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Gratitude is a wonderful thing, but in medicine it’s often weirdly disproportionate to the service rendered. As a junior doctor in neonates, I had to attend dozens of deliveries: every instrumental, every slightly premature birth, every faintly meconium-stained liquor.
Nine times out of ten, the baby would be completely fine. The obstetrician would pass it over and I’d dry it, do a quick check, and then wrap it up in a clean towel and hand it back to its anxious parents.
Quite often, they were hugely, embarrassingly grateful. I was never quite sure what to say – it felt dishonest to accept fulsome thanks for, essentially, wiping a healthy newborn, especially when the midwife, fully aware how little I’d actually done, was trying to catch my eye and make me laugh.
Just occasionally, though, things went differently. Instead of relieved smiles as the baby opened its mouth to scream, I’d see fear in the eyes of the obstetric team as they bundled a floppy, unresponsive little form onto the resuscitaire.
That’s when training takes over. Start the timer. Dry, stimulate and assess. Inflation breaths, watching carefully for chest movement. Reassess, and consider chest compressions. By this point, at least one of the baby’s heart rate or the SHO’s will be over 100, and if it’s the latter then hopefully help is on the way.
It’s a scary few minutes, but when it goes well it has to be a contender for the most satisfying thing in medicine. To see a silent, grey infant pink up, flex its limbs and take its first startled gasp is an extraordinary moment, and all the more so when you know you’ve helped bring it about.
So it’s a slight anti-climax when, after making sure the baby’s definitely got the idea about breathing, you proudly hand it over to its mother and get a casual ‘Thanks, Doc’.
I try to think of it as a compliment to the professionalism of the team if the parents haven’t realised there’s an emergency in progress. While it’s mildly disconcerting to have a dad leaning over your shoulder and saying ‘Do you always do that?’ when you’re trying to ventilate a baby, it does prove that the team has managed to stay calm, at least on the surface.
Most of medicine’s real successes are achieved without drama: when lives are saved by careful management of anticoagulation, or smoking cessation advice, or vaccination, no-one sends a thank-you card or chocolates. When the system works well, it’s hardly worth noticing with a ‘thank you’. Sometimes a doctor’s greatest successes may be totally invisible to their patient – and there’s nothing wrong with that.
By the Secret Doctor. Read the blog and follow @TheSecretDr on Twitter and on Facebook
that slight pang of disappointment when a procedure well done goes unnoticed - totally agree!
we accept and just move on .
I recall feeling bewildermenton on receiving copious thanks, thinking that I should have done better; that the outcome, despite my intervention, was failure.
Deliveries in general are one of the highlights of paediatrics, every single one moves me, even after decades of experience.
Fully share the sense of relief and achievement when a poorly babe improves, though sometimes this doesn't happen in the delivery room, but after months of intensive care. Equally, if delayed, joyous, satisfying and justifying the sleepless nights and hard work. Ours is the best job in the world!!