Week 1 of 12 of my Surgery rotation: complete.
The transition from Internal Medicine (IM) to Surgery was quick, and my experiences so far in the two disciplines have been completely night and day. During my 12 weeks of IM, I was challenged to THINK (…and think again…then think more deeply…and finally think some more…) about my patients’ medical conditions and how to manage them (all 1 or 15 of them, simultaneously).
By contrast, Surgery has been challenging me to DO. And this past week I’ve done things that I perhaps wasn’t quite ready to at the moment, but I’ve taken each task head-on and am excited to strengthen my technical skills.
SO, FIRST DAY, aka the day after orientation, an incision and drainage (I&D) needed to be done (i.e. a minor surgical procedure where an abscess, boil, or other collection of fluid under the skin needs to be cut into and drained). And of course, I volunteered to tag along with the hopes of first witnessing the procedure before feeling comfortable enough to eventually perform one. But alas, life is full of surprises. After we collected all the materials needed, the intern resident handed me my first lidocaine bottle and syringe to administer to the patient. You should’ve seen my face…one of confusion and shock and slight embarrassment. But with much patience and guidance, I was talked through how to fill the syringe and then sterilize and inject the patient…and again I thought my work for the day was done. Until I was handed the scalpel…
The moment I pierced the blade into my patient’s back abscess, I gathered a sense of confidence that I knew my patient needed to be comfortable during the procedure. I moved without hesitation, following my intern’s reassuring voice, but in my head I had questionsssss: Did I cut deep enough? Should I stop when the patient winces in pain? How long should the incision be? Did I administer the lidocaine in the right places? All these and more I kept in my little head to ask later.
We collected a culture sample, flushed it out, packed it up, and my first procedure came and went. To my surprise, I received positive feedback from my intern and walked away feeling good about taking a chance on myself and not shying away from a challenge.
I think this first day is a great example of what I anticipate to come during this Surgery clerkship: you gotta throw yourself out there to learn the things you want to know and don’t ever be afraid to try. That’s what I’m paying all this money for, anyway haha. I had to remind myself that everyone has had a first time for everything. And as long as you’re not putting the patient in danger, you’ve got to have the faith to try.
Then on DAY THREE, I sutured my first surgical patient. Right at the end of a procedure, the chief resident wasted no time telling me to gown up and before I knew it, the surgery tech handed me a prepped needle driver and forceps. Chief asked if I’d ever sutured before, and I admitted that my only exposure was a 1hr workshop two days prior.
Talk about experience. Again, I put my big girl boots on and went forward trying to remember what I had learned, although doing it on a living, breathing patient (with blood and fat and flesh) was a totally different game than the pig foot we practiced on. I finished my measly one suture in the same time Chief did 3, but at the end he gave me a high five for getting through it, haha. Another first, another opportunity to learn, and another step closer to mastering a new skill.
It goes without saying, I saw some pretty cool surgeries during my first week. These included a robotic hernia repair (SO COOL), laparoscopic cholecystectomy, and breast cyst removal (plus more). One of my favorite was the robotic procedure, unlike anything I’ve ever seen. The technology we have at our fingertips is just….wow. Beyond incredible. If you ever get a chance to shadow one of these, TAKE IT! It’s slightly reminiscent of a video game console, except…it’s not when you realize the stakes are much higher and the human lying on your OR table is trusting that you can fix their problem without any adverse outcomes. So while it’s fun and interesting to see, it’s still very much a serious procedure that requires attention and skill.
So that’s all folks! My first week is in the books. Lord knows what’s in store for the following 11 weeks but it’s such a privilege to be here, and I’m often reminded of that. Surgery, I’m ready for ya!
Peace & love (& needles & thread & amateurs),
The I.T. Factor