When the alarm went off in the pre-dawn hours, Tom Mitchell knew that a very long and very tiring day lay ahead. It wasn’t unusual for OB/GYNs to frequently take on 24-hour shifts, and today was Tom’s turn in the cycle. Even his senior status as the department head of Women’s Care at Caduces Memorial did not grant him amnesty in that area. He had to pull his weight just like everyone else, much to the older man’s chagrin. At his age, he felt he deserved a little leniency, but by that point, he might as well admit defeat. Despite being one of the best in his field, the hospital had already taken a gamble by extending such a prestigious position to him at age 57 – only five short years ago. He liked to refer to it as borrowed time. If he started to stir the pot too much, they were liable to hand him a severance package and show him the door. Out with the old, in with the new.
He wasn’t quite ready to accept the inevitable, and so, he soldiered on. It might make him miserable, but he couldn’t say that he didn’t enjoy the work itself. That was the only payoff. At least on this morning, things would start out slow. He was scheduled to begin downstairs in the clinic for routine gynecological cases, such as annual exams and infections, which meant he would actually have time for a quick breakfast – a bagel, fruit, and a cup of coffee.
Looking ahead, he had a C-Section scheduled at noon on a 26-year old in her third pregnancy; she had requested tubal sterilization, which required additional prep, but it was nothing too strenuous. Hopefully that would be the only real ‘challenge’ for the day. But as usual, his job was unpredictable.
By the time 10:00 a.m. rolled around, Tom was on his final appointment of the morning, and his third cup of coffee, long after his body had dispensed of the initial energy from his pitiful breakfast. He was running on pure caffeine when he entered the sterile room and immediately sat down on the stool to check the computer terminal in the corner. According to the records he pulled up, the young woman, who was six weeks pregnant with her second child, had some concerns about spotting and occasional abdominal cramps. It sounded routine enough.“So, you’re having some discomfort?”
he asked coolly as he turned away from the computer screen and swiveled the stool to look at her. The woman only nodded. Tom took note of the worry lines etching her face. Was there something else he missed? Or was she just easily distressed? “Where about?”
As she stretched and pointed to her left side, Tom grabbed a pair of gloves from the box on the counter and snapped them to his wrists.
“It’s not all the time,” she started to explain in soft tones, “but when it comes, it’s pretty sharp.” “And this is when you notice the spotting?”
he asked, now pressing firmly around the area she indicated.
“I would say it’s pretty consistent.” She trailed off and involuntarily flinched as his fingers probed an area directly below and to the left of the belly button. He immediately stopped and pulled back to look at her.“Did that hurt?”
A quick shake of her head. “No...no. I’m sorry,” she bit her lower lip and turned away to focus on a spot on the far wall, “I’m just worried, that’s all. I’m really jumpy. I’ve been doing some research on my symptoms and…” She closed her eyes briefly, clearly hesitant. “I found some information about ectopic pregnancies? You know, where the egg implants outside the uterus?”
He nodded, waiting her out.
“Well, I think--I think that’s it.”
Tom exhaled softly, not even bothering to suppress his relief. He could see where this was going. “You think you’re having an ectopic pregnancy?”
The woman studied him for a long moment, then nodded meekly. “Yes…”“Well, I have to say, that’s very rare, if so,”
he stated evenly, now leaning back as he pulled off his gloves. “About 1 out of 50 pregnancies. Where did you get your research from?”
She smiled in spite of herself; he could tell she was suddenly unsure of her answers. “I found this website...WebMe--”
And there it was, just as he suspected. A self-diagnosis courtesy of the world wide web. He held up a hand to stop her and merely smiled. He was used to this; this happened more often than he’d like to admit. The internet was a powerful tool, but it served as a real detriment to health professionals everywhere. “You’re fine, Sharon,”
he soothed, addressing her by her first name to make this more personal. “Next time call the office instead of going down that rabbit hole. There’s too many self-proclaimed doctors out there who think they know everything.”
He wheeled back to the computer, but paused as he rested his hand on the mouse. “Of course, there are some doctors here who think they know everything as well, but at least we have the credentials. We’re not hiding behind a screen.”
His smile widened in jest, clearly trying to lighten the mood. “That should count for something, right?”
She leaned forward and chuckled softly, her worry lines starting to fade. “As for your symptoms, I wouldn’t worry,”
he turned serious once more, his fingers now tapping against the keyboard. “It’s fairly common for someone in their first trimester to experience some bleeding and cramping, but just to be sure, I’ll go ahead and schedule an ultrasound for early next week. We’ll take a peek and rule out any problems then. Sound like a plan?”
“Yes, thank you, Doctor Mitchell,” she nodded with enthusiasm. “That’ll put me at ease.”“Good. Then I’ll see you next week…”
He stood, extending his hand to her in parting. As he gripped her palm, he noted that she was noticeably more relaxed than she was when he had first entered the room. Another crisis averted.
And with that, his morning in the clinic had come to a close.
Passing off some last minute memos to his receptionist, Tom grabbed his last cup of coffee of the morning – number four – and headed up two floors to the lounge and the adjoining locker room. From there, he would change into scrubs in preparation for his afternoon in the OR and his rounds in the maternity ward.