Friday, September 30, 2011

My first love has lost a bit of its luster

Last week, I watched a live donor liver transplant.



Well, I watched 6 hours of it anyways. They had just transferred the liver when I left.

Woah, talk about invasive surgery.

I got to hold a gall bladder. When I squeezed it, all the bile came out. I was not able to hold the transfer liver. But I could poke the cirrhosis-ed liver.  I saw my first portal vein, first stomach, first spleen, first intestines and first hernia. All of that was super neat.

You know how you keep a patient alive while they don't have a liver? You hook them up to this machine that acts like their liver, cleans all their blood outside of their body and then returns it through a vein back to the body.

And the surgeons! Incredibly smart, talented and focused. All 7 of them.

But, and you knew there was a but. Since when did it become cool to completely neglect your basic needs as a physician, in favor of 8 or 9 hour surgeries? Maybe it has always been cool, and this was the first time I saw it in action?

We went into the surgery at 9, and by 2:30, I was REALLY hungry. And the scrub nurse and circulating nurse laughed and said, "You'll get used to not eating." Mmm....no....no, I don't think I will. See, I need food TO LIVE. It's especially bad when you consider that I lift weights regularly, so my metabolism is a bit amped up. I get fairly uncoordinated without food. By 2pm, I had a raging headache from not drinking any water for 6 hours, and I'm pretty certain I would have given up with those fine veins and arteries left over in the donor abdominal cavity. Props to the surgeons that completed that surgery and stitched the patient up.

OMG, food, nom nom nom
Also, I don't know about the other women around here, but I need to pee at least once every 8 hours. And, shhh, I don't think that's too crazy to ask.

So maybe I'm not cut out to be a long-surgery type person. I mean, as the patient, I wouldn't want my surgeon to leave and eat some lunch while I'm lying open on the table. Well, unless they are a diabetic or something. What do diabetic surgeons do? Maybe they just don't exist.

There are still short surgeries. And maybe that is better anyways. I'm not a fan of getting a call at 3am in the morning that a liver has become available. On my way to an 8 hour surgery with no food or water, woot!

I guess I'm not hard core enough to be a crazy cool surgeon like the ones I observed.

But that's alright. There are lots of other fish in the sea. Maybe I am more cut out for medicine. Third year is going to be really interesting.

Anyways, I have plenty of time, so I'm not worried. I'm just surprised that the live donor liver transplant and what has to be one of the coolest surgeries in the world turned me off from surgery a bit.

Protip: Introduce yourself to the circulating nurse whenever you enter an OR for the first time. They really liked that.

2 comments:

  1. I think the longest surgery I ever stood through was 4 hours, and that was agony enough. Congrats for surviving 9 hours. I definitely would've passed out if I'd been asked to stand in one place that long (given that I passed out more than once during shorter surgeries).

    I do know one type I diabetic who's a surgeon (and a fabulous one at that). He typically does shorter surgeries, so perhaps that's his coping strategy.

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  2. double protip: offer to get (or just get) your gown and gloves for the scrub nurse. Tie their gown and hold the card for them to spin (obviously do NOT do these things if you do not know how to scrub, maintain a sterile field or where to touch/tie a gown ... instead stay far far away).

    When not scrubbed in, get blankets, hook up SCD's, roll patients, push beds, hold a patient during epidural placement, pubic hair tape, do whatever needs to be done. Watch carefully the first time if you don't know. Often, if you're keeping one eye on the circulator (and you're not scrubbed in) you can see things that you can help with or hear what the scrub nurse wants and quickly grab them from the cabinets on your side of the room if the circulator isn't anywhere nearby.

    One attending at University Hospital wants the rooms turned over ASAP, so his residents and medical students pick up trash, mop floors, sterilize the bed, lights and equipment stands, help set up the surgical equipment. If you have an attending like that, and you're not scrubbed in, then get started as soon as the surgical team starts to close.

    Triple protip: Pay attention to extremely small details - how does the surgeon blot, what fingers does she use to hold the scissors (thumb and ring or thumb and palm grip, up to the DIP only), are they righty or lefty, learn the names of all of the instruments (what's a metzenbaum? whats a mayo? whats a richardson? whats an Allis? whats a CT-1? what's an SH? ) and their purposes..

    HINT: http://www.orthonurse.org/portals/0/wound%20closure%20manual.pdf

    No, this is not expected from a first or second year student. But that just means you have ample opportunity to impress people with your precocity ...

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