[Tamar Braxton - The One]
[Album: Love and War]
which samples...
[The Notorious B.I.G. aka Biggie Smalls - Juicy]
[Album: Ready to Die]
Tamar:
"'Cause I don't look that far. Look where we are."
This past week was my final one on the Gynecology service, and it was a good one.
What has probably caught me most off-guard about GYN and this whole OB/GYN experience altogether is the amount of Surgery involved. For some reason I had the biggest misconception that OB/GYN would be overwhelmingly Medicine with but a hint of Surgery on the side. A garnish.
I've realized that the split between Medicine and Surgery is nearly equal if not, at times, slightly skewed in Surgery's favor. Of course I may be biased from my past 2 weeks. As far as Obstetrics v. Gynecology goes the GYN service definitely sees more Surgeries and a greater variety of it.
Well. Good thing.
I love Surgery. YOLO.
Biggie:
"Spread love...it's the Brooklyn way."
crate --
}}} Hysts on Hysts on Hysts.
I feel as if I've seen so many Hysterectomies that it's a wonder any uteruses (uteri?) are left in the world. I am exaggerating of course but it seems as if removing wombs is the mainstay of any Gynecologist's surgical repertoire. This is one mass-produced Crate and Mr. Ford would be proud.
There are a number of indications or reasons for performing a Hysterectomy...ranging from severe, uncontrollable bleeding to endometrial cancer at the most dire end. By far, however, the most prevalent indication I have seen (and what I believe is the most common one) is for symptomatic Uterine Fibroids...which, yes, in most cases results in the aforementioned uncontrollable bleeding.
Tamar:
"Without you I'm incomplete."
But won't they lose the ability to get pregnant and bear children?
Yes. But fortunately, Patients requiring a Hysterectomy are (most often) Post-menopausal and have either had all the children they desired or have already lost the ability due to the inevitable course of nature and time. This is not to discount the fact that younger women have, very unfortunately, had to receive Hysterectomies as well -- a reality which ranks high on the list of tragic circumstances I wish never existed. All of the Hysterectomies I have seen were, thankfully, in older women who would not miss the priceless ability to bring another life into the world. Though no major Surgery is desirable per say, in the Patients I have seen the procedure was life-saving and took away nothing but a spare organ that was no longer functioning. Thankfully.
Biggie:
"Uh, damn right I like the life I live.
Because I went from Negative to Positive."
As I mentioned in the previous post it is possible to use the Da Vinci robot for Hysterectomies. I've had the privilege of seeing both robot-assisted as well as the conventional 'open' version of the Hysterectomy. There are also different types of Hysterectomies where the one I have most commonly seen is the Total Hysterectomy, followed closely by the Supracervical Hysterectomy where the cervix of the Patient is spared.
At the end of the week I realize there is no better way to learn something than to actually and personally experience it. We took anatomy as first year medical students but I have never understood (as fully as I do now) the relationships between all the ligaments, nerves, and blood vessels that are within and around the human uterus. Just like the confusion that may follow the use of a professional moving service it's hard to remember and comprehend from hearsay rather than from one's own memories.
What better way to get to know these Anatomy Crates than to pack and ship them yourself?
Despite these Hysts being life-saving. Despite these Hysts having no consequences as far as fertility. Despite these Hysts resulting in little to no Post-Operative complications. I still can't help but wonder what it's like to lose an organ. Yes. Just tissue. Unconscious, non-self-aware cells and mitochondria.
But it's still a part of oneself. What is that like?
Any kind of loss -- physical, mental, emotional -- is bound to hurt. Right?
Tamar:
"I don't want nobody else.
Baby, all I need is you."
}}} The Ovarian Cancer National Alliance. (www.ovariancancer.org)
We have required OB/GYN lectures every week. And that is just what they are.
Lectures. Schmectures. Crates.
This past week, however, we had the greatest privilege of having a presentation from members of the OCNA. It changed the tone of everything. It was the most organic and unpredictable Crate you will ever see.
Many of them were Ovarian Cancer survivors and the rest experienced the blight of Ovarian Cancer within their loved ones. As such, not only were we taught the facts and statistics regarding Ovarian Cancer but some of the presenters would periodically share very personal stories and experiences to highlight just what it is like to experience that which is unwanted and unexpected and in every way terrible.
It's as if they were shipping Crates of Hippos. We learned. Then you opened the Crate to find the surprise Hippo -- and it surely took everything you had to hold back the mixture of surprise and tears and anger. Each personal story seemed to be more tragic and emotionally draining than the last.
Watery Eyes and Clenched Fists.
For the record, here is the most pertinent part of the Crate:
Ovarian Cancer Symptoms
1.One = Bloating
2.Two = Pelvic/Abdominal Pain
3.Three = Difficulty Eating or Feeling Full Quickly
4.Four = Urinary Frequency or Urinary Urgency
Ovarian Cancer is often missed and is, unfortunately, often diagnosed too late.
But you know what?
I'll always remember that Presentation for Ovarian Cancer.
What better way to learn than through Memories and Experiences?
Emotion can make things stick that books and lectures just can't.
Any kind of loss is bound to hurt.
Biggie:
"No heat. Wonder why Christmas missed us.
Birthdays was the worst days."
hippo --
}}} Why is Loss the ultimate Teacher?
Watery Eyes and Clenched Fists.
The strangest thing about all this is that we actually had a formal lecture on Ovarian Cancer earlier that morning. The presentation from OCNA was the last item on the agenda. By that time we were all hungry and restless and usually any lecturer to come at that point would have the hardest time holding our collective attention over our Hippo-loud bellies. Peristalsis to the max.
Admittedly, I did not remember anything about Ovarian Cancer from that formal lecture. (I accept all responsibility for that.) Yet. With hardly any pure mental effort I learned and still remember all the facts regarding Ovarian Cancer from the OCNA presentation and from the stories that were shared.
Every one of the presenters that chose to volunteer their personal experience did so willingly and painfully. It was obvious that despite the emotional scars being 'healed' that every word and memory they forcefully resurrected only served to lacerate their deepest wounds even further.
Why?
Tamar:
"It felt so personal.
You took the chance to get my love and now you know."
You know what? It doesn't matter why.
Just, Thank You.
Perhaps it was to fully and excruciatingly illustrate what it is like for those who may never experience it. Perhaps it was to break the monotony of a lecture -- a plain brown Crate -- and add the spontaneity and relative warmth of the Hippo human condition. Perhaps it was a form of personal healing for themselves....a chance...another to attempt to heal what may never be healed.
In all honesty it is likely to be all of the above.
Just, Thank You.
Biggie:
"Don't let 'em hold you down. Reach for the stars."
A colleague of mine, following the OCNA presentation, remarked how he wasn't ready for that one. It made me think that, with all that we know and don't know, we're probably never ready for 'that one'.
How do you prepare for Loss?
How do you prepare for something that you can only begin to understand after the frustrating fact?
Biggie:
"'Cause you're the only one. I'll give you good and plenty."
It was the big Hippo in the room. The specter and reality of loss. A lot of the time (and I will speak for myself here) it is gratifying to think of Medical School as a means to save lives. As we delve further and longer into these 3rd Year Clerkships it becomes clearer and clearer how much of a protective bubble Medical School really is.
Now I don't mean to burst this bubble for the sake of the burst. We are surely acquiring tools and attitudes -- Crates and Hippos -- to save lives. But perhaps we should not only learn about Living and Healing but do our best to learn what it is like to experience Love and Loss.
Tamar:
"And ain't none like you. One in a million.
But I'm the only one to count You."
Whether it's part of the Crate-y curriculum or an unintentional and inadvertent surprise Hippo it seems like Medical School provides the means to acquire what a physician will need to care and understand the human condition as best as she/he can. Whether it's a your favorite football team, or a Uterus, or a Life...
Any kind of loss is bound to hurt.
Yet Loss is the ultimate teacher.
It's really hard to forget. Maybe that's the point.
Biggie:
"And if you Don't Know, now You Know."
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