Today was maybe the first day where I felt how a surgery intern is supposed to feel like: I did almost nothing but make mistakes all day, and everyone else in the hospital told me about them.

That’s how it has to be, of course I’m going to make mistakes, and of course they better tell me about them; but it’s going to be a long year.

The worst part, actually, is the part I really know is coming to me: messing up in front of the attending in the OR. The fellow handed me one of the early cases of the day, a simple skin grafting. I was ecstatic. He didn’t even come in the room; it was all mine. But with this attending, skin grafting isn’t as simple as I described it when it was just the fellow and me. The attending has a lot of rules about how to prep the skin, how to hold the razor machine, how to start and stop the harvest, how to mesh the graft, how to fasten it down, and how to dress it. He made me so nervous while I was harvesting, I accidentally stopped short of where he wanted me to be. Because of how the razor works, once you let go of the button, that’s it, you have to be done. It turned out to be exactly the correct length (not intentional!), so he was ok with that. But then we started stapling a complicated pressure dressing on, and I just couldn’t do it the way he wanted it done. My excuse is that my gloves were slippery, but you can never make excuses.

Last year I watched the interns doing this, their hands turning all to thumbs once they got into the OR where they so desperately wanted to be, unable to understand the seemingly simplest directions from the attendings. I can tell well enough how the mechanics work when someone else is being instructed; I can see tissue planes when I’m not the one cutting. But I knew last July how it would be: now that I’m the intern, all my resolutions are no good; I fumble hopelessly when the attending is giving me directions. Now of course they think I can’t sew or staple worth beans, and the harder I try, the worse it gets.

Then there was another altercation with the angry assistant, made a little bit easier by her randomly deciding to take my mistake out on the medical student, which didn’t really make me feel any better.

Then there was the OR manager, about a foot taller than me, who stood right next to me to explain how I had messed up the whole intricate schedule by the incompetent way I sent a patient up from the ER. . . Now I know better, but he was kind of intimidating, although I don’t think he meant to be.

And finally, I landed the ultimate intern’s job: debriding a stage four decubitus ulcer (ie, it’s down to the bone) in the ER. I put on a mask, and managed not to pass out.

Actually, the day wasn’t too bad. I got two good cases out of it, there wasn’t much floor work to chase around, and it was fun to send a patient straight from the ER to the OR within an hour, even if it did step on the manager’s toes. We sewed him up nicely, and I really understood the hand anatomy involved.

Now if only my computer will cooperate enough to let me finish the powerpoint presentation I’ve been assigned for this Sunday. If I can get that done, I’ll feel a lot less stressed. For the rest, I’m telling myself to get used to it; that’s how surgeons teach, and this is how I knew it was going to be.

But it’s going to be a long year.

(Just discovered this other female surgery intern’s blog, Hurricane Jill. It feels like reading my own mind with the colors slightly changed.)

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