come when the nurses page you telling you your patient is pushing, and you enter the room and realize that "pushing" this time really means "the whole freakin' baby is coming out," and you just talked to your attending who is all the way across the street, your upper level resident was on call last night and left for the day already, and you realize that you are COMPLETELY alone, but hey - you've done ONE whole delivery by yourself, and watched maybe 10, so you should be ok, right? You take a deep breath, gown up for the delivery, and try to remember to act calm as you prepare to catch the baby, while inside you are screaming, "WHERE IS THE DOCTOR??!!?" and perhaps "I NEED MY MOMMY!" before you remember that now YOU are the doctor and your mom is not close enough to help. The seconds space out even more as you realize the umbilical cord is wrapped around the baby's neck, and you can't slip it over the chin. Thankfully, the wonderful nurses are right there telling you to clamp and cut the cord, which you didn't realize was even allowed. You manage to do it (but only after dropping the clamp into the bucket which is positioned to catch all the fluid) and FINALLY the baby slides out.
And in case you didn't know that time could nearly come to a standstill, then come the few seconds in between delivery, while you are suctioning out the baby's mouth and nose, and that gasp of breath and wonderful, loud cry. THAT feels like an eternity, especially when you are holding a somewhat floppy baby and you have NO idea what to do if he doesn't start crying soon. (Perhaps you have a little idea, but the adrenaline racing through your system takes away most coherent thought, and the only thing going through your head is "help.... breathe..... aaahhhh!!!... breathe.)
The sigh of relief after he starts to scream feels WONDERFUL and you realize you are shaking and sweating and that you can finally breathe. Then all that's left is to try and slow down your racing heart. THAT will take a while.
If you are anything like me, anyway.