one month later... lol

Okay, so it's been a while... but i have a faithful reader, so now I have more motivation to continue writing! HEEEEY LYNN! lol :)

So i finished out pediatrics. It was a mess. The last blog mentioned that someone screwed me over, it was so true. My last day of pediatrics was worse than any day I had on general surgery, which is supposed to be far worse than pediatrics. By the end of pediatrics, I wasn't allowed on the floor w/o someone yelling at me because I wasn't "doing my job" although I was probably the most consistantly prepared student on that rotation. It was highschool all over again, only worse, because I was well liked in high school lol

I still don't have the official evaluation turned in yet, but I do have one that the family practice resident filled out about me, and she gave me honors. If she doesn't get it in soon, I fail, but she couldn't get one of the attendings to sign it because one refused since he didn't work with me (that's fair i guess....) and she didn't see any of the others. I dont' know what else to do actually. I'm sort of at a loss.

General surgery was quite an experience. I'm going to be an Osteopathic Physician therefore my initials will be D.O. not M.D., and I was on the M.D. service, and they basically never like the D.O. students because they think they're superior to us. Well I think it goes deeper than that but who knows... I think they're threatened by the fact that we're usually superior to their students with patients and such. In the four weeks I spent there, I had 3 sets of residents (I started before Christmas, then I had a holiday week, and then 2 weeks with the last set of residents.) for the most part the residents were nice to me, but I could tell that a couple of them thought I was a joke put there just for them to laugh at.

While on the rotation, we had some interesting cases.

We had one man come in, he was about 300 + lbs and he didn't look like he'd actually done much walking recently. Well his story was that for the past 25 years he'd had this hernia, which is when your abdominal wall weakens for whatever reason and some of your abdominal contents can come out and form a pouch under your skin. Until Christmas he'd never noticed it being that big, but he got sick and coughed and then it got a lot bigger. What had happened medically is that his small bowel had protruded into his scrotum, and it was the size of one of those small basketballs you win at carnivals. I didn't get to see the surgery, because I was post-call (i'd worked 30 hours straight) but I heard about it, and they made an incision across his lower abdomen and with a lot of manipulation they got it all put back in the right place. Well, a week or so went by and he returned, and it was even bigger. I'm not sure exactly what happened but his bowel was still in the right place, so they think it might have been fluid retention. It just had to be the most impressive case I'd seen.

I had another lady with a large ventral hernia (same idea but this was in the front of her belly and had come through a weakening in her abdominal wall due to previous surgery). I met her before her surgery, explained that I would be watching, and that I would be there to see her the next morning. She ended up staying in the hospital 4 days. I went to see her every morning and spent 3 times the amount of time with her that Id id with any of my other patients. I really felt like she was a family member by the time she left. I was on call one night while she was in the hospital and we had some down-time (very rare) and so I went to check on her. She was up walking around. I told her if she kept acting like that she'd have to leave the hospital. (thats meant to be funny). I was thrilled to see her doing so well, because she had a rough first day post-operation. She introduced me to her family members who were there, and then she stopped the attending physician while we were on rounds and told him how great I had been with her and how much she appreciated me visiting her ever day. It made me feel so awesome to have a patient say that about me, especially when it disproves the attending physicians' theory that we suck at patient care.

The last patient I got attached to is probably still in the hospital. I admitted him (and by I, I mean Vlad and I) while I was on call. He was famous in the surgery department because around Christmas he had had an "insulinoma" removed. (this is a tumor on the pancreas which secretes excessive insulin, which causes your blood sugar to drop tremendously, causing you to change how you act and makes you very very sick). Surgery to the pancreas is very difficult to do, and most people avoid it at all costs, but this one couldn't be avoided. He had stayed in the hospital he had it done at for about 3 weeks afterwards, and had just been released 5 days before he showed up in the ER. he and his wife are the cutest couple. I spent a long time in with them just chatting and getting to know them. I feel like that is the job of the medical student, to make people feel comfortable. He was having a lot of drainage from the drain they had inserted in his belly and he was very nauseated. We decided to admit him and rehydrate him since he couldn't keep fluids down. He ended up staying all week and having some problems with the fluids in his stomach from the pancreas, and they really weren't sure what to do with him. I didn't know what to do either, but I just kept going in every day and seeing him, asking him how he felt, was there anything I could do. He gave me a hug on my last day, thanked me for being there every day with him, and wished me good luck. I still want to log on the computer every day and check his vitals, lab reports etc just to make sure he's okay. Its funny how I can spent 15 minutes or so every day consistantly seeing someone and become so attached.

The first set of residents that I worked with were awesome, as were the last set, (the middle set hated DO students). One of them, Dr Marghni, who is from Sudan, was hilarious. He really liked to teach so I made sure I spent a lot of time with him. When we had to work with the attending who didn't let residents do anything "it might ruin my reputation" he said, Marghni and I would have a contest to see who could have the most blood on our gloves at the end of the surgery. Sometimes, I would win, but I'd never touch the patient. The attending just handed me the instruments so I won on a technicality. It was great to have fun during surgery though, because it was so rare to not feel like I was in a hostile environment.

I never actually got yelled at, which surprised me. I just answered questions the best I could, did what I was told, and made my patients love me. It was all I could do... and it worked. I got Honors on surgery! They appreciated having me on the service because I was "an active participant" in the patient's care. Basically, I was the only one who knew what was going on w/ my patients, so that made me feel good. :)


Today I started Ortho. I had no idea you could do surgery without screaming. It was so relaxing. I got asked a bunch of questions, but I was never once told that I was an idiot for not knowing. It was such a vacation after my general surgery rotation. I have a really good feeling about this!!

We'll see how it goes. :)