The Eternal Sunshine of Vascular Surgery One week through vascular surgery (although, not really a true week, since Thanksgiving fell right in the middle of it) and I must say all is going well. I like my preceptor - he is a huge smart-ass, just like me. Also, I have not had to be in surgery yet, both because of the holiday and because of the slow holiday season. Again, playing into my dislike of the O.R. I've done a lot of reading over the past week, attended several lectures, and had a bit of free time.

The only downside of the past week has been the impending doom of the holiday season looming over my head. I have yet to seriously begin shopping for my loved ones, and christmas is only 4 weeks away. I like spending the holidays with my family and loved ones, I just hate trying to come up with a gift that each will like and fits them well - especially now that I almost never see them. That makes it really hard to know what they would like or what they need. I don't like getting gift certificates, since I see that as a 'cop-out,' but sometimes I don't see any other choice: I could get them something they don't like, they can take it back and then spend the money on something else, but what would be the point of that? Why not just give them the money and save them the trouble of standing in line to return it? Oh, yeah - because it's a cop-out.

Catch-22, here I come.

I hate it when I say something and it reminds me of a medical condition (CATCH 22 is a mnemonic for the symptoms of DiGeorge's syndrome. It stands for Cardiac abnormalities, Abnormal facies, Thymic dysplasia, Cleft lip, Hypocalcemia - all due to a deletion on chromosome 22). I'll be driving down the road and I'll see the letters on a license plate and think, "hmmm.. DVT: Deep vein thrombosis," or something similar. It drives me nuts. I've done it for years, and it's always made me crazy.

And now, on to something completely different:

I watched The "Eternal Sunshine of the Spotless Mind" the other day. Wow. I really didn't know if I'd like it (I had no idea what it was about..), but I rented it the other day. I must say, it had an amazing message. However, even if you don't get to the deeper meaning, the idea of the film is interesting: How many people would like to erase something that has happened in their past, but they are forced to live with it? This movie purports there is a way to absolve yourself of that suffering. The deeper meaning is what makes this movie really special, however. For those of you that have seen the movie, you'll know what I mean. If you haven't seen it, do so now - I highly recommend it.

Maybe sometime in the future we can discuss the movie. I just don't want to spoil the film for anyone.  ¶ 10:48 PM 0 comments

  Finished with General Surgery Finally!! The torture of q4 is over! And I managed to get through surgery without excessive OR time. I chose my cases carefully to prevent repetition and boredom.

This rotation has only further increased my interest in Emergency Medicine. How? you may ask. Well, I'll explain: When on call, you are the trauma surgery team. That means every major trauma that comes into the ED, you get called on and participate in the emergency resuscitation of said patient. It was really cool!! I've already written about the ED thoracotomy I witnessed, and that was by far the most dramatic event of the month, but there were many other patients we saw. Fortunately (or unfortunately, depending on how you look at it), someone in our group was a complete sh!t-magnet, so our call nights were always very busy with trauma and also other consults. The only bad thing about the whole situation is I am a student, and therefore get last dibs at every procedure. As a result, mostly all I did in trauma situations was a rectal exam (oooh fun!! But important all the same) and maybe insert the foley catheter. I did get to put in a central line, however, which was cool - especially since the intern had already missed on a previous attempt.

As a result of this surgery rotation, I have more experience in the ED resuscitation of trauma patients, and I love it as much as I always did.

So, today was my last day on general surgery. Since it's such a big rotation, my GF and I decided to celebrate by going to the Cirque du Soleil this evening. It was a really good show - I'd highly recommend it if you've never been. I'd also highly recommend it if you have been to see Cirque before. This show, "Varekai" is very well done. The best thing about Cirque du Soleil is that everything is done live on the spot - no nets, no pre-recorded music, no-holds-barred. The band is on the right, the singer is always in view (even though you can't understand what they say, since it's all either in French or a made-up language). The acrobatics are amazing, rope-work is stunning, and then there's always the super-psycho-flexible chica that can bend herself over backwards and put her head next to her butt... I always have problems with that - I wonder how can the human body be that flexible? The thoracic spine is not supposed to bend in that direction... It's really quite distressing if you think about it. Almost like when you see the video of an ACL going out and the knee just bends in an un-natural direction... eewww!

Ok. I'm finished babbling now. The next 4 weeks are specialty surgery: 2 weeks of thoracic/vascular surgery and 2 weeks of orthopedic surgery. Then CHRISTMAS BREAK!! and a much needed rest. I think we get 2 weeks!! I won't know what to do with myself. Any suggestions besides a nice 4 day ski vacation in Maine?  ¶ 7:32 AM 0 comments

  A few thoughts... Just a short entry...

I watched ER from last week, and was reminded of myself. No, I'm not the patient, but instead the physician.

I remember when I first entered nursing school - I was wide-eyed, open to everything. I always wondered about my patients: who are they, where are they from, what have they gone through in their life to get to here?
However, as time went by, and especially once I started working in the ED, I noticed myself caring less and less for my patients' story and succumbing more to the typical stereotypical point of view that so commonly grips medical personnel.

That is something that is so sad - that we, as medical professionals, become so desensitized to human suffering that Mr. Martinez (name made up) becomes "the lap chole in 507," or Mrs. Jones becomes the "uterine fibroids in 310."

I don't know exactly why it happens, but I have a theory. It goes a little something like this:
As human beings, we are emotional creatures. Our interactions (especially those of the depth required by a physician-patient relationship) require an emotional expenditure. With the number of patients we see in any day/week/month/year, the emotional drain would be enormous, so we (as medical professionals) try to limit our emotional expenditure by keeping a "professional distance."

Not to say this is good, but I think it is something of a psychological protection mechanism - to protect us from over-exerting ourselves.

Ok, I don't think I'm making any sense here... I'm quitting until I'm more rested. Thank goodness this surgery rotation from hell ends friday.  ¶ 7:55 PM 0 comments