Sunday, September 18, 2011

It's not called the Mercedes scar anymore; it's a Lexus


SMBC comics are awesome

So last week was my first time shadowing a transplant surgeon.

One of the first things she told me was that liver transplant scars used to look like this:

See the Mercedes?
But now, they don't make the third incision to the side, so the scar is just called the Lexus.

 It was completely different to be shadowing a doctor as a medical student instead of a premedical student. Suddenly, I was almost like part of the team. I shadowed the doctor during clinic, and she briefed me on every patient before we saw them. She explained the difference between fibrosis and cirrhosis, how liver tumors are treated, what influence Hepatitis C has on the liver - everything! I got to see labs and radiology reports (even though I had no idea what I was looking at). I did recognize a liver tumor on a CT scan though - before the doctor told me what it was. I win! Alright, I admit, it was pretty obvious.

 I saw a bunch of things I'd never seen before. I saw some jaundice, with significant yellowing of the whites of the eyes, and spots. I can't remember what they are called now, but there are some spots that occur with liver failure.

 I saw pitting edema for the first time ever. That's so neat! Not so neat for the patient, but I'd admit to being SUPER excited ABOUT EVERYTHING. Pitting edema is swelling that when you depress the skin, the skin doesn't bounce back like normal. Instead, a depression forms in the skin.

 The surgeon was incredibly candid with me. She told me that she'd much rather be in the operating room, but clinic was a fact of life.

 Watching her interview, I thought I was watching something out of "doctor blunders" in our interviewing class. Everything we've been told repeatedly not to do, was done by this doctor. She would click her pen throughout the patient talking. She typed into EMR the entire time the patient was talking, and rarely looked at them. She didn't ask for permission to touch the patient, etc, etc.

 But for all her "flaws" interviewing, her patients really seemed to like her. She had a way of paying very close attention to the patient when she wasn't on the computer. And she always made sure she was at the same level as the patient. If they were laying on the table, she was standing next to them. If they were sitting in a chair, she was sitting in a chair.

 In the middle of one appointment, a husband and wife started fighting. The husband began screaming at the wife, and the doctor just calmly talked over him until he paid her attention. I certainly learned a lot.

 But the most exciting part is yet to come. Wait for it, wait for it.....

 You probably didn't guess it. This week I get to watch a live donor liver transplant. You heard me. I have to miss class for it. Psh, whatever, I'm there. Color me excited.

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