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Sunday, August 28, 2011

Surgery, What's it like?

Morning round at 6:30 AM, end of shift 6PM if you're not on call, and the next day at 6PM if you're on call (36-hour duty), 6 days a week. What's up?

I've never felt or been so out of time for so long in my life. What's it like? Forget about having the slightest bit of time for anything unexpected like your car breaking down or your grandmother getting sick. These have no place in your loaded schedule and most days you have too little time to make a phone call or even to think about it!

On the floors, busy with more tasks than you can count, armed with a loud beeper that won't shut up or stop interrupting you, paged relentlessly by your numerous superiors and their ridiculous requests that could not come at worst times. You feel the need to be at 5, 6 places at the same time, and soon as the day goes by, like butter spread over too much bread.

You feel disrespected, unappreciated, and you want out. Out of the misery, the stress and humiliation. But somehow you pull through it all and get home almost too tired to get out of your clothes and crash on your undone bed and fall asleep to wake up a few hours later for it to start all over again. "Bring it!" seems like the only attitude to take if you are to have any chance of succeeding.

Here's what you do on the first year of a surgery residency.

First call on all your patients's issues.
Loads of paperwork.
Seeing and preparing all new admissions.
Keeping track on all occurrences and treatments done on patients in real time.
Making sure all the labs ordered on patients are within normal and making corrections as needed.
Handle incompetent nurses and be thankful that there are a few who want to help and actually know what they're doing.
Handle all of your superiors' scut work like ordering labs, getting consent forms signed, and transporting blood units or specimens back and forth between the OR and the pathology lab.
Keep track of everything your students are doing and making sure they don't screw up.
Dealing with obstinate and overconfident hypertalkative students, patients, and colleagues
Catering to every attending's immense ego.
Playing secretary and delivering messages between residents and attendings in the hospital who are just too stupid to talk to each other directly.

The list goes on. And the worst part of it is that you never get any form of recognition when you get all of this done right, but get reprimanded heavily at the slightest delay or bureaucratic mistake you make, to the demise of any shred of motivation you might still have had.

What a rush, what a time hole, making you appreciate your only off day in the week like someone starved for a year would appreciate a Big Mac. Wow.

But you know what? I love it! I love that feeling that no matter what happens this year, or the next, or the one after that, something is being built that seems to be worth all the crap you are forced to take. I have students under my supervision now. Students I have to teach, supervise, and help write progress notes. Students who - mostly - look up to their intern with respect and admiration.
And the single most rewarding feeling you have, that will make all of the above seem like a very small price to pay, is the recognition you get from your patients, who often are very sick people that you can help provide with a better life. And it's amazing just how grateful they can be, not because your attending surgeon just performed life saving surgery on them, but more because you devised a way for the dressing on their colostomy to stop leaking stool, the smell of which requires no description when it comes from s diseased colon, from their abdomen and onto their skin and bed sheets, keeping them awake at night. You do something like that, and you end up getting a disproportionate amount of gratitude, and that patient will smile every time you walk into her room.
This feeling, this gratitude, is worth more to me than the highest awards, from Penrose all the way to Alpha Omega Alpha (some of the most coveted awards), making them seem completely trivial once a sick patient calls you their guardian angel just because something you did helped them get a good night's sleep.
There's no beating that. And this mini surgeon is sticking round for more.