Trying to wind down enough to take a nap, three hours past the end of a 24-hour shift on the Labor & Delivery “deck”. It was steady, with bursts of frantic activity.

And always, gnawing at the hind-brain like a parasite, there’s the stress of wondering what might come through the door next. Labor and Delivery, by its nature, serves young women healthy enough to carry a fetus to term. But pregnant women are prone to a host of problems that can make their anesthetic care a nightmare. Ours is a high-risk OB unit, so we get more of those than at the average facility.

On the (thankfully) rare occasions that they try to die, pregnant women tend to do so in dramatic fashion – often involving teen-slasher-flick buckets of blood, or airways that can’t be intubated, while the pulse oximeter’s pitch drops from alto to soprano to tenor to baritone to bass, tracking the oxygen saturation downward into depths that signal, for all to hear, that the shit has well and truly hit the fan. Even worse, two lives could be extinguished when things go south.

Luckily we didn’t have to deal with any of that. I finally went to bed just after midnight, after placing two epidurals. Got three hours’ sleep before being awakened at the really-awful, low-cortisol hour of 3:30 am to place yet another. Amazed I could find the patient’s room. Luckily, at this point, the hands don’t need a lot of guidance from the brain to place a labor epidural.

Nature of the job I signed up for. I’ve been doing this sort of thing for so long I wonder if it will ever feel normal not to do it one of these days.

Michael Sebastian @mikeseb