I am now on the vascular service, which is probably the busiest surgical service in this hospital (as at most). There are enough attendings operating that I will probably get a few cases a week – of course, the ones no one else wants: ablation of varicose veins, amputations, simple angiography.

This service also tends to pick up a lot of pointless consults: our favorites are femoral pseudoaneurysms as a complication of cardiac catheterization (which a priori means that if the patient eventually requires surgery, they’re going to be a very poor cardiac risk), and generally whenever anyone is bleeding. Somehow, to the ER and ICU doctors, bleeding means vascular surgery should be able to help. Sometimes it’s interesting; most of the time, our advice is to hold pressure for a lot longer.

Anyway, after a few days’ worth of consults like this, I’ve learned not to be concerned about blood in reasonable quantities. I spent an hour holding pressure on one of our patients and practicing my calm, this-is-perfectly-normal voice. He was very pleasant, and not disposed to panic anyway; and I think my smoothing voice is getting better. Next time I’ll just remember to take my white coat off before getting close to arterial puncture sites. We got to talk about books, politics (noncomittally; I do know better than to start firecracker conversations with people whom I have to sit with for an hour to keep them from bleeding to death), and crafts.

The bad thing about this service is that they regularly have patients admitted in the evening for hydration prior to angiography/procedures the next day. Somehow, these patients always come right at signout, so we usually leave an hour or two later on this service than on others. Ah well, that’s how it goes.