Three Months Later

Patients seen: 88
Surgeries scrubbed into: 26
Lives lost: 7
Goodbyes said: 1
Hands held: 15

Surgery is over and I don't think I'll miss the ER/traumas or sad stories that bring the patients to the hospital. I'd rather not have to contemplate skin grafts for the women who fell asleep while smoking causing her bed to catch on fire and burn 30% of her body. Neither cup of noodles nor sparklers should never be given to children to children under 7. Gas stoves or BBQs and unsupervised cooking for children- please no. And just in case you didn't know: grandma driving while on amphetamines,  uncovered empty pools without water, holding a boiling pot of beans in your lap = very bad ideas. I use to think hang-gliding sounded like fun, but after seeing the results of landings that didn't quite work out maybe I'll rethink that. I have had my fill of gun shot wounds and stabbings. Pneumothorax, appendicitis, cholelithiasis - check, check, check!

The OR was actually quite fun most of the time. I can see the appeal, and I even liked about half of the surgeons I met. I'm crossing surgery off my list but am so thankful for the long rotation (even if I wasn't always thrilled during it.) I will probably never see brain surgery or even a lap appy again, but I'm so glad I got to experience them.

(Next time I post I'll be on inpatient family med. Stay tuned.)

Don't know what to call this post- surgery is almost over and I'm still happy to be a medical student

Just four more days of 4am note writing and surgery will be over. One more clinic day, one more call... it is winding down. In some ways I am done with surgery and glad that it is (almost) behind me yet it was pleasantly bearable. I like the hospital and the patients, most of the residents are amazing, my attending is great, I think I've learned a lot. I am now comfortable with all types of wounds, I know how to scrub, suture, tie and I can be of some help in the OR. I like clinic and seeing patients post-op. I don't mind consults and I've survived rounds more often that not.

That isn't to say that I want to go into a surgical field or that I've loved everything about these past 11 weeks but all in all, it could have been much worse. We'll see how the oral and written exams go of course but I'm content.

I have a few favorite patients and a bunch of sad stories to tell including some with happy endings, but that will come later. For now I am just trying to reflect, study and get ready for what is next.

My happy/celebrating patients...

Best news ever?
-How about telling a patient (and her family) that she doesn't have breast cancer. The biopsy was negative and the mass is benign. Yes there was a party in the clinic and yes I laughed and celebrated with the patient. And yes, I got to tell her the good news myself.

2ne best news ever?
-One of my first patient's from neurosurgery, a patient that was at one time in a drug induced coma -went home. I thought he was going to die, but despite the complicated surgery, new-onset seizures and hospital acquired pneumonia he somehow got better. Medicine is amazing!

My crying/scared patients...

Waking up from surgery can be scary. I have never had major surgery but I imagine that waking up in an unfamiliar room with what seems like a million people staring at you musts be a little unsettling. Today my patient woke up and she looked scared. I met her last week in clinic when I did her H&P and I had talked to her before the surgery so she knew that I would be present in the OR. She was having an elective surgery and the complication rate is low. She did well during surgery but it was slightly more difficult that anticipated and so her lengthened surgery status earned her an overnight admission. I held her hand as she woke up and her eyes told me she was scared. I went with her to recovery and told her that we would be keeping her overnight for observation. Or maybe the nurse mentioned this to her, but in any case I had to explain it to her. She didn't want to let go of my hand so I offered to stay. For half an hour I stayed by her bed and answered questions about her surgery. I tried to reassure her and I offered the only thing I could think of my time and my self. Eventually I tracked down the attending to come reassure her and I continued to check on her throughout the day. She will be fine. I was told by a resident that I wasn't acting like a surgeon. But you know- I am okay with that.

Being newly diagnosed with cancer. Being alone in the the hospital over a Holiday weekend. Being in pain. These are depressing things. So understandably my patient was minutes from tears when I entered her room this morning. She felt forgotten about. A simple procedure and biopsy of her mass were put on hold over the long weekend. As she talked and cried I offered her a tissue and she said they were bigger and softer the the hospital issued ones. She most likely has terminal cancer (and she knows this) and yet she thanked me for giving her a kleenex and listening to her. As a medical student I don't have much power, I can't make decisions and my knowledge of actual important medical information is tiny. But I can provide kleenex, hold a hand and lend an ear. Maybe these aren't behaviors of surgeons but they sure make me feel like I'm doing something.

Today was one of the most fulfilling days I've had in surgery. I went to the OR but it wasn't what I did in the OR that I am reflecting upon, it is all of the stuff I did beforehand and afterwards. Patients by their very nature are going to be scared, anxious, neglected. Isn't it our job as physicians to notice this and do our best to help them cry, accept and move on? Isn't it our job to comfort them?

Red, White, Blue and Surgery

Happy 4th of July to all! I am actually enjoying gen sx, suprisingly more than I expected, but that doesn't mean I don't appreciate having a three day weekend and especially today off. I'm home in SD with my hubby and have plans to watch the fireworks later. In the meantime I'm enjoying the day. And I have a bit of time to reflect on what has been two weeks of gen sx so far.

I've seen some interesting cases and have enjoyed clinic, consults and pretty much everything in between. The new interns have arrived and the whole hospital is fresh with new faces and lost looking white coats. I actually feel like I have something to offer the team, my intern finds me helpful and it is kind of refreshing.

I have discovered that I like being in the OR. It is fun, which sounds weird to say and I can't seem myself doing the training or putting up with the surgeon types for 5+ years in order to be in the OR but I do see the appeal.

I have confirmed that I don't enjoy the ER. I don't like the pace, the noise or the rawness of everything. And I hate not knowing what is happening with the patient after they see me. I need follow through and the ER doesn't provide that. However I do like the ER docs. Shift work and cool colleagues are definite pros.

I like clinic. I like taking to and examining patients without too much of a time constraint. I like reading the chart, knowing the history and seeing someone who is going to be followed. I love it when I get to see the same patient for 2nd time, either post hospital d/c or follow-up appt, etc.

So to recap. Surgery- I don't like surgeon mentality but the OR is pretty cool. ER- not my cup of tea, but the ER docs are awesome. Clinic- seeing patients makes me happy.

I hope you have a wonderful, festive and safe 4th!