Thursday, March 26, 2009

January, February, and March…all wrapped up in a pretty bow

Sorry I pretty much skipped January’s rotation at SLRMC which was inpatient medicine, and February which was ER (everyone thinks there will be great stories here – there is not; pretty much everyone is just crazy, and since I worked in ER for so long, it wasn’t too earthshaking for me, but I really really liked all the attendings, residents, and PAs and the schedule so I was sad it ended).
So, to get to this month, working with the cardiac surgery group at Intermountain Medical Center in Murray. These are all people I was familiar with and worked with when I was doing cardiac rehab at LDS Hospital (before it moved to IMC); supposedly they all claim to remember me…apparently my charming personality leaves quite the impression (HA).
Thoughts during my first few days:
I scrubbed in with Dr Jones; there are two Japanese fellows here currently who generally first-assist, so it gets crowded. At one point Jones stepped out and let the resident continue, so I had more room and got a better view. In my mind, I was hoping he’d stay out and it would be inconsiderate of him to come back in and push me out of the way. And then I remembered, “HE’S THE CARDIOTHORACIC SURGEON; MAYBE HE SHOULD BE IN HERE”. This was my first experience with heart-holding; observations: it is really really COLD; the heart, the blood, the ICE…everything is cold (I prefer abdominal surgery where I can stick my hands inside to warm them up); it is REALLY odd to watch them CUT INTO the aorta, and the HEART, stick in tubes and suck out the blood, cool it, and watch the heart start to fibrillate then stop. Generally, this is not desirable. But it’s even more amazing that there is quite a bit of cutting into important things like ventricles while the heart is still warm and beating—and it tolerates it quite well! So, holding the heart, as intricate little stitches are placed on little vessels that are responsible for keeping cardiac tissue alive, made me a little self-conscious. I felt like I was going to slip, or then I’d start shaking from holding so long, and the resident who was sewing sort of had a hand resting on mine so then I was worried I was making him shake…anyway, it wasn’t too bad but it would have been if I actually had slipped. Oh, the other thing; falling asleep in the OR. It’s not that it is uninteresting, it’s just that there’s not much for me to be actively “doing”, and these are LOONG surgeries; and I get drowsy in any setting. Haven’t actually fallen asleep or fallen over though yet so that’s good. This is DEFINITELY the best way to learn anatomy; it is so cool, especially seeing the inside of the heart.
Second day I went in with Doty. He is really also really good about pointing cool, interesting things out (but not asking questions, so no pressure for me). The whole procedure was pretty amazing and sort of a big deal. I’ve always wondered if neurosurgery or heart surgery is harder/more impressive, then today I realize neurosurgeons don’t STOP THE BRAIN when operating, and then restart it; so there’s one answer.
Most of the operations are 3-6+ hrs long. Apparent they don’t have students a whole lot like at the U, so generally nurses are nice to me, as are the docs (which I haven’t had any be mean, but nurses sometimes like to try to intimidate or make feel dumb). The Japanese residents are so respectful and nice.
The other day I was looking through a pre-op patients medical reports and came across his first open heart at 28 years old in 1977. There was the report in his chart by his surgeon…Russell M Nelson. It’s cool. I used to hear his name around when I worked at LDS but it was weird to see him as a surgeon more than a general authority.
It’s a big hospital, so I get lots of exercise walking around and climbing stairs (I hate elevators—with good reason; today one of the PAs was stuck in one for 45 minutes!). I don’t really know what’s expected of me but I can pretty much be in the OR when I want, or on the floor, or in the office (which so far everyone has recommended I not do—because it’s boring).
I did get my first experience of the stereotypical “surgeon” this month. In all the years (7) that I have had surgery experiences, and in all the specialties (urology, multiple general surgeons, trauma surgeons, ophthalmologists, neurosurgeons, etc) I have not encountered the rude, jerky, intimidating, temperamental surgeon and have never been yelled at…until now J I had the great pleasure of scrubbing in with one such a surgeon, who in all my encounters with him before this has been pretty fun and nice; not so in the OR when he’s having a bad day! I was even warned ahead of time; I think he’s bipolar or something, because he’d yell at me one minute then be perfectly nice and joking around the next; but as soon as someone set him off he’d be yelling and throwing stuff again. I mostly feel bad for everyone who has to work with him regularly, especially since everyone else is SO nice. Anyway, he’s crazy so not a big deal, but I’ve tried to steer clear so as to not experience that joy again. It just strikes me odd that in no other setting (other than celebrities maybe?) is it permissible for a grown, educated, intelligent, adult to throw temper tantrums!
This month was also our return visit at school, which included master’s presentations. That was fun. Finally finished my paper, and FINALLY finished my presentation the day before; the hardest part was getting it short enough to fit into 20 minutes, allowing 5 more minutes for questions. I think I did mediocre which isn’t really ever my goal, but it is good enough. The program has pretty much told us this is a technicality that is required by the graduate school, so we do it. It is a relief to not have to have it hanging over my head anymore! People such as us go into these types of professions because we don’t like writing papers or public speaking!
We also took a practice board exam; that was fun (I did worse than on the last one! Oops! I’m going to start studying though…soon). Had a few lectures as well, including topics such as finding jobs, resume/CV-writing, contracts, malpractice, etc; great way to get us looking forward to the future. I have been working on thinking about jobs, applying, talking to people, and working on my resume. So far, I’d say it’s amazing and I’ll have offers coming out my convoluted tubules by August.
I’ve been able to go snowboarding a few times (last time went to Sundance and there was not enough snow and it was all melty/slushy…but fun). I signed up for the SLC half marathon in April, and for the San Francisco Nike Women’s Half in October (almost got talked into the full…!) but that one is a drawing so we’ll see if I get in (didn’t last year); my goal is to do the Vegas full marathon in December! There, I said it; now I actually have to work on doing it. We’ll see how training goes over the summer.
Most importantly! Next week is my last week of CT surgery, and I don’t start at the VA until the middle of April, so we’re going to Mexico for a week! Yay! I can’t wait—especially since it’s been snowing the last 4 days after a week of 60+ degrees. Yay!!!


Marissa said...

Wow. Long post, but very fun reading. I like hearing about your medical experiences, especially when I don't have babies interrupting us every other sentence.
Funny that you "get drowsy in any setting". My Ryan is exactly the same way.
I'm excited to hear about Mexico!

Jonathan said...

Boy, what a terrific post! I should have read it when it was still current. We're ready for another one like this!