Brad’s version of the established and respected surgery practice of critiquing your juniors rudely in front of a large audience during stressful moments made for a rather unsettling night. At one point I found myself standing outside a room with two nurses (we having all been found fault with, loudly, me most of all). One of them said, “I’m just going to defuse some anger here before going back to my other patients.” I told her, “Then one of us needs to move away, because this cubic foot of air doesn’t have room for all of our anger.” Six hours later, I can tell myself that the attendings speak to the residents this way all the time, in the middle of the OR, during both elective and emergent cases. Seniors to juniors is quite normal, as well, I suppose. You copy your role models. This is surgery, a side I haven’t had much experience with yet, but it’s probably not too late to start.

There was a ruptured AAA tonight, and I got to scrub in and help. I saw the red mass of hematoma accumulating in the mesentery, and the attending’s deft discovery of the right spot for cross-clamping, more by feel than by sight. I learned that everyone’s hands shake with adrenaline – including the attending’s; but that doesn’t need to keep you from sewing neatly. And the whole OR listened to the chief being chewed out for not doing x y or z more efficiently. It comes with the territory. I guess.

Bottom line, my patients are all still alive. The nurses were right, and the certain knowledge that the attending is going to be angry with Brad and me because of what happened doesn’t give us the right to blame the nurses for doing their best.

One more night this week.