Last week I had the privilege of shadowing an obgyn at Northwestern Memorial! Dr. Howard Arof is a family friend from my church and attended Northwestern for undergrad and medical school as part of the Honors Program in Medical Education. He has been there ever since for his residency and practice. With such purple pride and over 30 years of experience, Dr. Arof was the perfect person for me to shadow!
I spent the first two hours of the day at my research office before walking over to Dr. Arof’s office at Northwestern Memorial. Dr. Arof was planning to see a few patients for general exams before doing three procedures in the afternoon. Some of those morning exam patients allowed me to observe, and what really stuck out to me was how close Dr. Arof was to these women. He had delivered many of their children and was well trusted by his patients. Even though he only saw some of them once or twice a year, he knew and remembered them. I really admired that special connection and know that it is something I will want to form with my future patients!
After seeing patients for their checkups, Dr. Arof and I had lunch in his office with a pharmaceutical sales rep. She brought in delicious Mediterranean food that I was more than happy to eat! I was a little embarrassed when I tried to cut a piece of chicken off a kabob and sent it flying across the table, but otherwise we had really great discussion about contraception. The sales rep was promoting Nuva ring and the arm implant with a target market of college-aged and early career women. My two years living in a sorority house meant that I had a fair amount of knowledge on these topics, so I was able to discuss with the rep and the physicians some of the concerns young women had about these devices.
After lunch, I scrubbed up to attend Dr. Arof’s procedures. The first was a very unusual labiaplasty where he was going to modify a woman’s labia minora that was causing her a significant amount of discomfort when biking. I had never heard or seen anything like her condition, so it was amazing to observe how Dr. Arof clamped and severed the tissue, cauterizing and stitching the wound. He said he had never seen anything like it in his 30 years, but that he was happy to give this woman some relief and help her do what she loves.
At one point in the afternoon I asked Dr. Arof how he had become interested in obstetrics and gynecology. Many people are curious how young men in medical school choose to go into this field, but Dr. Arof reported how in his third year obgyn rotation he was mesmerized when attending a birth. For him, this experience is so amazing that he considers it spiritual. It is a testament to his dedication that after 30 years he has only recently retired from delivering babies. I was amazed that he had delivered over 4,000 children in his career and how he said he greatly missed it now that he was retired from that part of his practice. Talking to him and then later shadowing one of his colleagues who was seeing a 34 week pregnant woman helped me be able to see myself performing this type of medicine. There is perhaps nothing greater or more rewarding than being a part of the process of the miracle of life.
Dr. Arof and I also had a discussion later on about the ethics and empathetic pieces of being a doctor. Obviously, the job is not only taxing but emotionally difficult. Losing patients is difficult not just for the family, but for the medical team. He even noted that obstetrics has some of the highest highs- bringing a new baby into a family’s life- and some of the lowest lows- losing a child to miscarriage or stillbirth. He talked me through his journey with some of these lows and it helped me understand better the challenges I will be facing in medical school and how to overcome them.
Later in the afternoon, Dr. Arof performed two hysteroscopies. The most time consuming part of this process was dilating the cervix, which usually requires multiple steps and can be uncomfortable for the woman even if she is under anesthesia. Once that was accomplished, Dr. Arof used a scope to show me the inside of a healthy uterus, which was pink smooth muscle. I even saw the holes in the uterus that lead to the opening of the fallopian tubes! On the first woman, Dr. Arof then performed an ablation, a procedure that is done to destroy endometrial tissue that leads to heavy and painful periods, and then showed me how the uterus looked completely different, like whispy cotton. He was content that the woman would now likely not have (heavy) periods and be able to live a much higher quality of life. The second hysteroscopy was to look for cells in the uterus that might be causing the woman excessive watery discharge, but the cervical dilation was unexpectedly difficult and he was not able to insert the scope or take tissue samples from the uterus. While her results are less predictable, there is still hope that the cervical tissue samples might reveal the nature of some of her complaints!
This was one of my most eye-opening shadowing experiences to date, and my first time observing a surgery. It confirmed my interest in pursuing obstetrics and gynecology as a career since it is such an interesting blend of personal clinical medicine and surgical procedures. I also feel more aware now of the difficulties of this career field, from frequent night calls to some of the ethical concerns. I am so grateful to Dr. Arof, a physician and friend whom I trust and look to for guidance, for allowing me to observe his work in the office!