Week 3 Vascular - at our program vascular week = do whatever you want week... but it's a little more enigmatic than that. we still have to attend lectures so you can't get away with too much but you definitely don't have any patients to round on.. so i was able to sleep in till after 6a. Things I saw: CABG -Coronary Artery Bypass Graft- long procedure but pretty awesome. I mean you dissect out an artery and vein and then you plug in some tubes into the right atrium and aorta.. put them on the heart lung machine which is wild because when you split the sternum you can see the lung inflating and the heart beating.. then nothing.. they both stop... you hook up the artery and vein.. to bypass.. punch some holes into the aorta.. stick in the other ends of the graft.. and then put blood back in.. and lo and behold.. praise God.. they start pumping and breathing... that was awesome to watch... I saw two AVG graft revisions.. meaning grafts for hemodialysis fixed because they can get clots (on one of those procedures.. I tried to scrub in but didn't realize my resident wasn't there and the doctor totally called me out for not introducing myself... it worked out fine.. but let me tell you ...how sheepish i felt for the next two hours .. standing off to the side) lastly i saw a below the knee amputation .. this particular doctor lets students and residents do alot.. so I ended up helping suture and staple at the end.... this was actually the first time I'd seen my chief resident... who totally wanted me to two hand tie the sutures... which i can't...
Week 4 Peds Surgery- best week ever. I'd like to end there but let's hit some high points.
First.. it's awesome to see patients who are just as pissed as you are about waking up early. An example - I usually round by 530/540a so I can see 3-4 patients before my resident.. who is one of the coolest guys ever. i'll get to him later... but yeah.. I rounded on my patients, one of them has leukemia.. but has a bit of a tude... but it just makes for more fun... and he totally told my resident that he wasn't having abd pain this morning... but did after my "not soft palpation"... hahahaha... so I totally apologized for it the next day and we've been much better after that... barring early morning wake ups... Pediatric patients are just cool, I mean you can laugh in the room and have fun when rounding. That's key for me. If I can't laugh and goof around a little in the field I choose, then I can't do it...
So the rest of the week was rounding which I haven't really done till now because of the way my rotation was set up.. so if i were to summarize rounding.. it's like a small gang roaming the hospital tending to each patient on the service. I like to thing of ourself as a gang.. I saw a bunch of different procedures and fixes for congenital defects : right hemicolectomy for NEC, pullthrough for Hirschsprung, gastroschisis , pyloric stenosis repair, some I and Ds.... interesting stuff...
Oh and the NICU... has to be one of the most space-age areas ever.. I guess it's just something else to walk in there and some babies have the blue UV lights for jaundice... so there's this faint blue glow throughout.. and most of the beds are "Giraffe" beds = they open up.. like a spaceship...
Peds Surgery was just awesome for me. I mean.. my Resident told me to consider it and the locum tenens doctor from Atlanta complimented me.. It's hard to feel competent your first rotation in your third year and in surgery for me especially but I felt I did something right this week. And I want to be just like my resident: He's a southern guy , Christian, married and just nice as ever. His form of critique is like a little lesson from Mr. Rogers... , never curses or insults anyone.. thanks patients and staff... just unreal..
To end.. he told me the rules of surgery:
Eat when you can, sleep when you can, pee when you can and don't mess with the pancreas.
Then he added.. some people use the eff-bomb with the pancreas...
Hahaha, he literally said that... awesome.
Oh since this is my halfway mark..and I have my clinical skills bit tomorrow.. let me pro/con some of surgery
Pros
Very organized.. it's not that hard to find patients .. procedures and you know reasonably well... where you need to be
Procedures can really impact people's livelihoods, it's high yield
The residents are awesome in my program
Night call can be quite exciting with traumas
Clinic is fun (which I've learned most residents and people interested in surgery would not say... hahahah.. must be the meds/peds coming out)
Cons
Early mornings.... I repeat.. getting up before 430a.... wears you down
Hours - anywhere from 55 hours on vascular to 81 hours last week
OR - my mind wanders so readily it's not even funny.. as a student you can't do a whole lot so I imagine the inactivity of standing for hours.. brutal
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