Call the OB PA!

Nine months to become a human. Nine months in obstetrics, and I still feel as new and dazed as the infants I see seconds out of the womb. I leave in darkness, bike through Central Park to an express train, and emerge from the subway into a different borough. The city skyline looks like flames touched by early sunlight in the distance. I enter a short-staffed hospital and am soon pulled and stretched to every unit. Moving from obstetric and gynecologic issues that walk into the ED downstairs (sometimes rushed to the OR for ectopic pregnancies or ovarian torsions), to labor and delivery triage, to screams and coaching in the laboring rooms, and to the obstetric ORs for scheduled and emergency cesarean sections. The calmest area of the hospital we oversee seems to be postpartum, until someone seizes or starts hemorrhaging. I try to embrace the quirkiness of my fate. Queens. A goulash of cultures, languages, and immigrants. All New Yorkers; quick, blunt, and sharp. Some harsher than others. My skin grows thicker each shift as I deal with a community hospital's lack of amenities. Why did I choose medicine? A hierarchical structure with bullying and belittling, where pleasing one person disappoints another. An adolescent Roma girl labors in a nearby room. She speaks a dialect only our Romanian chaplain can decipher. The younger mothers always go quickly. She was a mere 5 cm last time I checked. Her water breaks. My scrubs are soaked in amniotic fluid. Sometimes during a night shift, I get a chance to rest my eyes. Hopefully, there aren't many alarms or codes called. Ideally, just the galloping sound of happy, healthy fetal heartbeats from nearby labor rooms. "Rapid response to the main lobby, first floor." This almost always means us. "Call the OB PA! We're in the elevator with a pregnant woman!" I hear her screaming in the background. I ask the frantic messenger how many weeks. "She only speaks Bengali...." The baby is out and crying when the doors open. We rush her into the closest room to deliver the placenta. I have caught babies after just one push, delivered little ones whose umbilical cords are strapped around their body like a seat belt, Kazakhstani babies, half Polish/half Dominican babies, Haitian babies. Sometimes a little head floating, suspended behind a delicate membrane until their own shoulder breaks the bag. One thing I did not expect was how different each umbilical cord would be. Some thick and gelatinous, some coiled tight as telephone cords, some long as shoestrings wrapped four times around a little waist like a miniskirt, and occasionally some tied in a true knot. Once, a little hand popped out of the low transverse incision in her mother's abdomen, gripping the cord tightly in her fist. In another instance, as we delayed cord clamping, the infant's first moves were to try to snatch my suction, or any surgical tool in reach. They are the miracles, the drama queens and kings that make Labor and Delivery a rush of adrenaline. So much can go wrong, though. Delivery rooms can look like the aftermath of a massacre. My dream of working in OB/GYN has come to fruition, yet it is not exactly as I imagined. The long commutes, the switch from nights to days, and from days to nights. The staff members who are kind to the patients but brutal to me. I am up at the witching hour, charting and stressing and putting out fires. Manhattan is bustling and busy as I walk home from a night shift. I smell bagels and coffee. The world is rushing off to work. The doormen say, "Good morning." I close my blackout curtains and slumber; without an alarm, a code, or baby to wake me.Box 1