Blood on my Gloves – Surgery Core, その2

After 12 weeks of surgery, I have learned a great many things. I’ve listed some pearls below:
1.. Doctors treat patients, not CTs or X-rays
2. To be a good physician, one must make anatomy and physiology their bread and butter
3. To be a good surgeon, one might have to be a little crazy

The second half of surgery was certainly more intense than the first. After 2 weeks of OR, 2 weeks of Ambulatory Surgery and 2 grueling weeks of Night Call, I certainly have a greater appreciation for the scope and complexity of the role of the surgeon. It’s certainly more than deciding if, where and what to cut. The attendings and residents had very high expectations of us*, which made it one of the more intense rotations I’ve been through but even after having been raked across the coals a few times, I feel better about my ability to manage a surgical patient, even if I have no desire to wield a scalpel.

Our first week of Night Call, my group had the humiliating experience of being berated by the chief resident for not knowing our patients well enough. One by one, we were put on the spot and all were found lacking. After telling us we were the worst night call group he’d seen (which really hurt our feeling since we’d thought we were the best of the surgery groups for our camaraderie and competence), he challenged us to step up and I’m glad to say that everyone really did. The lesson I learned was that there really is no excuse for not knowing everything about one’s patients. Look at the imaging. Know the history. Know the anatomy, physiology, pathology – know everything! Seems like a lesson I should’ve learned by this point but I think the subtext was driven home – being a student physician isn’t an excuse for not knowing everything any more.

I had the chance to observe and scrub in on quite a few cool procedures. I know it’s probably not a big deal to some, but inserting my first foley solo, drawing my own labs and dressing wounds was probably just as cool as observing my first AKA, stapling my first surgical incision, feeling my first sentinel node or witnessing organ procurement following a very sad trauma case. I’m already registered for my surgery elective (otolaryngology) so I’ll probably never have the opportunity to observe or participate in any of those procedures again. Not that I’ve changed my mind (I don’t think any surgery core, no matter how awesome, would’ve been able to do that) but I can see what the appeal is. One of the surgery sub-interns pulled a 24 hour shift on the night of the harvest just to have the chance to see it (whereas I’d had the privilege of being consult student that night so I was lucky). As most of my group (myself included) was exhausted by the measly 13.5 hours of a typical night call shift, to us, the sub-I was kinda insane for doing that. Maybe he’s just really got what it takes.

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