In all the books and stories by/about doctors, the medical student walks around as a caricature, panting for an opportunity to suture, and then becoming ecstatic when it occurs.

It’s quite true.

After watching a chemo port being inserted and sutured in place this morning, it looked like there was nothing else on the schedule. An appendectomy had been added, but it “belonged” to the trauma service, and there were two students from there who would want to get in. So I took the schedule and ran down it again. The most promising case was a simple mastectomy by the chief of the surgery residency program. I’d never met her; but from the stories of how she dealt with the chief residents’ rude jokes against attendings at the dinner a few weeks ago, I figured she must be quite a terror. Nevertheless, my respect for the amount of money spent per day of medical school obliged me to eat lunch rapidly, and go look for her patient in the pre-op area.

What a sweet old lady, waiting with her daughter. Her name was the same as my grandmother’s, and they were about the same age, except mine is dead. . .

Eventually the surgeon arrived, and the resident – who had at the last minute realized that he was supposed to come to this case. The surgeon, although brisk, was cheerful and pleasant. I kept waiting for something to change, but it never did. After she used my name three times in ten minutes, I made yet another resolution never to listen to gossip by way of gauging someone’s character. It is so inaccurate.

I could tell you every single step of the procedure, including the very cool bleeping noise the geiger counter made it as it detected the radioactive tracer in the sentinel nodes. But I suppose the medical people out there already know how amazing it is to dissect muscle and fat away from each other, and come away with clean lines; and the nonmedical people would prefer not to hear what excitement we had with tiny blood vessels spurting in our faces. . . I thought of asking if I could do a little cutting with the Bovie, since it looked so easy. But it never is easy, they just make it look that way. And I got reprimanded in one of my ob/gyn evals for not knowing my limits; so.

But when it was time to start closing, I figured I might as well ask. The surgeon laughed and told everyone, “Look at that, she’s bold enough to ask!” and told the scrub nurse to give me one of the sutures. So I put stitches in the dermis along about a third of the incision, while the resident did the other side. Then we raced each other to do tiny, neat subcuticular stitches over the top, so it would close nicely. The attending said that if I couldn’t finish a third by the time he was done with two-thirds, she would have to finish (because anesthesia charges by the minute, so it costs to let the med student close slowly). I beat him by one stitch. The attending joked that if you want a really neat line, you should have the med student do it, because we’re still obsessed with tiny, precise stitches. Of course, every time she looked over to see how it was going, I started dropping the needle, and poking holes in the wrong place. It didn’t look too bad at the end.

I love surgery. I love suturing. I think with a little practice I’ll like cutting too. . .

On call tonight; we’ll see if I can finally find a few of the “normal” surgical cases, like appendectomies and cholecystectomies.

Advertisements