Slight improvement today. We only rounded for eight hours. So far I’ve gotten an inordinate number of procedures done, despite spending the entire day in pre-rounds and rounds, so I can’t complain.

I’m also becoming adept at placing Dobhoff tubes. These are feeding tubes, much thinner than an NG tube, with a wire through it, and a metal weight at the end, designed to be placed through the nose, and passed through the stomach and past the pylorus. The idea is that they’re less irritating to the patient to have in, and safer to use, since the feedings are given beyond the pylorus, so there’s less risk of aspiration. The catch is that you’re blindly trying to navigate a very tortuous passage, with no idea of where anything has gotten to. So the attending told me several tricks, and then mandated that five people needed these feeding tubes placed. The other residents all folded their hands and looked at me, so I decided to make a good thing of the assignment, and become our team’s first expert at placing these. It’s rather time-consuming, since you go and put one in, then have the nurse get an xray to see where it is, then look at the xray, and come back and re-adjust things, and repeat ad lib until it gets to the right place. So far, 3 out of 5 successfully placed, at length. Not bad, the way these things go.

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