What I did on my summer vacation

Sorry. A little tounge-in-cheek humor. I had a whopping 2 days off in between my surgery and peds rotations and I definately made the most of it!

My surgery oral exams went good. My board exams...well, we'll just see in a month or so. After writing those, I travelled with some classmates to a big lake many hours away to go on a classmates houseboat! It slept 15 anf came complete with a gas fireplace, dishwasher, hot tub and a slide off the top deck! It was a short but sweet trip and we got lucky with a day of sunshine. So much fun!

Now, it's back to the grind and my final rotation in pediatrics. Yesterday was orientation and I swear I may just poke my eyes out with a fork. After being relatively independent for internal medicine and surgery, the peds people want us to hold their hands like kids. We were getting a tour of the (very confusing) hospital and our tour guide (who is also one of our instructors) actually said to us: "OK, listen up students. Students? Are you listening?" And she would stare at us until every single one of us was looking at her and silent. Get over yourself.

I'll be doing my first 2 weeks in the childrens emergency department. Today was S-L-O-W. I saw a total of 6 cases in an 8 hour shift. Ahhhh...sweet, sweet, summer!

Surgery...check.

Well, OK. I haven't OFFICIALLY completed my surgery rotation, but close enough. Yesterday was my last clinical day and the surgeons and residents were nice and let us go early so we could study!

This morning was the oral exams. Basically, we sit down with 2 surgeons who grill us for half an hour on 2 topics and then we switch rooms and do it again with 2 other surgeons. For my surgery rotation, I did 2 weeks of plastic surgery, 2 weeks of peds general surgery, and 4 weeks of adult general surgery. However, for this exam, we're required to know some basics from all the surgical disciplines: neurosurgery, ENT, thoracic surgery, urology, plastics, peds, radiation oncology, vascular, and cardiovascular surgery. For the oral exams, they try to make it so you get a general surgery station, plus at least one station from a rotation you did.

For instance, my stations consisted of cases from:
1)general surgery (rectal cancer and bowel obstruction cases)
2)plastics (tendon laceration, burn injury, and scalp avulsion cases)
3)vascular (abdominal aortic aneurysm, peripheral vascular disease, and DVT cases)
4)neurosurgery (subarachnoid hemorrhage, malignant headache, and spinal cord compression cases).

I think I did fine. Now I just have to write the 2.5 hr standardized exam tomorrow morning and then I'm done surgery!!! I'm taking it easy tonight and not studying. These standardized exams are a joke and don't really test your knowledge or your experience during the rotation. I've written a few; studied hard for a couple and barely studied at all for a couple. Got the same marks for both of them, so I figure it doesn't really matter if I study anyways. I might as well have a relaxing evening!

Tomorrow evening...I'm going houseboating for the weekend!!!!

Last surgery call shift!!!!!

Well, so far I made it through all of surgery call shifts. I'm doing my last on tonight! My shift on Thursday was busy and I only got a couple hours of sleep, but I was on with 2 residents...one of which is cute and very funny. We (OK, I) basically flirted all night long in our own med-geek talk! I actually had fun being on call. Hmmmm, funny how that is?!?!?!

Today has been busy so far. We have been to the OR 4 times and done an appendicitis, tracheostomy (which turned out to be a subtotal thyroidectomy), a bowel resection, and a gastrectomy (stomach taken out for tumor). I'm working with a surgeon who is pretty fun. For example while we were doing the gastrectomy, he sees a bunch of liver cysts. "Cool...let's pop them!" Here MSI, take this a pop it! It's like zits...they're so fun to pop!"

Now we're just waiting to go to the OR for another appendicitis. I wonder when they'll make babies without an appendix. I'll leave that to the genetic engineers.

One more week of surgery left (exams Thursday and Friday)...then a whole weekend off to go houseboating!!!! Can't wait!

My most perfect day

My last post call day was so productive. My car is now fixed. I sort of miss the sounds of a racecar and gunfire as I speed down the highway with my exhaust pipe disintegrated. Makes people get out of the way!

I wanted to share my most perfect day. It will go down in the books as my proudest moment...probably ever. I spent the day in surgery with a surgeon who I'd never met. He was pretty cool, liked to joke around, and did a bit of teaching. It was the last case of the day and the patient was a 300lb young man who was having a second operation on a 'pilonidal sinus' (basically an abscess at the top of his buttcrack). After 6 of us positioned the unconscious man on his side and prepped him for surgery, the surgeon relegated me to the most important job a med student could ever get. My job, you ask? I had to hold his buttcheecks apart so the surgeon could operate.

I've had 7 years of university education for something that an inanimate object could do. Awesome.

Med Student in the house!

So after 4 days off of my surgery rotation for a conference in rural medicine, I am returned refreshed and ready to go. My call karma has been restored to it's natural place in the universe (namely so I get some sleep). And I may even be able to take my car into the "car doctor" today! Only took a month and a half!

The conference was up in the northern part of this province in a town of about 20,000 people. Not the prettiest of towns, but hospitable and friendly. The conference itself was great because after rotating through 3rd year, I knew what was going on in the sessions! Yea me! Most of all it was nice to get a break from the city and from school. For a weekend, I got a taste of what non-med people do on the weekends! One of the doctors there was kind enough to give us his SUV for the weekend so we took advantage of that and went for a drive to another town. Beautiful scenery! This province rocks!

Yesterday, I made a bit of a goof of myself...newbie mistake, but lesson learned! I spent the morning in the operating room doing breast lumpectomies (taking cancer out). On one case we were doing a 'sentinal node biopsy' which is where we isolate the main lymph node that drains the breast to see if cancer has spread there. We do it 2 fold: 1) inject radioactive solution into the breast and use a geiger counter to isolate the lymph node, and 2) inject blue dye into the breast so we can see where it drains. These 2 ways together improve the accuracy of finding the sentinal node. As we were prepping the patient, I thought I would be a good med student and help out a bit. I was going to draw up the blue dye into a syringe so we could inject it into the patient. I had done this act a bazillion times before when we draw up local anesthetics for suturing. So I put the needle together, pulled back on the syringe, inserted the needle into the vial, injected air into the vial (all of which we were taught to do), and tried to get the blue dye into the syringe. The next thing I know is that blue dye is spraying out of the bottle, onto the floor, onto my hands and fingers, onto pretty much everything in a 3 foot radius. The surgeon and nurses were laughing at me. They failed to tell me that you should NEVER inject air into the vial for this very reason!!!!! Now I have blue fingernails and a blue palm. The surgeon was good about it (I think I gave him a laugh!) and said that "at least I got involved in the case and I have the proof!" Nice. Lesson #1: don't inject air into blue dye bottles. On a good note, the surgeon complimented me on my suturing skills. (Yea me!)

I was on call last night.
# pages from the ward: 1 (for yep, you guessed it...low urine output)
# consults from emerg: zero
# times I got up to check pager just to make sure I didn't miss a page: 10
total sleep time: 7 hours
Call karma restored!