So I had my first week of my surgery rotation and I am completely exhausted. My day starts at 4am and I am home by 7 p.m. usually. And then it starts all over again. My wife has it worse too; usually I wake up at 4 am, but she is usually gone by 4am since she is on the hardest working team at LLU. Because of the crazy hours we have been keeping this week we both felt like we hadn’t seen each other at all, which made the transition even rougher. With all that said though, I still prefer surgery to all the other rotations so far.
On Monday when I first arrived at the county hospital we went through orientation, got our badges and reported to our team. I was assigned 4 patients that had already been seen that day so I spent the rest of the day going through their charts so I could learn more about them. The next day I arrived early (4:45 am), saw my patients, wrote my progress notes, and was prepared to present them. However there were a lot of traumas that had just arrived so the resident that was supposed to round with us was in the OR. And the way it works here is that when the attending we are assigned to for the 6 weeks is operating or in clinic, we go where ever they are regardless of whether rounds are done or not so I left and went to clinic at 7:45 am since that was where my attending was. I found clinic to be pretty okay; you didn’t really have to do an exhaustive internal medicine-like physical exam. The patient came in because of a hernia, or a painful thyroid, or a mass, or for follow-up after their surgery. Once I got the hang of seeing the patient’s then they let me start dictating the H&P’s (basically you speak the H&P into a phone and someone types them up). I am sure that my first couple of ones were terrible, but it was fun to learn how to do it. The attendings speak so fast into the phone it is a miracle that anything gets put into writing. I guess I will be like that one day.
The operations have been pretty interesting to see, although I am starting to see why General Surgeons tend to be categorized as mean and unhappy. Almost every time they are called to see a patient, if they miss something or if they don’t take immediate action the patient has the possibility of dying. For example, a patient came in with acute onset right upper quadrant pain (probably an inflamed gall bladder). If they misdiagnose it or if they don’t take out in time, then the patient can die. The same thing goes for their traumas; when a patient comes in after a car accident they have to evaluate them for all sorts of injuries that could possibly kill the patient. Being under all that life and death stress can truly wear away at someone if they don’t know how to handle it, and I can see how they can get snappy after dealing with these problems for 30 hours straight every 3 days. Compare that to orthopedics or urology where there may be traumas, but they can deal with the patient a couple of days later and the patient won’t die from their injuries (for the most part). Instantly I could see job satisfaction increasing in an environment like that. I do really appreciate the surgical skills that I am learning, but I just don’t know if I could deal with the life and death thing day in day out.
Who knows…I have 5 more weeks of general surgery to figure it out.
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