Confessions of an Intern

Week Twenty-six

O...M...G...Delivering babies is scary! So, I have gotten over the initial shock of what to do when catching a baby. Thankfully those first couple of encounters went as naturally as possible, so there was little intervention needed on my part. This week, I worked in the Newborn Nursery, but really, my main responsibility was learning and performing circumcisions. Thankfully, newborns are healthy for the most part. I don't work in the NICU with the sick babies.

Most of the baby boys I see end up circumcized here in the midwest hospital I work in. I understand that there is a coastal trend away from it, as there isn't a medical need for it. It is primarily a cultural, or aesthetic choice. Often, it is a desire for the boy to look like their dad. Interestingly, I performed the procedure on one little boy specifically because his dad was not, and he wanted the boy to be. I am duty bound to share the facts as we know them and answer questions. I was in charge of the informed consent as well, telling each parent(s) that the risks include bleeding, infection or an unsatisfactory cosmetic outcome.

I had two different attendings (if I haven't clarified attendings for those who don't know, they are those who have been doctors for some time, teachers if you will) and they both had a different take on the procedure I was performing. We do two different styles here, Mogan clamp and Gomco. Both have been around awhile and have very nice outcomes. My second and third procedures (ever!) were done with an attending with Parkinson's (so not a lot of help with the fine motor details) and with the fathers of the boys watching over my shoulder. Number two followed Murphy's Law, what can go wrong will...but in the end, the father and mother were satisfied we had done our best and the baby was fine...there was a little bleeding involved, and I did not maim the poor little thing! The next one went off without a hitch of course. Have I mentioned healthcare professionals are often superstitious? Well the one I had problems with was the baby of a healthcare worker. It seems they always have to be the ones there are issues with.

At the end of the week, I have met the requirements for each type of circumcision, and am able to them on my own. This is good, but I have decided I like the speed of the Mogan. The Gomco is great for those that like it, but it takes a good 5 minutes longer (which is an eternity when you have strapped down a little guy to a cold plastic board away from his mama. And yes, we use anesthetic and "sweeties", a sugar solution we fondly refer to as baby crack. These often allow for him to sleep through the procedure, but if the fella is going to cry, they will cry regardless, usually starting before he is ever prepped for the procedure.

I'd be interested in hearing what the concensus is on your thought on circs, or if you have any questions.