Sign Out: Take heed the court stenographer

I couldn't help comparing the students' enthusiasm with the look I saw in a colleague's eyes a few weeks before. Now part of an all-female practice in Manhattan, this woman had been a partner in our practice for a year. She's very caring, smart, and well-trained. And she's just had her first malpractice suit go to trial. It was a case of shoulder dystocia that required episiotomy to facilitate delivery of the entrapped shoulder. During the trial, the plaintiff's attorney pointed an accusing finger at my colleague and yelled at the jury that she had cut, "yes, cut my client's vagina!"

After relating this story, my former partner told me that she's cut down on her gynecologic surgery and is less enthusiastic about deliveries. Like many ob/gyns, she is suffering from posttraumatic stress syndrome. Not yet 10 years out of residency, this woman is already cutting down on her practice to reduce risk. Forget the amount of money and time that went into her training. This is a person who was staying overtime to make sure her post-op patients were OK while other women her age were out dating and socializing.

I recently talked to a court stenographer who works in a malpractice lawyer's office. I assumed she would be afraid to see a doctor after hearing so many "worst case" scenarios as part of her job. But I was wrong. Here's what she said: "After what I see in here, I'm much more afraid of lawyers. I wouldn't be an ob/gyn if my life depended on it." Even though I desperately love ob/gyn, I'd have to agree with that stenographer. And I wouldn't hesitate to steer my son, who is a medical student, away from ob/gyn. It's a "sitting duck" field. Nowadays, ob/gyns give too much and get too little. I don't want the sparkle of enthusiasm in my son's eyes to dim the way it did with my former partner.

Being the department of the walking wounded isn't good for our field, but I don't know when it will end. I see women being rushed off for cesareans at the first suggestion of fetal heart rate irregularities and high-risk patients being turfed to other physicians or sent to big surgical centers. Nothing new is ever attempted because it's too risky. If practicing ob/gyn means a bleak financial future, a havoc-ridden personal life, and deliveries and surgeries fraught with risk, why would anyone still want to go into our field?