Since I have little else going on in my life this week, this Friday's Quick Takes are recaps of my surgery rotation so far. And since I feel like I need a picture, I'm sharing this one from my work in Haiti to remind myself why I am doing this and why it's worth it even though I'm dang tired today (and on call all weekend).
1. My semi-enjoyment of this rotation went rapidly downhill this week, precipitated by the time change making my 5 a.m. patient rounds seem like 4 a.m. and exacerbated by my night of call this week which involved midnight surgery and the couple hours of sleep afterward consumed by me dreaming either about resecting bowels or my pager going off. And 5 a.m. rounds the next morning hurt. Really hurt.
2. We have now done two laparoscopic Nissen fundoplications, where basically you suture the top of the stomach around the esophagus to increase the pressure around the lower esophageal sphincter (and therefore improve severe acid reflux disease and hiatal hernias where the stomach creeps up through the diaphragm). Anyways, my job during the surgery is to hold the liver up with one hand using this laparoscopic probe thingy and manipulate the camera with my other hand. And it's so hard to hold that dang slippery/heavy liver up for two hours: I dropped it three times the first surgery and once the second.
3. Although my liver-holding skills are sub-par, I am now proficient with stapling wound incisions. Ok, there's not much to it. But I also am getting better at a running subcuticular stitch, which closes the skin internally and puts the skin together almost perfectly (at least when my attending physician does it). I'm pretty excited about this because if I do go into OB-GYN, I really want to close my C-sections up like this since it limits scarring. Anyways, I am now in charge of stitching up the laparoscopic sites after surgeries. Yes, they are tiny, but it's a start.
4. My attending informed me that I should have played more video games growing up. Apparently it would have helped me with my camera-manipulating skills during our colonoscopies (which are in need of some serious work).
5. The nurses realized that since my attending gets like a bazillion pages and can't possibly answer all of them that they will page me instead. I admit it, I felt a little 'special' when I first got my pager. That feeling has way, way worn off. I also am the official writer of all of my attending's patient notes (admit notes, progress notes, discharge notes). I have probably done over 100 notes in the last week, which is exhausting but will probably pay off when I start residency.
6. Every day of this rotation has involved rapid fire questions from my attending at some point. It's hit or miss; one day I answered every question right during our breast cancer surgery (it was a short-lived but proud moment) but the next day I could not remember anything about cholangitis/choledocholithiasis/hyperbilirubinemia. Seriously though, when the question came of "What is the thickness of the upper part of gallbladder wall in millimeters?" I kind of gave up.
7. I have met some patients that have really touched me this last week. There was the older couple so in love dealing with a remission of the husband's lymphoma. Then a young couple facing a diagnosis of metastatic breast cancer with a lot of courage. And an older woman who's entire family was ecstatic after my attending was able to remove her entire breast cancer during surgery so that she wouldn't have to go through radiation. Finally, an Afghan war vet in his 20s who was shot 4 times while on active duty and has multiple medical/surgical problems as a result...he proudly professed his love for our country to me.
So yes, this is all worth it.