This Is Going to Hurt: Secret Diaries of a Young Doctor

by Adam Kay

The opposite is breech, meaning bum-first.

Other terms for ketamine include K, Kit Kat, and Special K. Although if she’d told me she was having Special K every morning, I may well have missed the reference.

Total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH BSO) is the removal of the uterus, cervix, tubes, and ovaries.

Primip (short for primiparous), meaning first pregnancy. Multip (multiparous) for subsequent pregnancies.

Status dramaticus—Medically well but overemotional.

pessary

Twins occur in 1 in 80 spontaneous pregnancies—they’re

Chances of triplets are 1 in 80 squared (1 in 6,400),

quads are 1 in 80 cubed (1 ...

Adhesions are bands of internal scar tissue caused by previous operations or, sometimes, infections. They can cause pain for the patient and also make subsequent operations much harder by gunking together all the organs.

Colposcopy is a fancier way of doing pap smears—having a look at

Cesarean sections are much more difficult for premature babies. The lower segment of the uterus, which you normally cut through at full term, doesn’t properly form until around thirty-two weeks. This means you have to go through a much thicker part of the uterus, making it a harder and bloodier procedure.

Placenta previa is a placenta that is attached at the lower part of the uterus.

Cervical cerclage is the treatment for cervical incompetence—a slightly horrible, cervix-shaming term for when the neck of the womb opens far to early in the pregnancy, causing late miscarriages or very preterm births. The cerclage stitch is inserted during the first trimester of pregnancy and hopefully holds the cervix shut until just before full term.

Marsupialization is the treatment for a Bartholin’s abscess (an infection of the glands that provide vaginal lubrication). You create a pouch to help the abscess drain, hence marsupialization, like a genital kangaroo.

You want your blood pressure to be under 120/80 mm Hg (aka millimeters of mercury). If you stuck a glass tube full of mercury into your heart, it’s the number of millimeters the pressure would push the level up—though these days we use a slightly less invasive method to measure it. The top number is the pressure when your heart is going lub; the bottom number is when it’s going dub.

Shoulder dystocia is one of the scariest experiences for an obstetrician—the baby’s head delivers, but the shoulders get stuck. All the time this is going on, baby’s brain isn’t getting any oxygen, so it’s a ticking time bomb of a matter of minutes before irreversible brain damage occurs. We all train regularly in how to manage this particular emergency. Embedded into our brain stems are all manner of mnemonics to help us through it, and all sorts of physical maneuvers: exerting suprapubic pressure, McRoberts (hyperflexing the legs), Wood’s screw (rotating the baby by its shoulders), delivering the posterior arm.

Abruption is a complication of pregnancy where all or part of the placenta separates from the uterus. Because all of baby’s oxygen and nutrients are delivered via the placenta, this can be extremely serious indeed.