Each fall, as part of their residency applications, medical students around the country struggle to describe the reasons they have picked their chosen specialty. We all have a sense of what attracts us to a field, or to anything for that matter, and it is often difficult to put into words. That is why the personal essay, as a part of the application, is so challenging and often so bland.
Occasionally though, we are privileged to read an essay that connects with the deeper motivations that lead us to choose the paths we follow. When we read such an essay, it can serve to refresh and replenish the idealism that we all have and that is sometimes a struggle to maintain amid concerns about ACOs, RVUs, EHRs, ICD-10, and the rest of the alphabet soup that requires attention and effort, but that can distract us from our core mission of caring for patients and block us from participating in the wonder and majesty that such care can bring.
This is such an essay, and to read it is like drinking a refreshing glass of water on a hot day.
In Judaism, a baby is named within the context of a prayer for the mother and child’s health: “May He who blessed our fathers … bless the woman who has given birth (mother’s name) together with the daughter who was born to her in an auspicious time, her name shall be called in Israel: (child’s name) …” This prayer simultaneously acknowledges the risks and the possibility of labor – on one side the birth of a new life and continued health of the mother; on the other side the possibility of death and sadness.
Family planning and safe delivery impact not only the individual woman and her family but also society as a whole. The United Nations prioritized this concern in their fifth Millennium Development Goal of improving maternal health and decreasing maternal mortality by increasing access to reproductive health services, family planning, and skilled antenatal care in the developing world.
The obstetrician delivering a baby practices medicine at the edge of opposites: the promise of new life and the possibility impending death; the end of intrauterine existence for the fetus and the beginning of life outside the womb; the end of singlehood and the beginning of parenthood. All physicians are privy to vulnerable aspects of their patients’ lives, all will see them naked and listen to their fears, but it is rare to share in the joy that comes from shepherding a successful pregnancy and guiding the simultaneously joyous and terrifying event of birth. The assisting physician operates at the place where scientific knowledge and medical skills meet the mystery of human existence.
What draws me to the field of obstetrics and gynecology is the unique combination of being the physician who can provide counseling and primary care throughout a woman’s reproductive and postmenopausal life, while at the same time provide surgical and interventional procedures at critical times in a woman’s life. Ob.gyns. straddle the best possibilities medicine has to offer.
What I find so appealing about ob.gyn. – what had me scuttling off to the labor and delivery floor during slow afternoons on internal medicine, or requesting opportunities to have more exposure to the ob.gyn. subspecialties – is how unique, cutting edge, and imperative each aspect of ob.gyn. and its subspecialties are.
On the labor and delivery floor, I felt privileged to be a part of the birth and safe delivery of a new life. While working with the reproductive endocrinology and infertility team, I saw physicians help infertile patients have a chance of beginning a family. On urogynecology, I witnessed a skilled surgeon perform a precise procedure that enabled a marathoner to race again without fear of urinary incontinence. Rotating through gynecology-oncology, I saw the combination of cutting edge robotic surgery and compassionate care drastically improve the lives of oncology patients. While watching anatomy scans in the maternal-fetal medicine clinic, I was in awe of the beating chambers of each baby’s heart. And at the vaginitis clinic I learned how careful questioning, complete exams, and meticulous study of specimens could reveal vulvar and vaginal pathology that is often overlooked, but when discovered can have a huge impact on quality of life.
I want to be an ob.gyn. who has the capacity to council and teach women about their own health care and to provide comfort and calm during the excitement, anxiety, and pain of birth. But I also want to have the knowledge and skills to make difficult decisions, the capacity to recognize what needs to be done in times of crisis, and the surgical skills to intervene in the right way. I look forward to being a part of a specialty that is filled with compassionate learning, teamwork, and empathy worthy of the women who seek our care.
Ms. Machefsky is a fourth-year medical student at Drexel University in Philadelphia and a Gold Humanism Honor Society member. In addition to her interest in ob.gyn., she enjoys curling up with a good book, swimming, and running with her husband. Dr. Skolnick is a professor of family and community medicine at Temple University in Philadelphia and associate director of the Family Medicine Residency Program at Abington Jefferson Health.
