After years of anticipation, thegolden day had arrived: thefirst day of my clinical clerk-

ship. I reported to the obstetrics ward15 minutes early, wearing my favouriteshirt-and-tie ensemble and practicallyhopping with excitement. A half-dozen of my classmates, bristling withnervousness, were already gathered atthe nursing station.

The staff obstetrician responsiblefor coordinating our rotation sprangonto the scene at precisely 0730 hours.After a brief introductory talk, shehanded us over to the senior resident.The sleep-deprived young surgeonsolemnly nodded at my colleagues andme as we were introduced. I thought Idetected more than a trace of disdain inher voice as she looked at me and com-mented, “You are way overdressed.”

After a brief tour of the ward, our lit-tle group disbanded to begin our assign-ments for the day. To my delight, I wasassigned to Labour and Delivery, theundisputed centre of action. I bouncedinto the change room, hastily stuffed mysilk tie and starched shirt into the onlyempty locker I could find and quicklydonned surgical scrubs. I emerged fromthe locker room in a flash, feeling invin-cible in my new hospital attire, ready totackle any obstetrical emergency.

As if to spite me, the delivery ward wasunusually quiet. Late in the afternoon,however, I followed the resident toLabour Room 3 to reassess a womanwhose labour had been slow to progress.My understanding of the clinical deci-sion-making process was somewhatfuzzy, but when the resident began ex-plaining to the patient that a cesareansection was now the most prudent courseof action, I knew what was coming.

An emergency cesarean section! I se-cretly thanked the gods of obstetrics forpresenting me with this opportunity togo to the operating room on my veryfirst day. My heart racing, I lookedaround to see where my services weremost needed. The nurses, resident andattending physician bustled in all direc-tions. I spun around in the middle of thefray, more than a little unsure of my role.

Suddenly I felt the pressure of a steadyhand on my shoulder. I turned to see thewarm, familiar face of an anesthesiolo-gist whom I knew from my preclinicalyears. He offered an enthusiastic wel-come to the hospital. Whether by his su-perior intuition or the dazed look on myface, he seemed to sense my disorienta-tion and led me to the operating room.He pointed out the scrubbing area andsuggested I immediately ready myself toassist. I thanked him profusely as he leftto attend to his anesthetic duties. Left tomy own devices, I rushed to don mask,hat and boot covers, and began vigor-ously but methodically to scrub up.

In the time I spent carefully scrub-bing, both the resident and staff surgeonjoined me at the sinks, completed theirscrubbing and flew into the OR. The pro-cedure was almost under way by the timeI tentatively entered the room, but I wasquite certain that my hands had neverbeen cleaner. I was immediately gownedand gloved by a proficient scrub nurse,

who placed me beside the staff surgeon.For the next few minutes, I stood overthe patient’s abdomen in awe as the op-eration proceeded, scarcely remember-ing to breathe until the baby was safelybrought into the world. Behind mymask, I smiled and marvelled at howperfectly everything had gone. I day-dreamed, visualizing a brilliant medicalcareer lying before me, each day full of

excitement, challenge, joy and success.As the last of the staples secured the

wound, I once again felt the anesthesi-ologist’s reassuring hand on my shoul-der. His voice boomed from behind meand projected across the OR.

“Mike, congratulations on your firstOR experience, you did well! Next time,however, I recommend that you wearonly two boot covers instead of three.”

As I tried to make sense of his com-ment, I felt all eyes in the OR fall on me.Suddenly there was uproarious laughterfrom all corners of the room as thenurses, doctors and even the new fatherguffawed behind their masks. I turnedaround to look at him questioningly.

He whispered the answer in my ear:“The boot covers are for your feet only,not for your head.”

Michael D. O’ConnorResident in Ophthalmology, PGY-5University of Ottawa Eye InstituteOttawa, Ont.

Holiday Review

CMAJ • December 6, 2005 • 173(12) | 1493© 2005 CMA Media Inc. or its licensors

Auscultations

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