I think I may have said this before on here – only once or twice – but this has been absolutely the best day ever. Better than all the previous ones. I got to first assist/perform a whole big case, one which I later realized is actually pretty rare because of the unusual approach the attending took.
I was on call overnight, and you can imagine my dismay when (after a night filled with the almost cliched scenes of dark cars pulling up outside the ER and dumping out gunshot victims) just as I was setting out to round on my patients, on a tightly calculated schedule (calculated to allow for the longest possible nap prior to starting rounds, that is), I was paged by the ER. It was a patient for my service, so there was no way to duck. What was more, he needed surgery, urgently, so it took a while to see him. (Not one of these “oh yes, a wound infection, give some antibiotics and send them to the office in a few days” kind of ER consults.) The whole time, I was simply fidgeting to get out of there, trying to figure out exactly how late I was getting, and how many plans were spiraling out of control.
It was not until the attending said, after rounds, “Ok, Alice, go get the patient on the table and page me when you’re ready” that I realized what a wonderful day I was having. He didn’t even mention the chief on call, or any of the other junior residents in the hospital. I, of course, did not make any reference to them either, for fear that he would realize the oversight and correct it before we had scrubbed.
It wasn’t an oversight, of course. This attending is actually interested in teaching, not just residents, but interns. I cannot imagine where he gets the patience from. “Hmm, Alice, you probably shouldn’t have cut that. Stitch please. . . Ok, bovie through here, carefully, carefully. . . Next time try not to bovie [the skin] [the bowel] [my hand] [whatever else it might be].” “Time to sew this up. See how these three layers connect? Put the stitch there. No, that’s too little; no, that’s too much; no, don’t hold your needle like that; no, don’t tie the knot like that. Ok, next stitch.” I mean, I was beginning to run out of patience with myself. I have no idea what inspired him to put up with me so much, and in the middle of a busy morning.
Some persons were concerned about me doing a case post-call. I said, perhaps more precisely than I should have, that there was absolutely no way I would consider leaving the hospital when there was the prospect of doing a) any case b) this precise pathology c) a patient I had admitted from the ER d) a case I had been invited to by the attending e) a case with this particular attending. It was my decision to stay, and my decision to stay after the case and tie up loose ends with my patients on the floors, before signing out (because the ends were loose due to me being in the OR, so it wouldn’t have been right to hand them off like that).