Ahhhh, at last. I started this blog back in September of 05. Back when I was a young, handsome, single resident living the good life in Seal Beach. I let the blog slip, but over time I've found myself thinking fondly of it. So, I just completed transferring and updating all the posts.....and this is my first post of a new era. The intervening un-blogged months have been good to me. Of greatest note: I have a baby. And another on the way. i won't write much, now, but will include this little work exploit. At 0430 I was kind of loafing my way through a Sunday night shift. All of a sudden someone yells from the ambulance ramp "We need help! She's having a baby!". Well...usually this is bogus, a 20 weeker who is having some Braxton-Hicks contractions or whose water broke, etc. But, better safe than sorry, so I grab my goggles and a pair of gloves and jog outside. Ominously, there is a Plymouth parked out in front of the ED with a pair of legs sticking out the passenger door. Hmmmmm....I yell things about gurneys and calling L&D and run over to the car. There is a (surprise) young Hispanic girl laying across bench seats moaning and kind of weakly pulling at her pants and panties. On her face is a wan look of distress and between her legs if a round hairy crown of baby head. Ah-ha. This one probably isn't bogus. I'm no doctor, but this is probably the sort of thing that can't be blessed, tossed on a gurney and sent to L&D. I think "Well, I'd better deliver this baby," and I say "We're going to deliver this baby"--really more to convince myself than to impart any important information to the team around me who have already figured it out. I whip her pants off, kneel down between her legs, and realize that the front seat of a Plymouth, at 0430, between a woman's legs it is a dark, dark place. (Travis--I assume you already knew this....) One of the techs has enough good sense to flag down the next car that is driving into the ER lot and wave them over to shine their headlights on me and the "field". She's at eight months and obviously ready to go, so I put a hand on the baby's head and ask her to "empuje". The head eases out and a jet of fluid splashes all over my pants. I put my hand down to feel the little guys face and slide a finger around the neck to (not) feel a nuchal cord. So far so good. A couple more pushes and the shoulders are out and then the little guy slips on out and into my arms. I think "Don't drop the baby, don't drop the baby, don't drop the baby, don't drop the baby....." I flip the kid around, the tech who had the presence of mind to arrange my light also suctions the kid's nose and mouth, and then with a little stimulation the kid starts to cry pretty robustly. We dry him, put him on mom's chest, and I clamp and cut the cord. The little guy is fine except--horrifiyingly--appears to be missing his penis! Kid goes into the ER on the gurney to be resuc'd and mom goes in on the next gurney with a cord and clamp still dangling between her legs. I check on the kid and she looks pretty damn good--pink, breathing well, with a kind of philosophical look on her face. Thoughfully, I've left her a good eight inches of umbilical cord. Mom is also fine, but very tired. L&D comes down and they say: a) Hey, nice work! This must have been pretty hairy out there... b) Great work. Mom looks good, baby looks good. Perfect score. or....c) What were the APGARs? What you don't have a one minute APGAR?! Sheesh.....mumble mumble mumble "ED Doc" mumble mumble "incompetent" mumble mumble "eight inches of cord" mumble mumble muble, etc. What was the one minute APGAR?! Are you fucking kidding me? How 'bout I stick this clamp up your ass, lady? So I thought the mom might ask me to help name the baby--I would have chosen "Misty"--but instead she went with Dessiray Miracle Angel Jimenez, which would have been my second choice. I billed for 35 minutes of Critical Care time. Though of course that is fraud because the patient wasn't in the ED for 35 minutes and really I can only bill a level 3 (for $45 of Medi-Cal "reimbursement") since I was deficient on my history and physical. Rest of the shift was very anticlimactic and I got out on time.