Another gem

From an attending who doesn't seem to like the way I answer the phone (i.e. "This is surgery returning a page..."):

"... that's the way we answer the phone in America."

oh no he didn't.

Of course when I inform him I don't appreciate the racist remark and that racism isn't socially acceptable anymore "in America," he explains to me he can't be racist because he's "traveled throughout the world, speaks multiple languages and his son is dating a Korean girl." Whew. I'm glad he cleared things up. This coming from a guy who did 3 rectal exams on a guy looking for a rectus sheath hematoma. And if that is not the funniest thing you've ever heard, call your med school buddy and ask him/her to explain.

compliment?

small pleasures

Handball

One of the things you learn as a surgical resident are what to touch, and what not to touch, particularly with your bare hands. Given how anal surgeons* are about sterility in the operating room, it's interesting to see how cavalier we often are when outside of the OR. Bare hands over bellies, armpits, feet of people who probably haven't showered in a week. And when you have to see too many patients in not enough time, there are no guarrantees of a hand wash in between each one. And unless there's gross pus, blood, poo or an open wound, gloves aren't always a given either.. 

However, I have picked up signs of when to be wary of touching things with my bare hands. For example, today I had a patient with a groin abscess. One thing that I know about patients is that they're like normal people. If they have a bump, hump or lump anywhere, they'll mess with it all day. Just like when I have a big zit, I'll keep touching it, massaging it... until it pops in an inappropriate setting. So given the location of my patient's pathology, I had a pretty good feeling that he had his hand somewhere between his left testicle and left leg for the better part of the day, if not week given the duration of his symptoms. With that knowledge I deftly avoided shaking his hand. Even when I asked him to sign the consent for the operation, I ignored his attempts to try to return the pen I had stolen from the nurse's station. Since I'm such a team player, I shared these insights with my senior resident who examined the patient with me. Although this was after he was done shaking the patient's hand... b/c it's more fun that way.

*ironically, anal surgeons are actually not as anal with regard to sterility as their peers who operate on other parts of the body since their operating field is by nature unsterile.

21 days down, only 344 more to go. No doubt, internship is tough. I'm working harder than I ever have, and the year only gets tougher from here. Despite the crazy hours, residency does have its perks. Depending on where you go to med school, there is a variable amount of actual "hands on" training that you get. Especially at very academically oriented institutions, there is certainly a lot of watching (vs doing) that goes on. While scrubbed into cases as a student, you find your job limited to a combination of suctioning, retracting, and trying not to contaminate anything. As a resident, finally the attending says, "scalpel to Dr. <insert your name>."

That's what happened to me my second day on the job. I got pulled from my regular spot to help out with a case fixing an open tibia fracture. So I get scrubbed and position myself across from the attending at which point he directs the scalpel to me. I think, "cool, at least I get to make the incision." Then he starts explaining to me what we're going to do as if I'm going to do it at which point I start thinking "oh crap, I better start paying attention." So after an hour of a little bit of struggling and having the attending guide me step by step through the case (since I didn't have much of a clue as to what I was doing), we were done. We had the nail in place, leg was fixed, and I got to do my first real operation. It almost makes the 5am - 7 pm workday worth it.

example of tibial nail