Post Op

Two+ months later, I'm done with my surgery rotation. Maybe the first of several. I came out of those eight weeks pretty psyched about what I'd just gone through. This bodes well as a possible career choice. A few days into my psych rotation, I realize I actually miss my surgery rotation.

That said, I worked my ass off. Boards aside, surgery was the hardest two months of work I've had so far. Granted, I'm pulling from a small pool of experience, but still. Here's some examples of the type of hours put in.

Longest:
work day (on call) - 34 hours...yes, almost a full work week
regular work day - 15 hours
consecutive hours awake - 48
work "week" - 13 days...aka no days off for almost two weeks
calendar work week (7 days) - 96 hours
surgery - 7 hours

Fortunately, those were extremes. I typically got up around 3AM to make it to the hospital by 5AM. On a good day I'd be out by 6PM, on a bad day not so much. And then there's the issue of taking call. On a good day I'd be out by 11AM the next morning, on a bad day past 3PM. Surprisingly, there are times when insanely functional on no sleep. On that note, I was averaging probably about 3-4 hours/night. It personally wasn't my favorite sleep regimen, but you can get used to it.

With all these hours, there's also a decent amount of material that we actually were supposed to have read up on and learned about. At my site with these types of hours, it's incredibly hard to study when you're averaging 80+ hours per week, including one or two nights of call a week. There's only so long you can run on fumes before needing to recharge. And those fumes usually were burned off long before leaving the hospital.

Long story short. I loved my surgery rotation. It's been bumped back up pretty high on a short list of interests. I'm seriously considering it as a career, though I'd prefer better hours and a decent lifestyle...aka a subspecialty (maybe ENT). I loved my rotation because of all the exposure and hands on stuff we got to do at our site specifically. That said, all the hours detracted pretty hard from study time. I'm pretty concerned about how I did on the surgery final, a national exam. We need a 59% to pass. On the few practice questions (not exams) I got a chance to do, I averaged around a 50%. Oy. The shelf exam is only 1/3 of our grade, yes. But - we still need to pass it to pass the rotation. We'll see what happens.

Until those grades come out, I've been living in ignorant(aka anxious) bliss in the psychiatry world. One week down, five to go. Stories to follow.

Grinding Away

Two more weeks and I'm done with my surgery rotation. The six weeks have resparked my interest in surgery. I've always had an interest in it, just not so into the hours. It's weird. A 12-14 hour work day actually goes by pretty quickly, especially if I'm in the OR for a large part of that. Even my on call days/nights go by pretty quickly.

It's the time when I'm not at work that blows. All the hours just wear away at you. Once my ass hits my car's chair, I feel whatever energy I have left drain out of me. Once I get home, it's hard to really get anything done - aside form sitting around. And I usually have shit to do - working on presentations, reading up on cases, and whatnot. These days I have to add studying for the rotation final to that list. Studying seems pleasantly foreign to me now. But, it's something I'll have to do, along with reintroducing myself to a library. Sigh. At least it's all clinically relevant and interesting stuff at this point.

Side note: props to those residents who have real lives and families...I've no idea how they do it.

Boring and whiny stuff aside, there's been a decent amount of cool stuff. I was on trauma surgery two week, so that was pretty cool. Highlights include taking a bullet out of someone's hip (!) and pulling a rake/hoe out of someone's foot.



It seems mundane, but getting to sew people up is still pretty cool for me at this point...and I saw plenty of that. I was on call on a Friday night, and needless to say, shit got crazy. About 20 trauma pages overnight, most of which were between 8PM and 3AM...most which were in turn violence related. Aka gun shots, stabbing, beatings. Went to the OR twice that night. One guy nicked his aorta, bowel, and lungs - he was bleeding out and ended up getting about 8L of fluid into him. I think he's still alive. Another had about 10-15 holes throughout his intestines and a few liver lacerations. He's doing okay to my knowledge.

As much violence as I saw on trauma, a decent number of them are bound to be shady characters. As in pieces of shit. Two of them shot each other while one tried to rob the other in a retaliatory effort for something. There's one particularly sad story that also pisses me off. Some pieces of shit teenagers thought it'd be cool/badass to try and jack a UPS truck. Except they used guns to try and take the truck. And shot the UPS driver in the back. The 29 year old driver who was working a legitimate job. He came in unconscious and in critical condition. He's stable now and doing well. Except for the fact that he's a paraplegic. Motherfuckers. On the note of shitty characters, there were a few domestic violence related traumas that came through as well.

There were also a few failed suicide attempts. One guy shot himself in the head and lived. He obviously aimed pretty poorly...and ended up shooting out his orbits. He's blind in both eyes now. And he wants to live now. Another girl tried to shoot herself in the gut. Questionable mode of suicide, imio. She lived and now wants to. But, she managed to nick her cord and is now a paraplegic.

As many sad/fucked up things as I saw in a week, there are also people who were just in the wrong place at the wrong time. Plenty of car/motorcycle accidents. A surprising number of pedestrians hit by cars. Decent number of falls from roofs, buildings, scaffolds. And of course, numerous alcohol related traumas.

In just a week, it was impressive how much shit I saw. It makes one a little jaded, and it shows in the culture of the trauma service. Everyone from residents rotating through trauma to the attendings are pretty cynical and jaded. I don't blame them though. It's enough of a shit show enough of the time that I'd be the same if I was onboard for more than a week.