I’m going to have to stop talking about best days ever, because this is all good. The last few nights I and the other night people have been seeing one case after another of those “classic” things, where it looks like the textbook, sounds like the textbook, and even was caused by all the risk factors in the textbook. Not really famous cases, but I’m always tickled to find out that things exist in real life, not just in textbooks and legends. (Gallstone ileus, cecal volvulus, intussusception – that kind of thing.)

Several nights back we had a med student on call, and there was a unique case going on. It was the first I’d ever seen or heard of, and the resident doing it also knew it only by anatomical drawings. The attending was a great teacher – ok, so he whispers and has a thick accent, but if you listen closely, you learn a lot. I called the med student, told him what was going on, and encouraged him to go see the case. I think he went to eat dinner first, which is not laudable, but not reprehensible either. Maybe an hour later, I finally had enough free time to go back to the room. They weren’t very far into the case, but the med student wasn’t scrubbed in. He was just standing in the back, flipping through the chart, while the surgeons sliced smoothly through to expose some beautiful anatomy. I observed to the student that he was allowed to scrub in. I admit that I wasn’t too forceful about it, because I knew that in about two minutes I would be invited to scrub in. I did, and the medical student drifted off, to go study for the SHELF, maybe. It was a tremendous case: easy to see anatomy, the surgeon a great technician, teaching the whole time both about the pathology, and about how to use instruments. FYI, students, that’s one way not to make a hit on your surgery rotation. Always always always scrub in whenever possible. It’s what we live for, and we can’t really fathom why anyone would not be interested. (And yes, this student wants to do psychiatry or something like that, so he has an excuse of sorts; but not really.)

So this morning we had another one of these gigantic cases, the same kind of thing which not too long ago I found myself assisting at, and tremendously annoying the surgeon by doing so. Thus, when I knew a similar case was on this morning, I resolved to come only to watch, with no hopes whatsoever of scrubbing.

I guess my efforts to rehabilitate myself in that attending’s eyes (by studying the subject, and showing up at all times of day whenever he’s doing anything, and doing my best to assist exactly the way he says to) have paid off, because he was quite friendly, and invited me to scrub in right at the beginning. (It’s a good thing that my reading the day before actually covered that case, so I had some vague idea, finally, of what I was looking at.) I had a great time. It was a complex case, with plenty to do, and I got to do half the work on a fair piece of it.

The only drawback is that it took me all week to catch my sleep cycle up, after staying up all day for that first case; and now I have to start all over again.

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