Yesterday morning was glorious. As the chief was assigning surgery cases for the day, I spoke up and said, it being our last day on GYN, it would be awfully nice if the medical students could actually do something today. I was thinking of him telling the intern to make sure we got to touch a few things in the room that was completely booked with staff patients. So he sent me by myself with an attending who was doing a series of “hysteroscopy, D&C, laparoscopy” cases. And no resident!

Of course, that was because the attending didn’t actually need help. I had to leave for class before his afternoon case, where he sounded like he might almost have let me assist him. But he let me touch the dilator and the curette a little bit, and the hysteroscope was fun to watch. The second case, as soon as he touched the uterus he said, “Sorry, you can’t do this one; it’s too deep.” A minute later, he said he had touched bone, and there was a perforation. Everyone in the room told me what a good job it was I hadn’t touched anything, since otherwise it would have been logically assumed (by me too) that I had made the perforation. Since he had been planning to do a laparoscopy anyhow, he moved to that, to check on the damage; not without much miscommunication and confusion with the nurses. In fact, as they were tripping over each other to set up the laparoscope, he started cursing at them, and they cursed back, which apparently reminded him, so he apologized. Very interesting; the first really bad surgeon-nurse interaction I’ve seen. There was no damage except to the uterus, which stopped bleeding while we were watching. So he decided to continue with the planned ablation, and handed me the camera and probe, to hold things up above and watch the hole in the uterus. It was a good thing we did, too, because his very first try he stuck an instrument right through the hole again. Anyhow, I got to play with the camera, focusing it, moving it up and down and around, even moving the probe around a bit too, for a good twenty minutes. In the third case, he was going to let me try to put a band around the fallopian tube, but there were so many controls – to move the instrument in and down; to open the claw; to close it; to put the band on – that I got confused, and he had to finish it. Laparoscopy looks so clean and simple, but it must be much more difficult than the video games it’s always being compared to. (Uterine perforations are apparently not a big deal, unless the bowel is damaged too, because the uterus just contracts down on itself and heals quickly.)

I was grinning wildly all morning, under my mask. All by myself, just me and the attending. I wasn’t doing anything, but I felt a lot closer to the action than before. Plus, the nurses were all feeling friendly, and showed me how to prep the patient – I got to do all three by myself! And the nurses were saying complimentary things about me. I don’t know why, I was just tickled that they let me help with their jobs, since I can’t help with the doctor’s jobs.

This attending, by the way, is from Texas, a rather over-the-top cowboy type, who subscribes to the school of thought that “every woman over 40 needs a hysterectomy and/or oophorectomy.” I can’t think of that phrase without considering how rude/cruel it would be to suggest an analogous operation on men. . . Someday, when I’m a chief resident, I’ll say it out loud. Anyhow, I subscribe to the notion that, children being a gift from God, and it being prudent to have one’s quiver as full as possible, one or two children after 40 would be nice. And the male surgeons can just . . . keep their hands to themselves.

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