Surgery – Day 15

Call Day 2/4. Feeling pretty good today, but maybe ’cause we haven’t had to scrub into many cases. Also I’m on non-trauma today so there hasn’t been a lot of fast paced action, but all our surgeries got pushed to the night time. I don’t feel all that tired right now though, but I partially attribute that to these special fridges in the cafeteria that only open after everything else closes with free snacks inside for hospital staff. I would probably gain a lot of weight if I was a surgeon.

3 things I’m thankful for: the opportunity to observe and take part in surgery, my classmates who have all been very supportive and collaborative, free diet coke from the fridge

Impatient Education

We put so much emphasis on having answers readily available. When there’s a question we don’t have an answer to, often times the first instinct is to reach for the Google machines in our pockets if the answer doesn’t come to us within the first 30 seconds. This is how we were trained. In school, we are praised (directly or indirectly) for being the first student to raise our hand to scream out an answer. If we get called on to provide an answer and can’t provide one in 10 seconds or less, we are punished with a being shunned (teacher just moves on without being intentionally negative) or worse a disproving look or snarky comment. Our culture rewards outcomes and not processes. We are obsessed with facts and rote memory, leaving little room (and little patience) for recognizing the value of thinking things through.

So many people are convinced they are dumb early on in life simply because they aren’t as quick (or perhaps not as eager) to shout out answers. And that becomes reinforced as they go through life built by a society that rewards quick answers.

What if instead of jumping around from student to student fishing for the right answer, what if we paused for an uncomfortable amount of time and let students mull it over. What if instead of telling kids they are wrong or jumping to praise when they are correct, we said,”Can you talk us through that?” or “Let’s break this down.” I think kids would be a little less scared of learning.

Surgery – Day 14

The schedule for ACS for medical students really isn’t all that bad. Sure we spend 28 consecutive hours in the hospital once every 4 days, but we also essentially get to of those days off (granted one is ~supposed~ to be dedicated to sleep, but also there is no good way to fix your sleep schedule in that time). As I’ve said before, the life of the surgery resident really seems terrible among the specialties I’ve seen (except maybe aside from Ob/Gyn), but that’s why they get paid the big bucks, because you are literally trading in your life. I’ve never had more people try to convince me not to go into a specialty as I have in surgery. It seems like your life really has to revolve around medicine, but I think that works for some people (some of whom I have met).

Today I was in the outpatient surgery clinic which was very chill. Definitely different vibes from primary care clinic. I literally felt guilty about asking Review of System questions that weren’t strictly/ directly related to their surgery (even if they were maybe tangentially relevant). It’s just a whole different philosophy from what I came into medicine for.

Surgery – Day 13

We made it. It actually wasn’t as terrible as I thought it would be. It’s weird spending a whole 24+ hours in a building that is not your home without stepping outside. Now that I think about it patients in hospitals do that all the time. It must be weird for them as well, but this feels like a different think. It was weird to watch the sun rise and set from the inside of a building, know that time is passing, but also not feelings like time is passing. This morning after I left I was a bit disoriented to exactly when I was. Overall though it was a cool experience. Being on the trauma service we saw some interesting stuff, but nothing too crazy, but definitely stuff that I don’t think I would every see over at the private hospital. Also coincidentally, the 3rd year resident I was working with is a Cottage resident.

Surgery – Day 12

Currently on hour 15 of my 24(28) hour acute care surgery trauma call shift. To be honest it’s gone by pretty quickly. We’ve had to scrub in to a couple cases, nothing too crazy, one necrotizing soft tissue infection and accident leg-slicing (the medical term) with a Skill saw. I don’t mind staying up as long as there are things to do and on trauma there has been plenty to do. We have a bit of a lull right now so I’m going to try to get some sleep before all the action starts (hopefully not).

Rough

Past couple days of my 10 task challenge have been a little rough. Not because the tasks feel hard, but because there have other things going on in my life unrelated to the tasks; spending time with friends and family, driving homes, Thanksgiving stuff. The things about 10 tasks is that it doesn’t leave a lot of room for flexibility, but maybe thats’s more of an issue of the choice of tasks. I think the exercise is still valuable, but I think part of the practice is practicing self-compassion when you fall a little short on the stuff you set out to do.

Thanksgiving 2022

It’s a kind of wild to think about what Thanksgiving was like just 1 year ago. I have so much in my life to be thankful for, and even though we should be thankful for our good fortunes everyday, I for one am glad that there is a day (any kind of controversy/mythology aside) where people are encouraged to take a pause, perhaps in the mayhem of travel, family drama, and food comas, even if for at least a brief moment, on the things that make life worth living.

Surgery – Day 11

It was my last day on the HBS service and in a few days I start acute care surgery with a 28 hour call shift. I enjoyed my time on this service, but also kinda glad it wasn’t longer than it was. Similarly I’m looking forward to all the interesting things I’m going to see on ACS and the once-in-a-lifetime experiences I will have.

Surgery – Day 10

I did not think this was how I was going to spend today. The surgery gods graciously decided to usher me into my late twenties with a literal surprise Whipple procedure. The case started a little later than usual and was supposed to be just a relatively standard liver resection, but after we got in there the disease appeared to be more extensive than we thought and so we had to convert to the Whipple. Thankfully, I feel like it moved pretty quick for a this kind of procedure, only about 8-9 hours (compared to the 10-12 nightmares I’ve heard of). While it was a long time to stand and mostly just watch, it honestly didn’t feel like it was as long as it was in reality. It was fascinating to watch and it’s always cool to see things that you usually only see in textbooks fleshed out. Don’t get me wrong, if I had it my way, I probably would not attend another one, but I’m glad I was able to experience the whole thing at least once. Very thankful for my attending and especially my resident for their patiences and letting me participate. Very thankful to all the nurses and the scrub techs for their patience as well. Sending the patient all the best in their recovery and future treatment.

Anyways I’m tired, more thoughts on this tomorrow maybe.