Last Day in the OR

Surgery is almost over!!! The only thing left is the test tomorrow, at 9am. We had today off to study. I woke up at a glorious 10:30, when the sun was already out, and I got literally 2x as much sleep as I normally do in a night. Let's talk about my last day in the OR, shall we?

Here's the good part - I spent all day with the pediatric surgeon who is in charge of the surgery program from our standpoint. He makes the test at the end, is in charge of call, etc... In other words, he knows what's up. He cares about the students. I scrubbed into all 3 of his surgeries Monday. The first was a simple little esophageal dilation. No biggie. They consecutively stick these flexible tubes down little babies esophaguses? esophagi? in increasing diameter in order to dilate their precious little throats so food will go down and stay down. It's pretty fast, relatively painless, good times. The next one was an umbilical hernia repair. Super fast surgery. He let the intern do most of it.

The next surgery of the day was THE BIG ONE. Although it was about the same length of time as most of the cardiothoracic surgeries I scrubbed in on, it was the most physically exhausting. Partly because I hadn't scrubbed on a long one in a while. Partly because all I'd eaten that day was 2 brownies. Thirdly because I was actively doing something the entire surgery. We did a laparoscopic colectomy with ileostomy and ileostomy pull-down. This means the attending and chief resident took out this little girl's colon, connected her ileum to her anus, and also connected part of her ileum to an ostomy - or bag on the outside of her stomach. She had ulcerative colitis that left her colon an ulcerated, bloody mess. Taking it out decreases her chances of colorectal cancer.

Doing a surgery laparoscopically cuts down on healing time and huge scars, but it takes FOREVER. You're working through very tiny holes, which means the tools you put in are very tiny, which means you have to take tiny little bites at the tissue. So essentially they managed to get 95% of her colon taken down this way. It took about 6 hours. Then, for the last little bit, when her colon goes down into her pelvis, they couldn't take it down. Her pelvis was just too narrow. So at this point, at 5:30pm, we have to switch to OPEN. If we had started open, this surgery would've taken maybe 3-4 hours.

On the upside - I learned how to run the camera for the laparoscopic surgery. On the downside, we were in the OR forever. Dr. S did give me a 3 minute water break at one point which was nice since I had the unfortunate issue of food poisoning the night before. Don't want to get graphic here, but going to the bathroom 5x in 3 hours and losing 2 lbs worth of fluid just doesn't make a happy camper! Was definitely feeling a little woozy.

Okay, so we switched to open, made the ostomy, connected the ileum to the anus. I retract like a rockstar, get super sore, get to put in a couple of stitches, and then leave the hospital at 7:30pm. I got home at 8:00. I'm EXHAUSTED. I have less than 48 hours until the surgery test. I could study for an hour before passing out, or I could eat and go to bed. Guess which one I picked?

It was a rough day, but I think it was a good way to end surgery. The case was exhausting for everyone. The attending and I were the only 2 who were there for the whole thing except for our 3 minute water breaks. There's something about tough days in the OR like these that really suck, but it's such a rush when it's over that it's worth it. You really get to know the people you're working with because you're stuck in an area of 3-4 square feet and they can see your work ethic firsthand. They know if you follow instructions, if you listen, if you retract hard enough, how you treat the people around you, if you have a sense of humor, what kind of music you like, etc... I don't think I necessarily want to do surgery because I don't think I could sustain this kind of work ethic for the rest of my life, but I do think I'll miss it sometimes when I'm on services like internal medicine where we hardly touch the patients. Time will tell.

Good luck on the test everyone! I've had little time to study and now I'm wasting it writing this post, so I'm sure I won't do too well. Let's just hope I don't have to repeat this mess all over again :)