Surgery, week 2

Last night, I fell asleep at midnight trying to cram for this morning's "teaching session" with one of the surgery docs. I woke up 1.5 hours later, completely disoriented and freaked out that I had overslept. I jumped out of bed and was halfway in the bathtub when I happened to glance at my watch. I crawled back in bed, gratefully, only to wake up at 4 am (30 minutes before my fuckign alarm!!!) in another panic. This time I didn't go to bed, but got in my bathtub and took a little nap.

By 5:45, I was rounding on my two patients. Things seemed dandy until one of the interns happened to mention that overnight one of my patients had signs of a ruptured appendix and that we would need to take him to the OR as soon as possible. Woops. How did I miss that? Well, by the time I saw him, my patient was happily sedated on morphine, his pain had passed and he was feeling much better than a few hours ago. His super high blood pressure and tachycardia had been treated with beta-blockers. Since surgeons rarely bother with updating their patients on their own health status and since my residents never have time to talk to me, the interactions I have with my patients often result in huge lapses of information. Fortunately, this particular intern has his shit together, and he even had time to save my ass this morning.

After rounds, we had that "teaching session" I had prepared for. Unfortuantely, I had studied the material, not a book on "the fine art of reading people's minds". I got reamed repeatedly by the doctor for not being able to answer his very open-ended questions with the exact answers he was looking for. Unfortuantely for both of us, I was too exhausted to take his shit politely, and I gave him a few frustrated and sacrastic answers ...until I was able to control myself long enough to realize that only I would suffer from this encounter.

I spent the rest of the day in two surgeries. The first involved my patient with the ruptured appendix. The surgery went splendidly well until we packed the guy up, took off our sterile gowns and stepped out of the OR to check in on the other surgeries and patients. At that moment, my patient coded with (likely) respiratory arrest. A friend paged me about the code and by the time I ran back to the OR, they had successfully gotten back his pulse. I spent the next few hours with the residents, trying to figure out what caused him to crash.

The rest of my day was spent in a second surgery, my arms sometimes up to the elbows in a man's abdomen, trying to hold his bowels in place while the surgeons attempted to figure out why he had bled out 2 liters of blood in the last 24 hours. The surgery was stressful and frustrating, and at times it crossed my mind that this patient might bleed out completely on us, but amazingly, we had him (fairly) stable and sown up in 4 hours or so.

So um, the scary thing is, surgery is growing on me. There is something very gratifying about solving a problem with your hands, and doing it quickly and in a rigorous and well-tried fashion. Almost every surgery I have been on has involved a patient that would have died within days if we had not cut him open and operated, and that is obviously a very gratifying experience. And after doing trauma surgery for just one night, I have a small fear in me that if I don't go into this direction of medicine, I might always feel like I'm missing out on something that is almost guaranteed to give me a pretty good natural high.