The life and moods of a Gynaecologist

The life and moods of a gynaecologist are so unpredictable. I can feel super proud for something that went right, though I knew it was my luck that nothing bad happened. And I can beat myself up for days for an unfavorable outcome despite giving it my all. It's hard to be the one holding the reigns to the human body; it cannot be fully tamed. 

What even determines success or failure in a case? The exact same protocol used for two different humans hardly end in similar results. How should anyone predict what would work for whom?

And patients and families expect answers with such pinpoint accuracy. Will the mother be okay? Will the baby be okay? What time will she deliver? How many hours left? How long will the operation take? How many days will it take my infection to reduce? And such details.

We have so many patients in prolonged NBM that whose surgery we keep postponing. But also, we have patients whom we never asked to stay NBM and whose surgeries are so unpredictable that they end up having a risk of aspiration. We counsel a patient for normal delivery and end up rushing them to section ourselves. We counsel them about the risk of oligohydramnios or twins and how many risks those pose to the baby, only to ultimately lose the mother to an AF embolism. We counsel multiparae about PPH and how many blood packets they'll have to keep ready in order to prevent/postpone death, but their uterus ends up retracting perfectly like nobody's business. We counsel patients about the risks and problems of anaemia and instead, they end up having severe, life threatening reactions from the iron we transfuse.

We have guidelines about how a mother's height and a baby's weight during a delivery, but regularly end up doing emergency Caesareans even for tall mothers and small babies.

We think of and prepare for 999 different possible outcomes for a particular mother, yet sometimes, we're surprised by the 1000th one.

For decades we've been reading endlessly about how to 'doctor' correctly, and still can't answer any of your questions with absolute certainty. Let me be honest, this field instills deep rooted fear in me, that I'm sure I have in common with most doctors who have enough experience to share this apprehension.

After all the years of book reading, and information collection, all I can really say is what's most likely to happen or not, and there's no way I can predict whether any single patient falls into the norm, the predictable subset, or falls way outside of it and behaves differently due to some chance events. The body reacts to situations and medicines however it feels, and there's only so much we can do to alter it. All the information we have is really just a careful observation of many, many patterns-- that gives us an illusion of control. 

And with this illusion of control, we manage to do a better job than any lay person would in our place, which is all that gives us the authority to impart advice and sometimes call the shots. 

But hearing that a patient thinks of me as a God? This is another thing I fear deeply; none of us are God and we don't aspire to be. We don't even want to hear that; that's too big an expectation placed on our perfectly human sized heads. Please don't crush us with it. We're just another flawed entity of God's creation, trying our best to fix the physical flaws/prevent possible flaws in others.