Ob/gyn residency is defined by relentless tests of emotional resilience and the demand to make swift, decisive choices in moments that can alter the course of a patient’s life. We play an integral role in moments that may be ordinary for us, yet unforgettably life-altering for our patients. Our role as residents is dynamic, each year accompanied by graduated responsibilities.
My first night on call as the senior resident covering labor and delivery, gynecology, and gynecologic oncology laid bare this truth. It also crystallized how my role had shifted since intern year. As an intern, my focus was narrow: execute the mechanics of a delivery, write notes, follow orders, and master procedures one step at a time. But as a senior, the responsibility broadened: now it was my job to triage, delegate, and lead, all while remaining present at the bedside.
The evening began with our routine labor and delivery sign-out — latent laborers awaiting progress, an active laborer nearing delivery, a placental abruption in triage with no prenatal care, and an emergency C-section closing in the OR. After triaging priorities and delegating tasks to my team, I was called to the room of the active laboring patient. She was nearly complete, her face set with determination. Together, we coached her through those final pushes until, at last, I helped deliver a healthy infant, crying and pink, into her waiting arms. The joy in the room was electric — families cried, I smiled behind my mask, and felt the wonder welcoming new life into the world.
But soon, the atmosphere on the floor shifted. In a nearby room, the fetal heart tracing showed persistent bradycardia, unresponsive to every intervention we tried. I made the call for an emergency C-section, a decision as heavy as it was necessary. This room, too, filled with tears, though these were born of fear, sadness, and disappointment. The patient was rushed to the OR, where the air crackled with urgency. Every movement was brisk, every word clipped, the weight of two lives pressing on every second. Though my heart pounded, my hands remained steady. Relief replaced the tension in the room only once mother and baby were safe.
However, that relief was short-lived. Soon after, I evaluated a consult in the ED. She was a patient with a twin pregnancy at 14 weeks who was experiencing vaginal bleeding. Earlier in her pregnancy, she had been diagnosed with a subchorionic hemorrhage. While many of these resolve on their own, others progress with devastating consequences. On my initial evaluation, her bedside ultrasound reassured us with two strong heartbeats. Her bleeding was stable and she showed no immediate signs of miscarriage. Still, given the gravity of the situation, I decided to keep a close watch to rule out inevitable abortion.
Only a few hours later, my pager went off again — her bleeding had worsened. When I arrived at her bedside, I lifted the covers to begin a pelvic exam, but no exam was needed. She had already passed both fetuses in the bed without realizing it. Delivering this news to her and her mother felt like watching their world collapse in real time. Just minutes earlier I had celebrated new life with another family. Now I found myself sitting in the silence of their grief, before heading to the OR to perform a suction D&C. My hands carried out the procedure; my mind carried the weight of their loss.
As dawn neared, my pager went off again. This time, it was a patient being admitted to gynecologic oncology. She had advanced ovarian cancer with a malignant small bowel obstruction. Her face was drawn, her body frail, her pain constant. She did not want more interventions; she wanted comfort. As I wrote the admission orders and sat by her bedside, I realized this was not about curing, but about honoring. Within days, she was discharged to hospice care, where she would spend the rest of her life.
By sunrise, I had walked through joy, urgency, grief, and acceptance. I had celebrated new life, raced against time in surgery, confirmed a devastating loss, and admitted a patient nearing death.
The intern in me once focused on learning the mechanics of each of those moments. The senior in me now focuses on leading my team through emergencies, guiding patients and families through crises, and embodying steadiness even when my own heart is breaking open. Our training in ob/gyn is truly full-spectrum and necessitates the ability to shift seamlessly between leadership and compassion, between action and stillness, between urgency and grace. We honor the fullness of the human experience, even when it demands all of us.
Dr. Vidya Visvabharathy is an ob/gyn in Cleveland, OH. She enjoys dancing, baking, and taking long walks with her husky mix, Lilo. Dr. Visvabharathy is a 2025-2026 Doximity Op-Med Fellow.
Illustration by April Brust
