Friday, July 13, 2007

Two weeks down, six to go

So. Surgery.
What can you say?

I've had a fairly easy time so far, as surgery goes. The hours have been very reasonable (for surgery) and the people have been very nice (not just for surgery, but nice by any standard... with maybe one or two exceptions). I'm switching services now though, so things may get considerably more crazy.

So far I've seen some remarkable things. Today I saw a brain. It was just out there, with the skull about 60% removed. It pulsated with every heartbeat. I've seen surgeons drill holes through skulls and noses, bedsores that go to the bone, and tubes threaded through the tear ducts. I've smelled some smells I thought never could exist. I've put staples and stitches into people and taken them out, helped take and place skin grafts, and retracted for 34098213487.3 hours. So, now, at this one quarter-way point, what do I think of surgery?

In short, I have a great deal of respect for surgeons, and for the field of surgery. These people are cool cucumbers, and I salute them. They totally could have made it on the prairie.

From a medical student perspective, however, surgery is very challenging. They don't have much time to tell you what is going on, what you should be doing, etc. It's very scary, actually.

First of all, they engage in something called "pimping". Pimping is when they put you on the spot and ask you questions in front of a big group of people. Pimping is a very frightening experience, even when they are nice and don't really give you a hard time when you get the answers wrong. So far I have been really bad at this process. Even answers that I know fall right out of my head when they ask me in front of lots of other people, and most of the answers I didn't know in the first place.

Also, the OR is a very stressful place to be. It functions in a very regimented way, but that way varies depending on the people running the OR. Some are nice when you don't do things their way; others yell at you. It's hard to remember all the musts and mustn'ts.

Plus, sometimes you almost pass out. This happened to me. It was actually the first time I ever scrubbed in, on a breast reconstruction. I'm not 100% sure what happened, but I think it was a combo of sweating under hot lights and about 50 pounds of occlusive, non-breathing clothing, awkward posture, and the Bovie. The Bovie is an electrocautery device that they use to essentially burn through tissue and it emits all of this horrible smoke. It smells frickin' awful, especially when they are cutting through fat. Anyway I was about to pass out face down on the patient (not recommended) when I fessed up. They were nice as they told me to get out and get a drink of water. It was still embarrassing.

Anyway, there is more to my rambling, but for now I need to get some sleep. I will try to write some more random thoughts tomorrow. Until then, remember this: when they get out the Bovie, always ask for suction. You can suck up the smoke; it really cuts down on the passing out.


heidi said...



Can you imagine being Dr. Baker?

DHP said...

Wuss... the Bovie smoke is totally not bad at all. I actually thought it smelled really interesting. Not good per se, but interesting... like you said, it is something exotic that you never knew existed.

Stryker Saw smoke, on the other hand, can get to me a little (especially when used on a cadaver in gross anatomy)

jmama said...

oh yeah, dude. i'll take bovie over stryker saw ANY DAY.
i have not passed out yet - but i came VERY close to falling asleep face-down in a patient last night. 3am diagnostic laparoscopy in a patient that had so much scar in her belly that all you could see was, well, nothing. definitely not exciting enough to keep me awake and i very nearly made a complete ass of myself. i did one of those whole body jerks when you've basically fallen asleep standing up and right before you topple off balance you wake up and startle... luckily I think the attending didn't notice. (i hope).

Dr.VonB said...

I don't know... have you ever had like 30 straight minutes of Bovie burning through fat and (especially) glandular tissue during a breast reconstruction? I takes it to a whole new level... of grossness.