218301wcEB_w Today was nuts. It was absolutely nuts. My auto repair shop had called last week telling me the parts they ordered to fix my windows were in. Today was my first chance in a week to get my car fixed.

After dropping my daughter off at school, I drove over to the auto shop. I was greeted by a delightful elderly man there who asked me if I needed a ride home. I told him I did, and he directed me to where the Courtesy Van was parked. I climbed in and we headed toward my home.

We had a pleasant conversation about our city and all the history he had experienced over the many years he lived there. At his request, I punched my address on the GPS device so he could know exactly how to get to my house. I am not sure why he wanted me to do this, because he totally ignored anything it said. He had a better way.

GPS-500 Each time he went off of the prescribed course, the GPS would state it was "recalculating directions" and then try to get us back on the way it knew to be the quickest route. GPS devices are great inventions, although they do have their quirks. I was in Oregon once in a rental car and asked for directions to the nearest Wal-Mart. It gave me directions to a Wal-Mart in Las Vegas, over 1000 miles away. Perhaps my driver knew better. I gave him the benefit of the doubt.

By about the fifth time the GPS announced it was "recalculating directions," my driver was getting annoyed. He grabbed the GPS and started trying to reprogram it. Why he did not just push the little "off" button, I was not certain. Perhaps he felt that if he pressed enough buttons, the device would realize that his directions were superior and stop "recalculating directions". With his attention fixed on the task of educating this new-fangled device, he neglected the fact that we were driving through a residential neighborhood. We were headed us directly at a car parked on the right side of the street.

"Car!" I said forcefully, digging my fingers deep into the fabric on my seat. He looked up in time and redirected his course, dropping the GPS, which once again tried to recalculate our course (I was hoping it was trying to find a very wide road).

We wound around the back roads of our town and my driver decided to show me some sites of historic interest. "This is the oldest cemetery in the city," he said, pointing to the right. I let off a little prayer that we would not be in need of a cemetery any time soon.

do-not-enter"Turn Left" said the GPS in a voice that was sounding a bit perturbed at this point. We went straight, turning left at the next intersection. I noticed a "do not enter" sign that we drove quickly past.

"I think this is a one-way street" I offered, as the GPS once again recalculated our course. The drivers coming at us scowled and shook their heads. We passed another cemetery, and my driver again pointed it out. Was he trying to tell me something?

Cemetery

The rest of the trip was uneventful (aside from the refrain of "Nearer Oh God to Thee" that ran through my head). I thanked my chauffeur for the ride as I stepped quickly out of the car. There were deep indentations on the seat where my fingers had embedded themselves. He told me to call him if I needed another ride, and I smiled graciously to hide my abject horror at the thought. I think he wants to show me all the funeral homes in town. As he drove away I fell on my knees and kissed the ground.

After talking myself out of a stiff drink and filling my wife in on my near-death ride of horrors, I drove with her to work. I did the driving - not that I don't trust her, but I thought another ride in the passenger's seat would only lengthen my emotional recovery. When we got to my office, she drove home, leaving me there without a means of transportation. She would either pick me up after work, or I would mooch a ride from my partner.

The day seemed to be settling down and I saw my first two patients. As I wrapped up with the second, there was a hard knock on the door. "Labor and Delivery is on the phone. There is an emergency C-Section at the hospital."

As pediatricians, we have to attend C-Sections or complicated deliveries at one of our local hospitals. My training in newborn resuscitation was 14 years ago, and the number of times there are truly sick babies at these deliveries is quite low. I can go years between having to intubate or resuscitate a child - which is fine with me. But this always makes these deliveries a somewhat tense affair. The problem of our rusty skills is balanced with the high level of experience of the Nursery nurses who are there to "help us." The truth is, they could probably do it just as well without us.

2 So here I was in my office without a car, needing to get to the hospital quickly. The other pediatrician in our group is in Siberia right now (really, he is on a mission trip - he did not get sent there for being behind on medical records). I was the only one who could attend this delivery. I begged a car off of my other partner, who explained that the Air Conditioning was not working. I didn't care; I had to hurry to the hospital and be at this C-Section. So I drove the hot car through mid-day traffic to our hospital, which is about 7 miles from our office. Luckily, I don't have to drive by any cemeteries on the way.

By the time I arrived at Labor and Delivery, the baby was already born and was thankfully crying. I did my doctorly act and declared the baby born, grabbed a bite to eat, and headed back to work. The other physicians in my office saw the rest of my morning patients, and my afternoon schedule was fast approaching.

I was trying to catch up on charts in my office when my pager blasted an angry beep at me. I looked, and it told me to call Labor and Delivery for a C-Section. "You're popular today, Dr. Rob" the nurse told me on the phone. I guess I had done such a fine job declaring the last baby born that they needed an encore performance. Flustered, I grabbed the keys - still warm from my last use - off of my partner's desk.

sauna I once again maneuvered the sauna-mobile through mid-day traffic and ran up to Labor and Delivery. The Operating Room where the C-Section was to take place was empty. The nurse informed me that Anesthesia was taking a long time to get the epidural in. The C-Section, it turns out, was happening because the baby decided to stick his hand out first. Perhaps that is what his GPS told him to do. Unfortunately, the OB would have to recalculate his course and bring him out through another route.

After a 45 minute wait, the C-Section was on. It went fine, and I once again declared the baby born (to the jubilant cheers of the nurses and obstetricians in the OR), and I left go back to my office.

This whole day had conspired to turn me into a grump. I really had not wanted to be grumpy, but my course could not be recalculated and thus headed straight for Grumpville. My mind was jumbled. I had narrowly avoided death and then had then declared two babies born. I had been face to face with the beginning and end of life. Now there was work to do.

It is hard to reset your brain on a day like this and not wallow in your misery. You want everyone to know how bad your day had been, but as a doctor, you can't do that. The visits are not about you, they are about your patients. They are not there to hear your day was like, they want you to care for them. Taking mind off of yourself on this kind of day takes a whole lot of discipline (and perhaps some mild shock therapy).

And so this grumpy, self-pitying, GPS-hating, car-borrowing, birth-declaring doctor walked into his first patient's room and was greeted by a grin. A baby grin.

cutebabyblueeyes_01

Babies don't care who you are, they just smile. Between two and nine months of age, babies can't help but smile at everyone and everything. Even grumpy doctors; although this doctor had just been cured by a good dose of baby therapy.

Thanks baby.

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