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Logo of bmjThis ArticleThe BMJ
 
BMJ. 2007 September 15; 335(7619): 566.
PMCID: PMC1976479
In and Out of Hospital

Forceps at dawn

James Owen Drife, professor of obstetrics and gynaecology, Leeds

In one of his early films David Niven was a doctor in an Alpine sanatorium. Barbara Stanwyck was his patient, a beautiful concert pianist dying from consumption. When she became distressed in the night he appeared immediately, hair immaculately parted, his face filled with debonair concern.

This scene from an otherwise forgettable movie often comes to mind as the phone beside my bed lets rip with its infernal ringing and vibrating. (At 3 am, why do the registrars call my mobile instead of my home number? I suppose I should take it as a sly compliment.)

You don't go to the labour ward in pyjamas. It will only amuse the midwives, frighten the patient, and disillusion the trainees, who will assume your valet has resigned. In fact you rarely need to rush. The more urgent the call, the more likely the registrars are to have sorted things out by the time you arrive. But you keep slip-on shoes ready and a shirt with cufflinks inserted. At traffic lights you do up your bow tie. Best to be legal.

After 25 years of this, your emotions are predictable. You start with self pity, particularly if it is raining and your up-and-over garage door empties itself down the back of your neck. You become sanctimonious as you drive past drunks emerging from nightclubs. If you are going to deal with a nasty complication you tense up, thinking of worst-case scenarios.

Usually, though, you are simply going to supervise a rotational forceps or breech delivery—things you did as a registrar without bothering the boss. You think dark thoughts about the epidemiologists who turned these procedures into rarities, and wonder what will happen when you and your ageing contemporaries retire.

You hurry past the smokers (always at the door, whatever the hour) and into what feels like the last reel of a western. “I know you're there. I'm coming to get you.” For baby and professor, the stakes couldn't be higher. One false move and we're both in trouble. Too often, you ease the registrar aside.

As the birth ends you feel a sense of wonder, even after all these years. You drive home remembering the parents' faces and baby's name. A silly smile, yes. A little tear? Surely not. Dash it, you're supposed to be debonair.


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