just call me Surgeon!

I know i havent updated in a long time end of the rotation got a little crazy, a little busy and full of evening activities for the trauma team (visiting professors, journal club, happy hour etc). The last month of my surgical rotation included critical care management. Each day i spent in the ICU managing neurosurgical patients and other trauma patients, and LOVED it more than i ever thought i would, the patients were complicated, interesting and involved lots of procedures!!

We had a patient who decided to get drunk and drive a boat into an overpass, smashing his head. The NS team declared his injuries incompatible with life, on his license he identified himself as an organ donor, so the transplant team went into full speed. The night before the harvest i had been on call, and around 2am rounded through the ICU and it turned out the patient needed to have 2 central lines put in for IV access for the harvest. I asked if i could do them, thinking they would say no, and to my surprise they said, "sure, get all the supplies and be in the room in 10min." That night i put into two subclavian central lines, without causing a pneumothorax and did it on the first stick! After those two lines, they let me put in any central line i asked to do...

The last month had some interesting cases come through the door, and most of them involved interesting lessons:

1. dont break up fights
2. dont sleep with another mans wife
3. dont drink and __________.
- ride a motorcycle, lift weights, work construction, drive a car, ride a scooter
4. dont rush to the IKEA grand opening on a scooter on I95
5. dont drink red bull while doing cocaine
6. dont misuse hardware
7. if you are going to try and kill yourself, at least know where the arteries are located
8. dont fight with your little brother around glass doors
9. "never sit on the stoop of church reading a bible minding your own business, you may get shot." - trauma patient


Some of the other things i have learned on my surgery rotation:

- only go into a patient room if you have to
- if you can smell the patient down the hall, dont go into the room alone
- ALWAYS double glove!
- surgeons are not doctors, so call medicine!
- ICU nurses are the backbone, dont piss them off
- cover your own ass at all times, because someone will always be there to make you look bad
- know everything about your patient!
- take some time for yourself
- keep a change of clothes in your car at all times
- smile, laugh and keep it fun or else you will go nuts
- call the attending only when you have too
- know when to use lidocaine with epi
- be nice to the triage nurses in the ER they can make or break your night call


At the end of the rotation, the chief of surgery called me into his office, and told me he sees me as a surgeon. He also mentioned that he would be willing to make some calls, and write me a rec letter for residency. Every student coming out of this rotation that wanted a spot in surgery got a spot in surgery. The chief knows people everywhere and is a big name in the world of trauma and surgery...AWESOME!!!

just glad i have found an area of medicine that i loved and could see doing every day for the rest of my life....not sleeping and living life in a chronic state of fatigue is awesome! currently i am on family med and my hours are so boring, 8:30-5 monday -fri...i have so much free time i am not sure what to do with it...

anyways family med is another post entirely!