Trauma surgery @ Elmhurst

I'm apparently making a habit of posting to this site only after my week is over. It's almost 8pm on Saturday night, and I am exhausted. I just got back from spending the day shadowing in the Department of Surgery at Elmhurst Hospital in Queens. I got there at 8am, which was just in time for a red trauma call: an HIV+ drug user had been brought in after having been held up at gunpoint and then stabbed in the throat by his neighbor. The patient was being wheeled in as I walked in, so I didn't even have time to change into scrubs. After a tense hour or so, I followed the surgical team on its rounds. The stab patient ended up being fine: I saw them do an angiogram of his aortic arch and great vessels to see if there were any lesions, and I also saw an esophagram. Both came back negative. As I left tonight he was being stitched up, and was going to spend the night in the hospital and probably be discharged in the morning.

I saw a number of other patients that were on the Surgery team's service today, including a 20-week pregant woman with signs of appendicitis (major epigastric and LRQ pain, extremely high white cell count), a Riker's Island inmate with HIV and a severse case of anal warts, a 14yo with appendicitis, a Peruvian man with cholecystitis and a history of appendicitis and peritonitis, a man with MRSA who recently had a left lung lobectomy, a woman who fell off a porcelain sink and had a hugh laceration in her right gluteal region, and a HepB+ Chinese man with esophageal varices caused by portal hypertension (he was bleeding profusely from his mouth, and probably wasn't going to make it through the night). I found the last case to be particularly interesting because of the amount of time that Dr. Laitman spent on collateral sirulation routes in the body, especially between the portal and caval systems. It's one thing to try to memorize the routes of circulation for an Anatomy exam, but it's something else to actually see someone dying from it.

The experience at Elmhurst was really remarkably interesting. I don't think it hit me as something that "I want to do for the rest of my life," so to speak, but I found it to be exhilarating, and on a couple of occasions I found myself thinking: "I think I could do this." This says a lot considering that I've always thought that surgery was something that I wasn't cut out for. It can be intense, but also immensely interesting.

The rest of this past week was about me recovering from my M&C exam on Monday. The exam was alright, which was amazing since I really didn't feel prepared enough for it. They could have definitely made the exam more difficult that it was. I couldn't say whether I beat the curve, but I might have been more or less close. It depends on how other people did. The problem was, though, that since I spent most of last week locked in the library, I started this week low on sleep, and so these past couple of days just seemed to drag on forever. Some things of note this week were: in Anatomy we opened the skull and exposed the brain-- and then ripped it out and exposed the cranial nerves-- and then cracked the frontal bone and popped out the eye; we had our first Belize trip meeting with the people that are actually going on the trip, which was successful; we practiced our history-taking in ASM with a standarized patient (an actress); and on Thursday I gave my first shot, which was 0.5mL of saline, to Milla (which she then reciprocated).

I must say, these weeks have been long. I have been genuinely tired. But it has never been boring. I still have doubts every now and then abut whether I really should be here or not, but I can't ever say that it's not something that's been really interesting so far. I'm having a great time, not considering all the adjustments that I've had a tough time with.