Tuesday, August 16, 2011

That's ironic right?

So all of last week and for the rest of this week I've been on doing my ward experience with the Acute Care Surgery service. This is the surgical team that deals with trauma and emergent surgical cases that present at the Loma Linda University Hospital.

Ironically even though I'm with a surgical service I somehow missed any time in the OR all of last week. I was hearing stories from classmates in other surgical services about being in the OR everyday and to be completely honest I was getting a bit jealous.

Beginning this week our team got a new attending physician and a couple of new cases that could potentially be managed surgically. Yesterday morning the team saw a woman in her mid-twenties who had a 5 month history of small bowel obstruction. In other words the thought was that something was obstructing the natural pathway of digestion.

Today I got to scrub in on the exploratory laparotomy, which means I had the ability to be in contact with the sterile area during the surgery. Its a whole different mindset when you're wearing a sterile gown. You have to resist the urge to scratch an itch on your face or adjust your glasses. Anything you touch that isn't sterile means you have to re-gown before you can get near the sterile field again. I was in the OR with the surgery attending, the senior resident and one other third year medical student. Since there were fewer people I was able to be really hands by helping hold parts of the bowel as well as suctioning.

The patients small bowel had a lot more motility than normal which gave it a pretty weird appearance. When the bowel was visible the entire small intestine was wiggling a lot more than normal. The surgeon examined the small intestine to look for a potential obstruction and couldn't find one but it soon became apparent that the peristaltic activity of the bowel was not moving any of the stool. To alleviate this problem the surgeon made two incisions in the bowel and inserted a catheter into one and flushed saline into the intestine. He then ran the bowel to force the stool out of the other incision farther down the bowel. According to the attending and the resident the consistency of the stool was abnormal and indicated the patient could have cystic fibrosis.

Since the surgery started so late I had to leave for class before they closed the wound. After spending all that time on the surgery service this one case more than made up for not getting any OR time in the past week. If I'm lucky I might get scrub in on another case later this week. On Monday we start classes and we won't get any clinical experience until next summer so I'm trying to soak up as much as possible because I know I'll need the motivation later on in the year.

Friday, August 12, 2011

Some specialty stereotypes

Reposting this from the LLUSOM Facebook group. It gave me a good laugh.

Thursday, August 11, 2011


I'm exactly 7 days into my first year of medical school. So far this week has consisted of mind-numbing orientation sessions, organizing my new house, and most importantly following med students and residents on rounds in the hospital.

In the past 7 days I've been bored, overwhelmed, nervous and excited sometimes all at once. I've known for 8 months that I would be attending Loma Linda University School of Medicine, I've known for much longer that this career choice will define the rest of my life. Up to this point this knowledge has been purely intellectual, however in the past week it has become a reality. Beginning with this week I've entered into a new stage in my life, one that will be forever defined by my career as a physician. My current reality won't change much for the rest of my life.

At the same time these are sobering thoughts they are also exciting and inspiring. Today we spent the afternoon listening to faculty physicians from the School of Medicine talk about their various specialties. Listening to these doctors, it was clear each of them had a passion for their specialty. I learned a little about personality types in medicine and more about how competitive each specialty is. Most of all I was reminded that although the path will be daunting the end will be very rewarding.

All in all its been a good week. We have one more week until classes start and although I'm valuing the free time I'm getting anxious to start learning (I'll probably slap myself for saying that in a month).

In the meantime I'll make an effort to update this blog more frequently with interesting updates about medical school.

Sunday, May 8, 2011

She just wanted her mom...

To start my theme of inteteresting experiences I'll relate one small experience from the last 6 months as an illustration. I work as a phlebotomist at large a hospital here in Lincoln, Nebraska. Because of its colocation with the the alcohol independence center and psychiatric units as well as its geographic location, the emergency department at this hospital recieves a very unique slice of Lincoln's population. This uniqueness is often more evident on the weekends and after 6 pm in the evening.

This particular evening I was working in the emergency department and I saw orders to draw a patient in room 26. As I walked by the desk on my way to the room one of the nurses called after me, "Wait! let me come help you." Of course I was thinking to myself, "I'm Phil Stokes, I've been doing this for so long, I don't need any help thank you." I conveyed this to the nurse in a more polite fashion and continued on my way to the patients room. In the room I found a very calm looking woman in her mid forties who we'll call Lucy. The only thing that caught my eye about Lucy was the fact that she was in restraints, strapped to her bed.

I often draw blood from patients who are in restraints so I didn't think anything of it. As I walked in I gave my usual greeting, "Hi my name is Phil, I'm from the lab, I need to draw a little bit of blood from you" I even added an extra "Is that ok with you?" I thought I'd cleared the major hurdles to a successful blood draw but as soon as I tied my tourniquet and began to look for a vein Lucy began to scream "MOM...MOOOMMMM!" and started squirming and fighting at her restraints. This led to some consternation on my part and many people including the police to run into the room. After me, two techs, two nurses and a police officer had sufficiently secured Lucy, I proceeded to draw my blood but not without continued ear-piercing appeals from Lucy for her mother.

Just another night in the emergency department.

Sunday, April 24, 2011

Nothing interesting has happened?

Its been a while since I've blogged about anything substantial. I've been justifiying it because I thought nothing interesting has happened in my life recently. I look at other people who blog. like my friend Dylan Wren, and see tales of adventure and roadtrips around the country. My experiences here in Nebraska pale in comparison I say to myself, but the other day I realized that a lot of interesting things do happen in my life and often on a daily basis. So I've resolved to chronicle more of the interesting things that happen in my life in this blog.