Doctor Shadowing

My doctor shadowing this past Friday at the Washington Hospital Center was great!!! The surgery resident I was shadowing was just finishing up his second year and he was on the burn service for the hospital. So if someone came in with any kind of severe burn, then they took care of them. When I arrived at the hospital I met the surgery resident and he took me downstairs to get some scrubs (I truly love those things…I would wear them to my wedding if I could, lol). After that, we went up to the burn unit and into the OR where they were prepping a guy for surgery. This guy truly went through a lot; he had gotten into a bad car accident and his car burst into flames. It took an extended period of time for the ambulance to arrive so he was in the car burning for awhile. As a result of that, his legs were basically burnt to a crisp, and he had burns on like 92% of his body, pretty bad burns too (I can’t remember what burn degrees equal what). So when the guy first arrived into the trauma center, they had to rush him to the OR immediately to amputate both of his legs because he was losing too much blood due to the extensive damage. So they amputated both legs above the knee and proceeded to get his other burns in check. By the time I saw him, he had already had a couple of skin graft surgeries, but that day, they were working on the palms of his hands. Now while shadowing, I’ve seen some pretty bloody things, but nothing made me quite as queasy as watching them prep the guys palm for the skin graft. You see, in order to place a skin graft there, they had to make sure that all the burnt and dead tissue was gone. So first they took an instrument similar to what you would used to peel a potato, and they started shaving off the tissue on his palm, layer, by layer, by layer. And then, in order to see whether they got all the dead tissue, they released the tourniquet on his arm so that the blood could flow back to his hand. You see, if there was dead tissue then it wouldn’t bleed, but if the tissue was alive, then it would bleed. So there is a lot of shaving, and a lot of bleeding involved in burn surgeries, but it was also very very fascinating. Once they finished prepping his palm, they looked for good areas on his body to take the skin graft. He didn’t have many good spots because he had been burned on so much of his body. They ended up taking a skin graft from a part that they had already taken a skin graft from. But the chief surgeon there said that as long as you haven’t taken out the hair follicles from previous skin grafts then you can take another skin graft from that area. So yeah, they took an instrument similar to that used in a black barber shop and they took the skin graft and just laid it on top of his palm. The skin graft part was the easy part, it was the previous shaving part that really took most of the time.

So yeah, it was an interesting surgery. I’m not sure whether I would do a fellowship in burn surgery but you do significantly improve how they look. But the surgery did raise some ethical questions for me. This guy was basically dead when he came in. Both of his legs are now gone, his fingers were charred so badly that his extensor tendons are gone, so they had to pin his fingers together, meaning that he will only be able to use his hands as a lobster does, with his four fingers and his thumb. Burn patients like him have almost eternal pain and are constantly drugged up, and he’ll probably have to have like 15 more surgeries to take care of the rest of the burns. It made me wonder (if I was in his shoes) whether I would have wanted to be saved. Should the doctors have saved his guy’s life, or just let him die? Yes he’s alive, but his quality of life will be so horrible that I don’t even think it can be called “quality” of life. I know that it is not the doctor’s decision on whether this guy should have been saved or not, but it kind of makes you wonder whether it’s fair to the guy to let him live like this. This was just something that crossed my mind. And once again, I know that doctors can’t make that decision, but it’s something that should be discussed.

Also, while the surgeons were performing the surgery (it was a resident and the chief burn surgery attending), they were discussing the current fate of the possible merger between the Georgetown residency and the Washington Hospital Center residency. You see, both hospitals are run by a company called MedStar, but talks are underway for merging the two surgery residency programs (I’m not sure if its just surgery or all of them). The problem with Georgetown is that its in basically a very rich part of D.C., and most of the people in the area are very healthy, so the surgeons don’t see a wealth of cases. On the other hand, Washington Hospital Center is in the middle of D.C. and they have a Level 1 trauma center with 3 helicopters so the surgery residents there get A LOT of cases. Because of that, the Georgetown residents rotate at the Washington Hospital Center to get their trauma and their burn experience. The problem with this is that the Georgetown residents are getting Washington Hospital Center cases, but they still have the advantage of the Georgetown name, while the Washington Hospital Center residents are getting great experience, but they don’t have the world renowned name. Anyway, it was more of a political talk, but it was cool to hear what goes on in the higher levels of the hospital.

I have SUBMITTED MY AMCAS, and the status is: Submitted to AMCAS- Ready for Review. So now I just have to wait for AMCAS to process my application and check my mailed in transcript against what I wrote on my AMCAS app and the secondaries will start rolling in!

The surgery resident I shadowed on Friday will be starting his 3rd year on July 1st, and he will be on the team that basically does what normal general surgeons do, which is basically bread and butter surgeries. This will be great for me to see because it will let me see whether I would just want to stay a general surgeon or go on to do a fellowship. I truly admire surgeons because (as the burn surgery attending told me), surgeons are the only doctors that actually heal people (lol, he could be bias though). But he said that all the other doctors just treat patients, but surgeons actually fix things. And that’s the kind of doctor I want to be. I want to fix people not treat some never ending disease.

So yeah, I had a great time and hopefully I can do some more shadowing.

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