Orientation gets to me. One of my character flaws is a large distaste for spending time slowly or repetitively; I think to myself that I could say it so much faster and more efficiently, and there are so many other things I could be doing with this time. (Especially true since I didn’t dare bring my knitting to a surgery orientation; and the baby shower is on Saturday.) By 6pm, after spending the last hour listening to one of the team attendings explaining local procedure to the smaller group who will be at this particular hospital, I was just about fidgeting. When she left, and we had to arrange our call schedule, I abandoned all my resolutions to be polite to other students, to let them do things their way, not to be controlling; and took control of the discussion, and managed to get the schedule done in fifteen minutes. I was past caring whether they resented or appreciated my leadership. . .

Part of the afternoon we spent sewing on pigs’ feet; and abandoned that when the flies eventually arrived through the windows opened to air out the stench. I was pleased with myself. I did several neat sub-cuticular closures, a few vertical mattress sutures (which I had never understood on previous explanations), and numerous instrument-ties (instead of two-handed knots; you pull the thread through the knot using the needle-driver [pliers, if you like]). Then one of the older attendings arrived and did several demonstration sutures; and he flipped the instruments through his hands, and smoothly manipulated the kinky suture material, so it looked like an art, instead of my laborious placement of each object in the correct position. I need to practice tons and tons more.

This same doctor, Dr. French (we’ll say) was the one who did most of the talking in the morning. I hope I can give this grand old man a proper description. He’s not too tall, fairly round, rather bald; with a great air of authority, and yet joviality. This cheerfulness is different from many surgeons, and made all his remarks tolerable. Dr. French managed to make even the asking of names a pimp question. He would repeat each name a few times, and then inquire into its national origin or etymology. When one student admitted to being from Albania, he demanded what the name of Albania was in the Roman Empire. (I was impressed that the guy knew: Illyria.) When an Indian student explained that for English purposes he leaves off the last half of his name, Dr. French launched into a discussion of the honorable meaning of that suffix in Hindi.

Dr. French then explained that he would also be working with several first-year students, or “wedges” today. This must be his favorite joke: First and second years are wedges, because these are the simplest implements known to man, and require pressure to make them work. Third and fourth years are cretins, since they know nothing useful. (I forget his complimentary name for interns; after that it improves.) The first time he told us, and the first time he explained it to the first years, I cringed, because he was so matter-of-fact. But by the end of the day, it had become a term of endearment between us. Because he proceeded to discuss “wind [lungs: atelectasis, pneumonia], water [urinary obstruction, UTI], wound [infection], walking [DVT>>PE], and wonder drugs [drug reaction, especially to antibiotics],” the classical causes of fever and complications in a post-op patient, in order to prove to our satisfaction that we were indeed cretins. He did this by pimping around the table, till the student in question was reduced to helpless stares, and then proceeding to the next in line. Since we all invariably, on the first day of the rotation, blundered within a very few questions, he pointed out every few minutes that we were cretins, all the while laughing uproariously, so we couldn’t be insulted (since we didn’t know anything), and all laughed too. I especially didn’t mind, since I luckily knew the answers to the questions I got (atelectasis, patient not breathing fully because of abdominal pain, don’t take an xray, get them to cough).

Dr. French also has a vast store of anecdotes from his days as a student and resident, under the direction of some greatly revered names in medical education. The stories were generally derogatory to medical students. He thus accomplished several things: to tell funny stories, to impress on us the rigor of his own training, to put down students in an indirect fashion, to make us all appreciate the relative gentleness of his own method, and also to teach some important surgical axioms. ( His preceptor’s approach included swearing at everyone so much that it took Dr. French three years to realize that one instrument was named “the Babcock,” not “the @#$% Babcock.”) My admiration for Dr. French was sealed when he explained that, in his opinion, contrary to the surgery chairman, the point of the surgery rotation is to teach students to do procedures, not just for them to study about when surgery needs to be done. Exactly what I’m hoping for.

I drew the first week on night shift trauma team. I am thrilled to pieces, in spite of having been carefully warned to stay at the back of the room, and make sure all the important people get gowned before I do; and in spite of a sinking feeling that, with my luck, absolutely nothing big will happen any night for the next week, or any day for the week after, when I’m on day shift. But the student pagers get the general warning when the helicopter is going out to pick up a case, and the warning when they’re five minutes away, with very brief particulars about the patient. That feels so important, like I might actually need to know. I’m also thrilled that we were given cards to fill out on learning to do many small procedures: blood draws, NG tubes, catheterizations, etc. We were advised that the phlebotomists have been warned to let us help with these things. If nothing else works my way on this rotation, I will learn how to draw blood and start ivs. In all the stories – and even many places today – this is the job of the medical students; and the interns are supposed to be able to succeed, if the regular nurses can’t. Finally, I will get to do one of the procedures I always thought students in hospitals did.