A Place in History

You know how I said that sometimes the complex patients are hiding amongst the forest of more commonplace patient complaints? Well, today I learned that sometimes they don't hide at all. Rather, sometimes they just jump out and smack you in the face. Proverbially speaking, that is.

Let me back it up.

Today started like any other day on OB call. I went to the hospital to round on the postpartum women and babies, found no laboring patients, then headed to the clinic. Right when I arrived at clinic our OB coordinator pulled me aside to ask me how to triage a particular patient. She was a G2P1 who was at 37 weeks and started having some mild contractions early this morning, about every 15 min. The OB coordinator said the patient was not very uncomfortable but was surprised to be having regular contractions at 37 weeks. We both decided to have her come to clinic for evaluation before sending her to hospital triage.

Fast forward 20 min: OB coordinator finds me at my desk preparing for my morning clinic session. "She looks very uncomfortable now and says she has to poop."

I high-tail it into the exam room to find a very uncomfortable woman clearly in labor, clearly about to have a baby on the exam table. Everyone around me is bustling about, but to me it all seems to be slow motion. I check her cervix to find (no big surprise) it completely dilated with the baby's head at the ready. I have the nurse call the paramedics but explain to the patient and the husband that their baby is about to make clinic history (not in so many words). Somehow I manage to coach the woman not to push, and more importantly somehow she listens to me. The medics arrive in record time and take stock of the situation. "Whoa doc, looks like you've got your hands full." I have one medic place an IV (which he does in record time), start fluids, and prepare warm blankets. The other medic prepares oxygen for the baby (Oh yeah! Crap. The baby! Just a few of the thoughts going through my head). Finally the woman (bless her soul) requests to push. In the nick of time I ask for some sort of gown to put on and find myself being wrapped into a backwards large white coat. After delivery I looked like some sort of perverse butcher. The baby is born with 1 push (of course). Thank goodness for the medics who were ready with the infant sized oxygen mask because that little bugger (weighing in at 4 lbs eventually) wasn't doing so hot on his own. But he did let out a feeble cry eventually and pinked up pretty well. After the placenta delivered and mom was stabilized the medics whisked them both off to the hospital. We later heard everyone was doing well. Whew.

The whole thing lasted between 9:15 and 9:45 am, the room was quickly cleaned, and next thing I knew I was seeing my 10 am patient like nothing had happened. But I was informed more than a few times that I will go down in my clinic's history books as the only person to deliver a baby in clinic. Do you think I get some sort of plaque?

Just another day in primary care.