Don's diary: delivered into rude reality

January 17, 2003

Six months
Teaching starts with first-year medics. "So when does it drop?" asks a man being taught to take patient-centred case histories and develop his communication skills. My GP warns that home birth puts babies at risk - he attended one that went wrong. Perhaps a limited evidence base from which to generalise?

Seven months
Will my ligaments, slackened by two pregnancies, hold up as I lecture on the doctor-patient relationship? Students are incredulous at examples of doctors who dismiss mothers' knowledge of their own previous pregnancies.

Eight months
Lecture on ethnicity and racism to 140 local students and video-linked to others in Leicester. I cannot speak authoritatively sitting-down - so instead, hidden behind the podium, I rock my pelvic floor.

Nine months
A research student wants to discuss my pregnancy more than her writing. She is an expert, compassionate midwife, experienced in clinical note-taking but she has not written essays since she left school aged 15. With limited knowledge of grammatical and syntactical sentence construction, should she have been enrolled as a research student?

Birth day
Driven to hospital by the midwife. A home birth is off-limits due to the baby's dipping heart rate.

I am missing my students' final presentations. Instead, a consultant obstetrician is trying to break my waters, apparently with a crochet hook. Semi-naked and prone, I nonetheless get him to withdraw and describe what he is up to. The released waters contain meconium (faeces stored in the baby's bowel during gestation), necessitating, in the consultant's view, an emergency Caesarean. Do the midwives agree? They nod. I sign consent papers. Wheeled to theatre past posters explaining National Health Service policy on obtaining fully informed consent. Wake up attached to a drip, drain and catheter and with a perfect daughter.

Birth + one day
"We've just read your notes - you're lucky to be here. What a rough ride!" What does the night-shift midwife mean?

Birth + three days
I still do not know. Of the dozens of clinicians I have seen, none except the physio introduces herself, and none had attended the birth. The young anaesthetist and paediatrician run through a checklist of questions on behalf of their seniors. The junior obstetrician discharges me without a visit.

Birth + four days
Today the students are sitting the "Molecules" exam that they have dreaded all semester. Their crammed knowledge of biochemical reactions may prove as little use as theories of the doctor-patient relationship when it comes to treating patients humanely under the hospital system. Does university teaching have any effect on students' ability to communicate? Research evidence is patchy and equivocal.

Birth + seven days
Community midwife takes out stitches. Scar pronounced "lovely". If I obtain a copy of my notes (cost: £50), the research student midwife will interpret them for me (over red wine). In return, I try to bring order to her report's sentence construction.

Hannah Bradby is lecturer, department of sociology, Leicester-Warwick Medical School, University of Warwick.

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