I have a new diet plan. It’s called: come in to work so early you’re not hungry, start in the OR so early there’s no time for breakfast, operate straight through lunchtime, and spend the end of the day running so hard to catch up that there’s no time to eat, and you get out too late to eat much dinner. Actually it doesn’t work too well, because then I get tired of not eating, and very depressed about peanut butter sandwiches and ramen soup, and I let myself believe that Chinese takeout is healthier because it contains vegetables.

The day was crazy. I found myself once again holding a retractor and the suction while blood spouted all over me and the attending (more him than me, which was somehow comforting) and the anesthesiologists started spinning around up top, which is usually a bad prognostic indicator. The scrub tech calling for more suction canisters is also a bad sign (because the first set of canisters is full of blood).

In between demanding what I thought I was doing, letting blood get in the field, and demanding what the scrub tech thought she was doing, not handing him five different things at once, he was angry at himself for getting into that situation. I’m not sure it was really possible to foresee the events, or if foreseen, to prepare any better (we at least had blood on hold; not always necessary in general surgery, but always a good idea in vascular); but if he missed something, I did too. It was nice that he blamed himself and not me for the problem, but I remind myself that I can’t keep taking refuge in that. In four weeks, I’ll be responsible for getting patients from the ER to the OR, and all the preop planning will be in my hands. In four years, I won’t have anyone to fall back on. I need to think ahead more.

I sense impending burnout. There’s a limit to how many days in a row you can work 16 hours at top speed continuously. It’s ok, though, I’m planning to be out of patience in two days – the end of this service. I’m going to miss the people a lot, but it will be nice to change pace. (Not that the trauma ICU in June is likely to be any kind of improvement.)