[After trying to post this three times, and having the computer eat it, I’m beginning to think I was saying something imprudent, so here’s a more discreet version.]

Talked with the chairman. Conclusion: he thinks research is the most important thing in the world, and can’t imagine why I wouldn’t want to spend a couple extra years in residency just to do research. So, his advice about what residency programs are good is mostly unhelpful: the more academic they are, the better he likes them; and his is better than all the others. But, after he said about ten times quite frankly that he wants me in his program, I feel pretty sure that if I want to match here, there won’t be any trouble about it. So there’s only two questions left: surgery or OB? And, do I want to take a safe local program again, like I did for college and med school, or is it time to be more daring, and move at least a couple hours away, to a city I don’t know?

I stayed after lecture in the afternoon because the orthopedic attending was doing a kyphoplasty, and he thought there wouldn’t be any residents coming. It took two hours longer than I expected for the case to get going (the patient was being moved as though he had an acute spinal fracture, although it was really a week old and in the thoracic area, but there were all these complicated maneuvers to get through), but the residents didn’t show up till we were almost done. The attending insisted on everyone in the room wearing lots of lead (some of the older doctors and nurses don’t wear lead aprons for the ortho cases, which involve scores of xrays, but last forever) because the level of radiation involved in verifying the location of the pins would be so high. He put two pins into the pedicles of the vertebra in question, then pushed through into the vertebral body directly. The bone was very osteoporotic, and he could almost get the pins in place without using a hammer. He let me help inflate one of the two balloons (with water), withdraw the balloon, and inject cement. As we were waiting for the cement to harden, he put some of it on my hand, and then, playing with some himself, remarked, “This stuff is neurotoxic; that’s why I don’t do total joints.” I said probably the gloves we were wearing would be protective and he said, no, it goes right through the gloves. Thanks a lot! But apparently you don’t notice the effect until you use a lot of it; years ago in doing total joints you molded hunks of this stuff with your hands. About half an hour after it had been mixed, the cement had an exothermic reaction, became very hot, and solidified in our hands (and hopefully inside the patient’s spine).

He’s on call for spine cases at the children’s hospital this weekend, and promised to call me if any big cases come in. So I’m trying to keep track of my phone for a change. He said the residents often don’t come to his weekend emergencies. Although ortho surgeries are extremely boring to watch (tap tap – xray! – bang bang – xray!), it should be much more fun if I can get to actually assist.

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