Friday, September 15, 2006


This week has been busy, I calculated that I worked 62.5 hours in five days although that really doesn’t sound like that much compared to how long I feel like I have been working. I saw four surgeries including two biopsies (I didn’t do anything except watch), a laparoscopic Roux-en-Y gastric bypass (I just watched), and a subtotal gastrectomy with revision of the gastrojejunostomy. The lap bypass was very interesting, it was amazing to see the surgeon do everything including suturing with long instruments through tiny holes in the abdominal wall. What was discouraging was that one of the surgeons (did a laparoscopic fellowship after surgery residency and has been in practice for several years) kept getting yelled at by the head surgeon for making mistakes—I always thought that once one got out of surgery one didn’t need supervision anymore. This could be a longer road than I thought…

The gastrectomy was interesting though I couldn’t see a lot of it since the surgeon was blocking my view. The patient had a gastric bypass a couple years ago, and a fistula (connection) had developed between her stomach pouch and the rest of her stomach, essentially making her bypass useless. The surgeon opened her up, and spent several hours with the resident dissecting to the proper area. They ended up just taking out the main stomach since it had lost much of its blood supply. The resident let me staple the incision, and I grabbed some ties on the way out to practice my knot tying (I learned the one-handed tie a couple of days ago) at home.

This morning was GI conference, and I was supposed to present a patient who had left the hospital the second day of this rotation, I had never spoken to him. Yesterday I had to track down his chart via the very crabby nurse practitioner, and when I did get it it really didn’t have much information. I spent 1-2 hours piecing together his history, and fitting it into a one minute spiel. I got home last night and had to practice it in the small amount of time I had before going to bed. At the conference this morning, the attendings spent so much time talking about other patients that I thought they wouldn’t get to me. Fortunately my resident spoke up before everyone left and asked if we could go over the patient I was to present really quickly so I was able to give my presentation. Not that I especially wanted to talk in front of everyone, but after putting so much effort into preparing I would have been a little miffed at not presenting.

I have tomorrow off, I am very excited about that. I might not get out of bed at all (one thing I have learned on this rotation: it is a bad sign when instead of feeling sorry for patients you feel envious of them since they are always in bed when you see them—one of the residents mentioned that one of the patients spent 70% of her day at home in bed and my first thought was “that sounds great”. It is also a bad sign when the nurse practitioner stomps through the room loudly saying “I’m going to shoot myself if this pager goes off again”]). The only problem is that I have to work both Saturday and Sunday next week, but usually we are out by noon on the weekend so it shouldn’t be too bad. The weekend after marks the end of this rotation—it has gone by very quickly. Next is cardiothoracic surgery, but there will only be one other student so it is unlikely that I will be getting full weekends.


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