Nur360 clinicals day 3

I spent the day in Lake Champlain OB-GYN and Midwifery Services today. All in all, quite boring. The midwife I was supposed to follow ended up having the day off. So, first I spent 30-45 minutes sitting in her office. (They gave me a stack of charts to look at--woohoo!) Then I was ushered over to the office of a general family NP, who I thought I would be following. But, although nice enough, for some reason she didn't seem to want me shadowing her. So, after talking with the NP for 10-15 minutes, I was shuffled over to an OB-GYN doctor with whom I saw about 8 ob patients (I wasn't invited to observe the colposcopy). He was very efficient, almost machine-like. This makes for good business, but isn't so interesting to observe.

The most personally significant event was one visit with a mother who was, well... a babe, in modern bachelor parlance. This cinched my belief not only that I am completely wrong for maternity nursing but also that men are in general. In pediatrics last semester, I took care of one 17-year-11-month-old patient who was pretty but it was my first clinical rotation, and I think I was keyed into wondering about this issue. I haven't had a younger patient in med-surg, but with older med-surg patients I am able to turn off that switch in my brain. Not so in obstetrics. With all the femininity, babies-talk, vaginas, etc, everything about the situation says "reproduce!" so that on meeting attractive women it is not so easy to turn off that switch. Even if there are some guys who could function in this environment, I don't think it's fair to women to have to wonder.

I was supposed to go home at noon, but I went back to the office after lunch so I could meet a C.N.M. I was able to take in two visits with her, both with patients who had complicating medical problems and one of whom I knew, so I felt this was a good use of time. Plus, it turns out the C.N.M. ran the Lamaze class my mother took when I was born! She seemed like a highly competent person, but I was really hoping to see the midwife who ran the delivery I saw last week. They share an office, and I note that her bookshelf had a few too many books of too old a vintage for there not to be some sort of antiquarian-scholarly-nerdy-collector interest there (id est cool and intriguing to me).

The office (which is shared with a third midwife as well) also has a print hanging on the wall above aforementioned bookcase with the inscription "And the midwives feared God and did not as the king commanded them, but saved the children alive." In case you don't recognize it, this is derived from a passage from the first chapter of Exodus--
ותיראן המילדת את־האלהים ולא עשו כאשר דבר אליהן מלך מצרים ותחיין את־הילדים׃

I find this a very odd print to have in the office since, as I discovered using the UPIN registry, cool midwife also seems to be registered at Planned Parenthood. The print differs from the usual translation of the Exodus text on two important points: it removes "of Egypt" from the mention of the king and the modifier "male" from from before "children." These changes de-contextualize and universalize the text. I think that they're supposed to be liberalizing--midwives fight the power ("the king") on behalf of the women (not those boys!)--and that this is the spirit in which the print was hung. However, the changes really serve to highlight the point of this passage--"...the midwives feared God and... saved the children alive." The meaning still cannot be changed if universalized to a secular context--the midwives' emotional and ethical response led them to save the children. In a pediatric office, this print could have a different meaning, but in an obstetric office, there can be only one. How could someone miss it?
And the king of Egypt spake to the Hebrew midwives... And he said, When ye do the office of a midwife to the Hebrew women, and see them upon the stools; if it be a son, then ye shall kill him: but if it be a daughter, then she shall live. But the midwives feared God, and did not as the king of Egypt commanded them, but saved the men children alive. And the king of Egypt called for the midwives, and said unto them, Why have ye done this thing, and have saved the men children alive? And the midwives said unto Pharaoh, Because the Hebrew women are not as the Egyptian women; for they are lively, and are delivered ere the midwives come in unto them. Therefore God dealt well with the midwives: and the people multiplied, and waxed very mighty. And it came to pass, because the midwives feared God, that he made them houses.

No comments:

Post a Comment