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

Impressions

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.