Saturday, October 07, 2006

CTS

This week has been my first week of cardiothoracic surgery. It is quite a bit more laid back than I was expecting it to be. The team is set up a bit differently than what I am used to. The only resident is an intern. There are five attendings, two or three fellows, and then several nurse practitioners and PAs. The NPs and PAs manage the basic components of patient care in the hospital, except on the weekend when the intern takes over.

Monday was orientation; afterwards the other student and I saw the last half of a lung lobectomy (removal of a lobe of the lung) for lung cancer. Tuesday we had teaching rounds in the morning which made us miss the one surgery scheduled. In the afternoon, we saw a consult patient. We went to her room and looked through her chart, then as we were about to knock on the door it suddenly opened and the patient, all dressed up in coat and gloves was about to walk out. She informed us that she was going to go to the grocery store. We talked her into letting us talk to her first—she was a very pleasant lady, but didn’t tell us anything relevant as to why she was in the hospital. We finally left, and I mentioned to the front desk clerk that she was about to go to the grocery store. They got the nurse and put a guard at the door.

Wednesday was lecture all day. Thursday the other student scrubbed in for a triple bypass with aortic and mitral valve replacements, and I went to clinic. Clinic was very painful, although I did learn a lot and saw a wide variety of problems. The pain was largely because for the most part I just shadowed the doctor and nurse practitioner, and also because there was no lunch break so I didn’t eat from 5:30am til 5:00pm. Thursday morning I experienced what was quite possibly the most awkward situation of my medical career. I went to round on a young lady I had not seen before (on this service students often round on different patients every day which means that in fifteen minutes we have to read the chart and figure out why the patient is there, go see the patient, and then write a note including a plan). She had had cancer as a child, then was found to have some suspicious lesions on a chest x-ray recently, so she had to have the lumps removed. I’m pretty sure they were negative for cancer. I went into the room and introduced myself, then she asked if I knew a certain person who happens to be another third year student in my class. I said yes, and she told me that he is her husband. Then, all of the sudden, he walked into the room to see her. It was horribly uncomfortable, what on earth do you say to someone you don’t know very well whose wife just came close to being diagnosed with a fatal disease in her early twenties and you didn’t even realize he was married, much less in this situation? What makes it worse is that I can’t even share this story with my friends at school because it involves someone we are all familiar with.

Friday the four students and I went to an hour and a half long pimping (doctors asking students questions for the purpose of teaching, a practice often abused in the past by some to humiliate students) session at the VA with a cardiothoracic surgeon which was rather painful but very helpful. I found it impressive that he was taking an hour and a half out of his day to help third year students. And he brought cookies, which ended up being my last caloric intake until 8:00pm. When we got back to the main hospital, I went to a CABG x2 (double bypass). It was about a five hour long surgery but very interesting. Very amazing to be looking at a beating human heart. My role was basically as an observer until the end when I helped the fellow wire the sternum back together and sew up the incision. After, we rounded on the patients, then the intern and I went to see how the operation the other student was involved in, an esophagus removal on a 420 lb man, was going. The intern really wanted to go home, so she was hoping to make an appearance then leave, but the attending said as soon as she walked in that she could scrub if she would like, so of course she couldn’t tell him that she wanted to go home. The other student, who has no interest in surgery whatsoever, looked like she was ready to die. The case ended in an hour, and I was at last able to go home and watch the new episode of “Lost” which I had taped two days before. It is getting very interesting.

3 Comments:

Blogger Just_Tiffany said...

I watched lost the other day, too. I don't really know what is going on because ellen chose to rent them out of order

10:36 AM  
Blogger Chris Emlyn said...

Watching Lost out of order should be considered a criminal activity.

6:31 AM  
Blogger Just_Tiffany said...

yes i think it was....

9:50 AM  

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