I found myself in the OR at the beginning of a big case. A rather stupendously big case, to be precise – ten times over my head. But the attending was starting by himself. So I asked: “Would you like another pair of hands?” Sure, he said, scrub in, there’s always room.

Back in medical school, I learned the [very] hard way to give warning before trying to do something (close fascia, place a line, etc) that I’d never done before. Sometimes, it seems that I still need to give warning that I’m only an intern. Here, I didn’t. For one thing, I kind of assume that the attendings will recognize which residents have been around the OR a lot, and which ones are relatively new faces. Wrong assumption, apparently.

Five minutes in: “Tell me again, what year are you?” Never a good question; they only ask when you’re doing something wrong. “An intern, sir. [I don’t know anything, I’m good for nothing, I’m sorry.]” And I proceeded to not-very-helpfully assist with the very first, basic part of the procedure. I think his frustration was evident, because a senior showed up and scrubbed in pretty quickly, and I took the excuse of my pager going off to leave quite shortly. It was a retreat, but I knew people would keep paging me (it was that time of day), and there was no point to adding the noise of my beeper to that tense room, since I couldn’t contribute anything to the case.

I hate being so awkward. Everything moves so smoothly for the seniors and the attendings, but when I try it, nothing goes quite where I want it, the threads get tangled, and I fumble for everything. It seems rather unfair, that I rarely scrubbed (until last month, and then the simple cases), but when I do scrub, they expect a lot. I guess that’s the way it has to be. There are no graduated expectations, because every patient needs things done completely right. One day, I’ll get the hang of it. (Anyway, I suppose I should have known better than to even go near such a big case without reminding the attending that I was only an intern.)

For the next week I’ll be sewing up dozens of hands and faces in the ER. Resolved, to go very slowly, and do everything very precisely. Who cares how long it takes, or what the audience (patient, family, nurses) think of me. Who cares how miserably useless the ER suturing tools are (a pickup that won’t hold, a needle-driver that lets the needle slip out every time you try to place a stitch, a scissors that won’t cut). I’m going to pretend this attending is watching me, and I will plan ahead, think of everything I need before I get started, and make every motion delicately. The car-accidents-waiting-to-happen don’t know it, but this week they’re going to get the most painstaking repairs ever.

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