Sunday, February 11, 2007
As was common during my third year, I took call on the first night. I'm not all together sure why I do that, but it seems to be some deep seeded gunner in me. The first week was actually pretty light with respect to surgery, with one small exception. I watched a kidney transplant which ended up being a little painful. Since the current residents that were going to the OR were relatively new, there was a significant amount of instruction going on during the procedure. The attending that was working the procedure is known by me to be very meticulous in his instructions. Like all of the transplant attendings, he is an expert and an artist at the procedure. However, watching a person being trained is somewhat painful. Not to mention that there is not a whole lot for a student to do in a kidney transplant. Liver transplants and resections are a different story and they are the procedures I most enjoy experiencing. As a student, you get to clear the field of blood (if you can see), suspend the liver for a while as the final stitches are placed, and help close. Students usually help close on the kidney transplants, but that just does not do it for me anymore. I'm such a little surgery snob.
Although there were not many transplants last week, there were plenty of patients on the service. So the floor work has been very busy. I have been most helpful working the rounds and doing big dressing changes (wound-vacs AKA vacuum assisted closure), drawing blood from PICC lines and placing IV's. Well, actually, I tried to place an IV but I was not successful. Oh well.
I've been taking call every third night (Q3), which is why I should not have taken call the first night, but the other two students on the service really wanted the break and, after all, I'm not going to be taking two big exams at the end of the rotation. Speaking of students, there are only two M3's on the service. When I was on the service last year, there were three M3's. I was hoping there would be three M3's and I would be a fourth student. Why is that a big deal? Well, I had hoped to spend a little more time on rounds with the interns instead of running around changing dressings with the M3's. Life is not perfect, but it is better than many of the other options for a sub-internship.
As part of my M4 experience, I spend some time each day doing what I call M4 rounds. I round on my own checking on each patient. The benefit is since I am not pressed for time, I can talk with the patients without rushing them. In fact, I found one of the patients on my service so interesting to talk with, we talked for a long time. That is a luxury I will not have in a few months.
