Today was better. This whole month really is the best of the year so far, so I don’t know why I’m getting such a bad attitude as demonstrated yesterday. I have more responsibility and more OR time, and they’re thrilling. It’s the in-between parts that get me down.

The chief and I found ourselves diving into a complicated abdomen. The attending was there, but for some reason was content to let the chief and me keep working our way through. Perhaps he was disgruntled. Perhaps, more complimentary, he trusted the chief (which was warranted). I didn’t really care why; I was deeper in the abdomen than I’ve really been so far, and the chief was expecting me to pull my share of the work. (Our medical student was present, but was one of those persons who is clearly cut out for a life in internal medicine; unable to even handle scissors, but enthusiastic about certain other, worthy, areas of medical knowledge. He and the residents have basically settled on peaceful coexistence: we overlook his inability to master the most basic manual skills, and he listens politely as we engage in surgical shop-talk: discussing in details the pros and cons of different incisions to use when approaching a problem.)

Anyway, I’m fairly certain the chief didn’t appreciate my rediscovering-the-wheel approach to abdominal surgery, but he put up with it, and kept pushing me to do more. What can I say; it’s a sad state of affairs to be sure, but some basic things, like how to keep the small intestine out of the way while you’re trying to go somewhere else, were new to me. Usually the attending does it, because it takes so long when I try to do it. The cases I’ve done so far have been in corners of the abdomen (inguinal hernias, gallbladders, transplants to the iliac fossa) where the disorganized nature of the middle of the abdomen doesn’t usually come into play.

I hope the chief’s patience extends to letting me into the OR with him some more, because the only remedy is more practice. I admire this chief a great deal, for his operative skills, and for┬áhis ability to put up with my efforts at assisting in the OR or managing ICU patients; but I doubt whether he recognizes, or cares about, my admiration.

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