A Dying Breed

This is what happens when I have too much time to think. In recent days, it's likely due to the amount of time I've spent travelling in planes, trains and automobiles (honest! all three!) to get to various emergency medicine fellowship interviews. Which are done now, thank God.

So I've been more than a little pre-occupied with thoughts of procreation lately. Partly because now that I'm married apparently everyone thinks it's the next logical step. And partly because I'm 32 years old and am starting to picture my ovaries shrivelling up like a pair of raisins from both age and neglect. And I do want kidlets... I just don't feel ready. But if I DO wait until I'm ready, we may be pulling the goalie shortly before I start getting pension cheques from the government. Which is not promising for fertility.

So here's my first observation. Medicine begats medicine. I remember reading a statistic somewhere that nearly a quarter of medical students in Canada today identify at least one parent as a physician. It's hard to say why. Maybe simply from being exposed to medicine as a career earlier than other kids? Maybe from parental pressure? Maybe it's a reflection of socio-economic status? Maybe from some weird genetic mutation that confers on them the desire to pick at scabs? Who knows? But the point is that the children of physicians are more likely to pursue a career in medicine than other children.

Here's my second observation. Residents have trouble making babies. This isn't based on anything other than my own observations of the people around me. I don't know any female resident who has managed to get pregnant easily, stay pregnant to term and have an uncomplicated labour and delivery. Scary, isn't it? Male residents don't seem to suffer from the same curse, getting their wives and girlfriends knocked up at a dizzying rate. But female residents struggle. There are plenty of reasons why the cards are stacked against us. We delay childbearing later than the norm since we tend to spend our peak childbearing years studying. We work crazy hours that stress our body to the point that achieving a regular menstrual cycle is nothing short of a miracle. We work through pregnancy in conditions that expose us to a number of bacteria and viruses. We work though pregnancy in conditions that are often stressful. We eat erratically, often from vending machines. We spend one night out of four sleepless, and often compensate with higher-than-average caffiene intake.

It's scary. As a medical student, three of my female classmates had babies before graduation. There were miscarriages, early rupture of membranes (and I'm talking before 30 weeks gestation), preterm labour, multiples (although this one was through word-of-mouth since the mom in question left med school during pregnancy and didn't come back before the class graduated)... nothing simple or straightforward. Most recently, the resident that I did surgery with last year gave birth at 33 weeks. Her baby is still in the nursery, plagued with many of the problems common in premature infants. So it seems that women who get pregnant during residency not only have problems getting pregnant, but don't have much luck carrying their babies to term without problems or complications.

Add observation #1 and observation #2 together, and I'm forseeing a major physician shortage in the next 30 years or so. It's pure Darwin. Or IMpure Darwin, at least.

It's trains of thought like this one that are the reason why I need to be kept busy at all times.