Sorry guys, short on further stories. I think at some point it has to get tiresome to an outside observer to keep hearing how excited I am about simple things like hernia repairs (well, ok, not simple, but today I finally managed an important step in the procedure myself, without the attending handing it to me).

Other than that, I am disappointed to observe that I have become as cynical as any jaded resident I’ve ever watched and wondered at. Maybe it’s the time of year. I’ve had conversations with nearly all the junior residents in the last week or two, discussing our regrets at being in surgery, and our fantasies about what we should have, or perhaps still could, do differently. Some of my colleagues had remunerative careers before going to medical school; unlike me, leaving is at least theoretically an option for them.

As for students, I make no effort now to attract medical students. If they’re enthusiastic, I’ll help them find where the most interesting things are; and I’ll always answer questions. But I have no patience for the silly ones, who talk as though they know something only to reveal their own ignorance, or who are so bored by the whole concept of surgery that they walk off in the opposite direction while the intern and I are pulling up a CT scan to see if we can confirm a diagnosis of appendicitis. (I mean, come on; CT scans are fun. You can always learn something by looking at a scan, especially a positive one.) I did grab the student and make him look at the appendix (classically swollen and inflamed, in this instance), but I had no energy to carry on to general principles of reading CTs, or general principles of how to behave when seeing a new consult with the team. As far as┬ácareer choices, I haven’t even finished second year, and I’ll advise anyone to do something other than surgery.

And medicine interns. Don’t get me started on them. It makes me so angry when they write an order for a stat surgery consult, and then walk off, leaving the secretary to call us, not caring that it may be 12 or even 24 hours later that we finally hear about the situation. As often as not the matter is not urgent at all, but if they are puzzled, or concerned enough to mark the order stat, then they ought to take two minutes to call me themselves. Or, when they consult us for a longstanding hernia in a patient admitted for a completely different matter. We’re not going to operate during this admission. I personally will be off rotation by the time they finally follow up in the office and schedule surgery with my attending; so why do you force me to go through the pointless exercise of talking to the patient, writing up a complete consult note, and then calling my chief and attending to tell them about it? Or when every day they try to feed the patients who’ve just had surgery for a bowel obstruction, and still have an NG in. Such a temptation to write rude things in the chart (which I never do, though).

My friends and I all seem to come to the same conclusion: no matter how tired we are of residency, or of the hours, or of the hierarchy, or of our inability to perform miracles, in the end, being in the OR makes up for everything. There’s nothing else in the world like it, for pressure and power and danger and reward; that’s why we stay. (That, and the paycheck; which of late months is more appreciated.)

(Equal-opportunity grumpiness: the surgery interns sometimes drive me crazy, too. There are a couple that have a knack for always choosing the less correct of two possible options, or of doing whichever thing will annoy this particular attending the most. Then there are some who will call me late in the afternoon to announce that there are four consults on the floor, and two patients in the ER, and maybe one coming in from the office. . . why they couldn’t tell me some of them sooner, I don’t know. But them I have a little more patience with, because I know was, and probably still am, just as annoying in similar ways.)

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