Surgery

An Honest Narration of My Surgery Rotation 

Dressed head to toe in sterile protective equipment, surrounded by blue drapes and beeping machines, I watch a surgical resident cut into bare flesh with a scalpel. It feels counter intuitive. The patient must be harmed in order to be healed. I wish I could take a picture of what I see now every day. I guess Google images will have to do.

My life feels like an episode of greys anatomy (Season 1) without all the sex and drama in the stairwells. I am running after my residents like a little duckling and getting chastised for either taking too long to interview a patient or not gathering enough of the history (depending on who I am with that day). I am a minion.

Two weeks of gyn surgery. I did endometrial biopsies and sutured skin incisions closed and even did a little work with the tools during a laparoscopic hysterectomy. I watched a uterus filled with cancerous tissue get removed from a woman's body. I assisted on LEEPs and endometrial ablations and got my Well Woman exam down. 

The attitudes of those in the surgical field has been the greatest contrast to my previous rotations. Everyone is a little more abrasive and I've needed to remind myself a few times (per day) not to take anything personal. I almost hate to generalize just because it does not give credit to those who haven't been hardened by the lifestyle, but it is a vibe that you can feel. And then we have lectures where the hot shot lecturer tells us about how great he is. Other specialities are insulted. We force ourselves to laugh at his jokes. We are taught to be motivated by ego - not by serving patients. I can't help but wonder what long term effects an environment like this has on me and my colleagues.

Two weeks of anesthesia which was awesome. I did IVs, injections, laryngeal mask airways, manual ventilations, orogastric tubes, and endotracheal intubations. Doing procedures for the first time is such a rush. I've also been able to see lots of different surgeries from the anesthesia spot like a cataract removal and a total knee replacement. It took me 6 tries to get my first intubation by myself.

I can take being made fun of. I would even describe myself as easy to get along with. But I won't tolerate sexual or misogynistic comments. You don't have to like me but I don't have to laugh off your jokes either. Even if that means that I become the "student who can't take a joke" to certain people. Even if that leads to another person getting a procedure instead of me. And that pisses me off.

One week of endoscopy/colonoscopy where I watched cameras travel through colons and I held butt cheeks together. There was a lot of farting and projectile poop bits involved.

One week of wound care where I changed overflowing colostomy bags and did debridement on diabetic foot ulcers and applied dressings to wounds. I like the busy work. I am happy to not have a very sensitive sense of smell.

Six weeks of general surgery. First removal of a gall bladder. I got to make the first incision. I got to control the camera. Sometimes I look around and wonder how I managed to be standing in a place where people give me these sorts of responsibilities. My daily life is what I could only dream of 3 years ago.

Hernia repairs... 

Appendix removal...

Anal fistula repairs... 

Breast surgery...

Colon removal...

Port-a-cath placements for chemo...

Retracting... 

Cutting... 

Suctioning... 

Suturing... 

Watching a foot get amputated was one of the most traumatic things I have ever seen. I was supposed to go into another surgery right after and I was planning who I could ask to fill in for me so I could sit down for a little while. It got canceled.

Total thyroid removal has topped my list of favorite surgeries. Just the resident and me. She planned and I helped execute. I cut, sutured, and used the "bovie" which is basically a surgical tool that uses electric current to cut tissue.

When you spend 10 minutes scrubbing yourself and having someone dress you and your hands and torso are sterile so you can't touch anything... And your nose is itchy. 

I realize that I say this about all the specialties I rotate in, but I could see myself being a surgeon. I could picture myself learning the skills under those bright OR lights and even teaching my own students some day. Maybe if the lifestyle was better. If I didn't want to have kids anytime soon. If I didn't get my education on a foreign island. If I was an American applying here. If it didn't feel like it was giving up so much of medicine. If I felt that I could fit in among the surgeons.

Perhaps this post is better titled as: Why I want to be a Family Physician.

I saw one of the hospital couples in the stairwell... maybe this really is Grey's Anatomy...

Held a lobe of a lung that we removed and touched the tumor inside it...

Watched a mastectomy being done after breast cancer was found...

Felt a beating heart on the palm of my hand...

13+ hour days wear me out... Coffee it is. 

Found out that the pathology on a previous surgery I did came back as cancer. Need to bring the patient in to tell them.

Each new surgery I see is like traveling to a beautiful new city. I experience art and science and beauty and brilliance. My mind is blown and my heart races. But I wouldn't want to do it for the rest of my life.