of it is strangely hopeful.
I thought I’d summarise this placement with a learning point from each component. I hope you find some use from it.
Obstetrics and gynaecology: mansplained
Okay, the title is ironic and I hope this won’t feel like mansplaining. However, as someone who does not possess female anatomy (or the problems that come with it), this placement was an exercise in shutting up and listening.
To any male medical student who may be approaching their O+G placement with any mixture of anxiety, trepidation, or even disinterest, I offer the following advice:
- Listen. Just be quiet and listen. Everything from the difficulties in selecting contraception, to the bad experiences patients have, to their descriptions of sensations you will never feel (what even is a “dragging sensation in your pelvis?!”) It’s the best way to learn the patient experience and will help no end in remembering the complex pathologies.
- You can still empathise, but you might need to tweak it. I liken this to any patient experience that I myself have not shared. The best you can do it try to compare it to something you have experienced, and also don’t pretend you know exactly what the patient is going through. “I obviously have no personal experience with what you’re going through, but it sounds like its significantly impacting you. Let’s talk about it” is the idea here.
- Look out for bad practice, because it exists and isn’t talked about. I remember reading the MBRRACE-UK report (https://www.npeu.ox.ac.uk/mbrrace-uk/reports) that identified some serious racial disparities in maternity care. I also had the unfortunate experience of a clinic with a male consultant who needs a bolus dose of empathy straight to the brain. These issues exist and, considering how vulnerable O+G patients can feel (especially with male staff), it’s important to look out for this.
I’m of course just a student, still learning how to negotiate these issues, and I present this as discussion points. I’d also like to say that the majority of staff working in O+G are fantastic, and genuinely lovely people. Also, pregnant abdomen exams are super fun and banter with expectant fathers is quite something.
Paediatrics: fluids from every orifice
The first thing that struck me about paediatrics was the staff. They are all so damn lovely. Some stereotypes are unfounded, but this one is somehow an understatement.
The second thing that struck me was how fun paediatrics can be! Regardless of whether you like children or not, the fact that they have no filter, no shame and little-to-no control of their bladders (depending on their age) makes every consultation a new challenge. I’d never before been told, when asking a patient to cough (to check for hernias) that they’re sorry, but they “don’t need to cough right now*”.
I’ve also seen the sadder side of paediatrics. A child with a fracture- an accident, or possible abuse? A child with a chronic illness, far more comfortable with needles and stethoscope than they ever should be at that age. Paediatrics makes the happy moments happier, but also the sadder moments that little sadder.
(*I called the little tyke’s bluff and asked them to lift their head up, another way to tense the abdomen and check for hernias. “Are you smarter than a 10 year old?” still haven’t returned my call)
My advice for this part is quite brief: remember that a child is developing in all aspects, meaning they are so much more than their illness. I asked the mother of a child who has Down’s syndrome what advice she would give for me, and she simply said: “he isn’t “The Down’s Child”. That doesn’t define him. He’s a person who can do so much more than some doctors think.”
And honestly I think I’ll leave it at that.
Oh and also, prepare to get some sort of bodily fluid on you. Probably wee.
Hardeep Lotay 