"There's no heart beat."

OB/GYN is a long, difficult rotation with a lot of complications and catastrophes.  A lot of doctors say pregnancy is one of the hardest things someone can go through in a physiological way.

Gametes become a zygote, an embryo starts growing, and a foetus begins to develop.  The placenta is growing as well, and must be healthy, find "good real estate" in a healthy uterus, and the spiral arteries need to find a good place as well, or pre-dispose a patient to pre-eclampsia and a high risk pregnancy.

Probably the most formative time on my OB/GYN rotation was on the OB part, where I met a lot of patients with high risk pregnancies at every stage of gestation, ranging from a few weeks to nearly post-term.

Pregnancy can be a very happy time for some people, but also scary for some who have gotten pregnant after a lot of times without success due to some immunological, anatomical, or physiological problem, and scary for those who have not had successful pregnancies in the past.

I remember when I had seen a patient who came for an OB visit and we were trying very hard to find signs of a viable pregnancy.  There were a lot of delays in the visit, like waiting on the right equipment, waiting for a team member to finish seeing a patient, and so on.

You could feel the worry of this patient ripple through the clinic.  I nearly felt as worried as her as more and more time went on.  We didn't have the best equipment at hand, and it took an experienced doctor a bit of work to get a good ultrasound.

It took us a long time and we weren't sure we could find a heart beat, but the gestational sac wasn't collapsed.  At one point we were all thinking there wasn't a heart beat and were about 99% certain, but we wanted to keep trying.  We moved the ultrasound here and there, twisted the probe this way and that way and most of us were getting uneasy.  Our patient was probably going to start crying.

We didn't give up.  We kicked on the Doppler function, spent more time making adjustments, and finally saw something promising.  This patient was going to have the baby they wanted for the longest time.

I had a good bond with this patient during their visit, even though I'll likely never see them again.

As a med student you have more time than anyone on the team because you don't have the extra responsibilities of a resident or the experience that enables you to work more quickly, so use that time to make your patients comfortable, take a good history and physical, and make sure you get what they need.

If you connect with each patient of yours in whatever way it is, you're helping preserve humanism in medicine.  It's hard with the time constraints, but it makes practicing medicine wear you down less, and it actually helps build your reputation in your community.