The Curious Scalpel

I had a great time on call (again), this time we happened to see 3 gallbladder cases in a row: one with cholecytitis and two with probable choledocholithiasis.  It was a good learning experience, I think, because I have since assigned faces to these amorphous disease monographs.  Two other exciting events took place yesterday: 1) I scrubbed in on a laparoscopic splenectomy and got to see it done with great skill by an expert (it really makes a difference when the surgeon has a plan 5 steps ahead of time), and I got to do the closing sutures... and 2) I got to scrub in on a hip replacement! Here, let me describe some wonderfully gory detail since I haven't done that in a while and want to see if the red on my screen's pixels still works (Ed's note: Storbag is turning 4 in Feb ( Meta -Ed's note: Storbag is my computer)).  Ask our old friend Joe Everydude how to replace a hip, and he'll probably sit there for a minute asking himself why on Earth one would do such a...

I'm going to use today's post to discuss the Medical Student Gloves Phenomenon (MSGP).   The MSGP is a proposed principle of universal functioning, observed by yours truly (and probably several hundred thousand other people before me, but they didn't put it on their blogs and if they did I'm not following their blogs, so it's their fault).  It is basically summed up thusly: The Medical Student's gloves will almost always be the cleanest gloves in the OR. The Corollary to the Medical Student Gloves Phenomenon(MSGP-c) is that whenever the medical student's gloves are NOT the cleanest gloves in the room, one or more of the following things MUST be true: 1) it's a trauma, and blood just goes where it goes. Just as likely to hit the student as the ceiling. (90%) 2) the medical student contaminated him/herself (8%) 3) resident or attending just changed gloves (1.9%) 4) it is an extremely boring case and they're letting the student do everything (...

No surprise there. But interestingly enough, the thing that really clinched it for me did not happen in the OR. I was on call last night, which basically means I worked during the day (it's usually 6am to 6pm, ish) and then stayed overnight in the hospital to do more work.  It's better than it sounds, if you like what you're doing. Anyway, I was on the consult service with the 2nd-year general surgery resident, who is really awesome - knew exactly what he was doing, had a good idea of what I knew and what I was supposed to get from the experience, and a very good teacher. Anyway, so we get a few calls, go see a few consults, and before I know it, I look at the clock and it's past midnight.  It was crazy.  I hadn't eaten in 7 hours, I hadn't slept in 20, and I felt like I could stay there working for another 24 hours.  It was that good.  Now, that isn't to say that the OR is not as good.  It's also awesome.  I got to operate the bovie a bit this we...

It seems like forever ago that I was in a rotation that was NOT Internal Medicine.  IM is, at 12 weeks long, the longest rotation we have in third year. It's not so much the length of each day that wears you [I should say, "me"] down, but more the sheer enormity of all those days, all in a row, all the time caring for patients with CHF and Type 2 Diabetes. But, finally, today we took the exam that heralded the end of IM clerkship.  This is kind of a big deal... it covers pretty much everything in medicine, since Internal Medicine is the sort of "gateway" into healthcare.  They're the ones who refer you to specialists when they're in over their head because you've got some weird infection from touching rose thorns. (Editor's Note: Quit doing that.) Now that this massively long rotation is just about over, I'm focusing on some relaxation techniques. I have a pretty brutal schedule, with OB/GYN and now Internal Medicine behind me and the ...

Hey! Long time since my last entry.  No surprise, really, I had a lot keeping me busy since January... I mean first there was skit night , that took a while, and then I had to study for the boards, that took almost as long, and now I'm already just about done with my second rotation.  Time flies when you're chronically sleep-deprived.  We started 3rd-year rotations in June. The point of these rotations is to expose us to many fields and get our wards senses to sprout. We have to do Internal Medicine (12 wks), Surgery (8wks), Psychiatry (6wks), OB/GYN (6wks), Geriatrics (2wks), Pediatrics (8wks), Radiology (2wks), and Family Medicine (4wks). We have little input regarding the order of our rotations - we get assigned a specific schedule, but we can trade with a classmate - but the order isn't really that important, anyway, unless what you want to do is last. (Well, that depends who you ask, truthfully.  Some would tell you it's really important and determines what...

Today, we went to the hospital to play doctor and practice the physical exam.  A lot of my friends were nervous, worried they would mess up or forget how to do a certain test, or something, or the order of the tests, etc.  But there was really nothing to worry about, my preceptor at the site is very relaxed and just wanted to make sure we took a systematic approach, rather than making sure we found every little medical detail. Though I DID identify a murmur and make a diagnosis... that was pretty cool. Our patient today was in very good spirits, and I think that helped a lot. I t's fun!! It's like the history-taking course we took last year, only we get to actually DO things to/for the patient and relate to them better.   More to come, possibly, the next time we do this (a week from now). For now, we're watching some of the Planet Earth DVD. Ice Worlds.  You know, because of the blizzard and all. .