Dr. Monique Rainford, MD
I still remember it vividly although it was more than 20 years ago. I was a medical student rotating in Obstetrics and Gynecology at the Beth Israel Hospital in Boston. I was doing the night float, meaning, I was on several consecutive nights in a row. I have never enjoyed working at night and I often felt tired but despite that, it happened; the experience that changed the direction of my life.
I knew I wanted to be a doctor from the age of seven. I had burst my chin playing and I needed suturing. The kind caring doctor not only fixed my chin but also gave me a reward of a 50-cent coin for my bravery. Shortly after that and for the first two and a half years of medical school I was going to be a pediatrician -up until that day.
I was allowed to participate in a delivery. It was with Dr. Henry Klapholz, not only a great teacher but the director of the Obstetrics and Gynecology residency program and the course director for the third year clerkship at the time. I got hands on experience of the awesomeness of bringing a baby in this world. I was humbled to share in this intimate moment with the couple. They were a French couple and I will always remember their tears of joy at the birth of their baby.
I could not get the experience out of my head, but I had to convince myself. Being an obstetrician and gynecologist could be a hard life, certainly a hard residency. But from that moment it was already too late. The die was cast. It was what or who I was meant to be. I thought it was my life calling.
But something changed along the way from those early experiences in medical school to today. I still enjoyed the special moments building that special relationship with the women who not only chose me as their gynecologist but as the doctor to deliver their babies. I looked forward to the many visits of the expecting mothers or couples and the joy and satisfaction of handing them a healthy baby. However, now I had to worry about being sued not necessarily because of any human mistake or error but for my inability to be “God” and have or effect a perfect outcome every time. I had to worry about being adequately compensated.
Regardless of the time or effort I placed in patient care, the insurance company would decide that it would amount to a figure way too small to make ends meet unless my delivery numbers were high. But if my delivery numbers were too high those essential visits to build relationship would be rushed and it would severely compromise the time that I could devote to my own children and family.
So to achieve that “ balance” I am forced to make choices that almost violate the very essence of my love for my field. Shift based hospital work, which while it may provide abundant delivery experience leaves little time for the relationship building with my patients that I had so loved and cherished, or a large group practice where I may never have met the person I deliver and conversely for the women or couples I follow through the pregnancy the odds of my delivering their baby is low. But if I continue to practice the way I love the income is so compromised that it can only be afforded by those whose ever shrinking earnings is sustainable simply because they have other sources of income. Or those who are prepared to relegate their post as the primary care giver for their children.
So I lament the loss of my first innocent love of Obstetrics and Gynecology but I am committed to find whatever it takes to keep my love alive.