Fourth year: Oh yeah, I learn everything from youtube. During a trauma the other day the resident asked me if I knew how to do this particular stitch. I told her yes and then stood in the corner of the trauma bay and quickly watched it on youtube. Then I was ready to go.
Tuesday, July 23, 2013
Friday, July 19, 2013
Not safe to drive
Patient, after the procedure done under sedation is finished:
Patient: But doc, I'm still under the influence!
Doctor: Under the influence of what?
Patient: The happy juice.
Patient: But doc, I'm still under the influence!
Doctor: Under the influence of what?
Patient: The happy juice.
Sunday, July 14, 2013
Someone is gonna get hurt
Teaching hospitals are a funny thing. You are going to get the best, top of the line care at the forefront of medical research. You are also most likely going to get poked and prodded by less than skilled hands (ie medical students and new residents).
I'm on my anesthesia selective for two weeks. In the week I have been there so far, an elderly woman woke up with an extra bruise on her hand from a botched IV, another woman woke up with a swollen lip from a botched intubation, and still another woman woke up with the back of her throat possibly more scratched than it had to be from yet another botched intubation. I asked if I could practice intubations in a sim lab and was told that it isn't at all the same. In the sim lab, the tongue stays put and doesn't flop everywhere. I need to practice on real people, I'm told.
I watched the attending leave the first year anesthesia resident alone in the room for ten minutes. The apnea alarm started going off. I asked why it was saying that, he had no idea. If anything bad had happened in those ten minutes, that woman might have been dead. I watched the junior resident accidentally bovie the stomach serosa instead of the fascial adhesions. If you told patients during the consent that their surgery might have a few mistakes, the anesthesiologist is new and doesn't know what to do if anything goes wrong, and a med student is going to practice with their veins to put in IVs and try intubation only to probably just scratch up their mouth, I'm unsure they would consent.
It's a necessary evil of a teaching hospital. And you know what? If one day I need to wake with a few extra bruises and minor abrasions from a surgery that maybe didn't go as smoothly as it could have because a resident messed up, then so be it. That is what it takes to make doctors of tomorrow. We have yet to find a better way.
I'm on my anesthesia selective for two weeks. In the week I have been there so far, an elderly woman woke up with an extra bruise on her hand from a botched IV, another woman woke up with a swollen lip from a botched intubation, and still another woman woke up with the back of her throat possibly more scratched than it had to be from yet another botched intubation. I asked if I could practice intubations in a sim lab and was told that it isn't at all the same. In the sim lab, the tongue stays put and doesn't flop everywhere. I need to practice on real people, I'm told.
I watched the attending leave the first year anesthesia resident alone in the room for ten minutes. The apnea alarm started going off. I asked why it was saying that, he had no idea. If anything bad had happened in those ten minutes, that woman might have been dead. I watched the junior resident accidentally bovie the stomach serosa instead of the fascial adhesions. If you told patients during the consent that their surgery might have a few mistakes, the anesthesiologist is new and doesn't know what to do if anything goes wrong, and a med student is going to practice with their veins to put in IVs and try intubation only to probably just scratch up their mouth, I'm unsure they would consent.
It's a necessary evil of a teaching hospital. And you know what? If one day I need to wake with a few extra bruises and minor abrasions from a surgery that maybe didn't go as smoothly as it could have because a resident messed up, then so be it. That is what it takes to make doctors of tomorrow. We have yet to find a better way.
Tuesday, July 9, 2013
First day of surgery clerkship
My attending had wise words. He said that it is a guarantee that we will harm people and we will be an instrument of some people's death. He also said that this career is amazing. In no other career will someone meet you for 15 minutes and then agree to let you cut them while they are asleep and vulnerable. His opening speech was much more profound than I can summarize in a few words, but it made me both excited and scared for the upcoming years.
Two tips for those starting third year:
1. Always roll up the sleeves on your white coat when you eat. It will avoid ketchup vs. sleeve mishaps.
2. Always carry cash with you so when the cafeteria is cash only, the attending doesn't have to pay for you on your first day.
Other than that, I start my anesthesia selective tomorrow. We will see how that goes.
Two tips for those starting third year:
1. Always roll up the sleeves on your white coat when you eat. It will avoid ketchup vs. sleeve mishaps.
2. Always carry cash with you so when the cafeteria is cash only, the attending doesn't have to pay for you on your first day.
Other than that, I start my anesthesia selective tomorrow. We will see how that goes.
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