My surgery rotation is done … for now.

My rotation through surgery ended for the semester and I am glad that it is done. I did not enjoy it – I worked hard for little gain. The surgeons I worked with all had first assists, senior doctors, or residents to help with the procedure at hand. This meant that I was relegated to the farmer john pose (where ones hands are held at chest level on their imaginary suspenders). On top of this school policy, I found out later, limits third year students from getting too actively involved. I suppose this comes much to the relief of the patient but from my point of view this made for a very tedious 3 weeks. Standing and watching somebody do surgery all day long is probably one of the most boring things you can do. Couple this with 1:4 call and the biggest challenge becomes trying to catch a nap with no one noticing. I found the experience really frustrating to say the least.

It’s frustrating because I feel at this level of training where a large number of medical students are still undecided there should be some encouragement or enticement for the particular specialty. There are ways to get junior students involved (in my humble opinion) that would not endanger the patient in any way, or even slow down the surgery in any aspect. What I found instead was a speciality that almost discouraged junior students from wanting to join. If someone is interested in surgery at this level it would have to be part of higher calling, in order to give you the strength to put up with all the crap. The sad part is that I don’t really see much of a change in the attitudes post graduation.

From the residents I saw working in surgery, they were working damn hard for a few scraps of OR time. The first two years of the surgery residency program, at least at this school, doesn’t seem to offer much other than scut work. By the third year the residents seem to gain some good hands on experience, and their level of responsibility increases from there. Once the 5 years of residency is done there is the need for a fellowship which adds another 1 or 2 years. This is a long time in a system that is geared more to break you down than build you up. I couldn’t do it. I have neither the intestinal fortitude nor the patience.

In the end I suppose I did get something out of this rotation, by this I mean I can definitely cross surgery of the list of things I want to do with my life. I’m not quite done with surgery yet, as I have another rotation after Christmas, something to look forward to I guess…Meantime, Monday brings a new rotation in Obs/Gyne which promises to be good.

I delivered my first baby today

I can’t believe it – today I delivered my first baby. Honestly – it’s a good feeling and I tend to be one of those that really doesn’t get that excited about babies. It left me with a warm fuzzy feeling for the rest of the day and put me in a good mood.

It started with a call at 0530 hrs. I had been on call the night before so was on my 3rd hour of wonderful sleep when my cell phone when off. The attending doctor quickly commented that there was a woman who was 7 cm dilated at the hospital that was expected to deliver soon, and that he was on his way – so I should meet him in maternity in 10 minutes. I should note that when I’m on call I sleep in my scrubs – I think like most do, and since I was already at the hospital it wasn’t a problem to be in maternity 5 minutes after the call. Once there I met the parents for the first time and realized that things were progressing rapidly.

I should stop here – one of the problems with being a medical student on the maternity ward is that you are meeting some of the couples for the first time. This means that you essentially have no relationship with them before you are involved in a very personal and intimate time in their lives. it is no wonder that people say no … So, there is always this period of awkwardness, the time when I am holding my breath, where the attending will ask if it is ok if I am present while the baby is being delivered. The couple simply nodded their heads in agreement, and I exhaled slowly with the hardest hurdle of the moment being out of the way.

The delivery happened fast and I really don’t remember when I doctor asked me to step in. As the doctor (or pseudo doctor in my case) the role you play seems to one where you are more like a coach than anything else. You shout encouragement, you get the mother to focus and then you simply catch the baby as it pops it. I may be simplifying it a little but few would deny that the mother does all the work. Much to my surprise once the baby starts coming out things progress fast. With a bit of popping sound (and maybe I imagined that) I found myself covered in all manner of fluid (name it, I seemed to be wearing it) holding a healthy, bluish pink little boy. I stood up and asked the mother if she wanted to hold her new little boy, and placed it gently on her chest. That was probably the best part and I won’t bore you with the rest of the details because they’re really more academic than anything else. All I can say is that it felt good – it was an honour to be involved and I hope the memory stays with me, to maybe remind me of why I am doing this while up all night on call.