Surgery

I think the reason why I haven't written much is because I experience so many different things every single day that I just cannot find the words to articulate these experiences. It's also hard to express the excitement and befuddlement (is that a word?) at the FACT that I will be graduating soon.

Really soon.

I just finished my first week in Surgery at a hospital in Queens. I have to report to "Sign In" at 6:30am every morning. From 6:30- 7:45am 20 surgeons, residents, interns, and med students meet in a conference room to discuss every patient that has been admitted to the surgery department. From 7:45 to 9:00 we do rounds. The entire team (20 of us) walk to every patient's room and check in on them. From 9-noon we work in a clinic...either surgery, orthopedics, or wound clinic. And from noon to whenever...we can go in and assist in surgeries.

In the surgery clinic, my job is to examine a patient that had surgery within that last few weeks. I examine them and then present the patient to the head attending. In the othopedics clinic, I examine the patient and determine whether or not they are a candidate for surgery. Then I present the patient to the attending. In the wound clinic, I remove bandages and inspect patient's wounds. Most are diabetic ulcers and the smell is unbearable. One of the other students started gagging the hallway. Some of the docs put Vics under their noses for certain cases. I've seen some nasty wounds...

I participated in my first surgery on Friday. I was second assist on an inguinal hernia. Turns out the guy had a direct AND indirect hernia. I really had no idea what was expected of me and I left the surgery completely surprised by the amount of responsibility I had during the surgery.

There were three of us working on the patient. The surgeon, the resident, and me....the student. The surgeon made the first cut and pointed out all of the landmarks. He handed one retractor to the resident and the other retractor to me. I stood to the right of the surgeon. The resident was on the other side of the patient. I held the retractor with my left hand and was surprised when the nurse handed me a pair of scissors. I grabbed them and when the surgeon said, "Cut"....I cut! I would cut the internal stitches that the resident made under the instruction of the surgeon.

After the surgeon repaired the hernia, he closed the deepest layers of the wound and left the resident and myself to close the wound. The resident did the second layer and I closed the superficial layer under his close supervision. I'm glad I had my ER rotation otherwise I wouldn't have known what to do. There was a medical student in the room with us and she had never sutured before.

The curious thing about this rotation is that I am treated EXACTLY the same as the medical students. There are 4 medical students and 2 PA students. The interns and residents really don't know the difference. The majority of the interns and residents are from overseas and are male. Out of the 20 surgical staff...only 4 are female (including me!). I am asked the same questions as the med students. I've had doctors, nurses and patients address me as Doctor. I explain I am a PA student. So then I'm called "student doctor".

Once a week I am required to do 24-hour call. I work a normal day: 6:30am to 5pm...and then I stay in the hospital with a pager and wait to get paged until 8am the next morning! So technically that's 25.5 hours...but who's counting? Either way, I still don't get paid!

I can sleep in between pages. I do have a call room. It's a small room with a desk and a bed. I don't think the room has been cleaned since the 70's...but there is a door and I get to close it and have some "alone" time. I slept about 3 hours during my first call. I could have slept more but since I was in a new environment and was paranoid that I'd sleep through the pager beeping...I woke up frequently. It is the student's responsibility to update a list of patients. We have to update their conditions and treatment plans and make sure they haven't changed rooms. So, at 5am, I have to run around to the different floors and check up on the patients and their status. Then I have to type up the new list and make copies for everyone at the 6:30am meeting.

So, these days, I wake up at 5am...leave my house by 5:15am. I arrive at the hospital at 6:15am and change into scrubs before the 6:30am (sign-in) meeting. The sign-out meeting is usually between 3-4pm and can last up to two hours. I'm usually home by 7pm. I try to get to sleep before 10pm.

I have to say that I do like surgery. As demanding as this rotation is....I like the challenge and the responsibility. I also like the team approach and the dynamics involved. I would like it even more if I were actually getting paid to work all of these crazy hours!

Less than 4 months to go...

Holy Crap!