this has been one of the busiest rotation weeks i have had yet. but, it is by far one of the most fun weeks i have had. i love surgery and everything about it. i have seen: lap chole’s, appendectomy, colectomy, mastectomy, tracheotomy, abscess incision and drainage, etc. i have put in stables, taken out stables, shot up patients with lidocaine after surgery, ‘steered’ the laparosopy camera during surgery, and of course...held a lot of retractors :) i have worked in his clinic which he has tuesday 9-1 and thurs 2-6 where i saw a ton of patients and worked as fast and efficiently as i could. i have really enjoyed it all. and even though i walk in the door late sometimes [8:30 or 10:30pm] i really am not upset about it. as long as i have a snack in the afternoon, i survive and i enjoy it.
the surgeon i am working with is an older philipino man who is the most gentle, patient, and hilarious doctor i have worked with. he is incredible in surgery and with his patients. everyone loves him. He is also amazing because he appreciates the time we [the PA student and I] are putting in and knows we are working hard. he repays us for this hard work by teaching us during surgery and letting us get valuable hands on experience. he and his colleagues, who are all very old friends, are entertaining as well as wonderful teachers. i consider myself extremely lucky for having the opportunity to work with all of them. after the past week, i drove home today being confident in myself and my abilities. that is what good preceptors are supposed to do. teach, help you with your mistakes, and build you up. during surgery yesterday, another surgeon asked if i was following what they were doing and dr.B said, “of course she does, she is a very smart girl.” i was so grateful to hear this. also, a patient today told me i am going to be an amazing doctor. that was a great feeling too.
ironically enough, for the last 3 years when people asked what specialty i wanted to go into i would answer, “i am not sure yet, but i know it will not be surgery.” HAH. now it is getting pretty high up on my list... i love the procedures, the formalities of scrubbing in, the importance of what you are doing and [i know this makes me sound like i have a huge ego] but i love how important it makes me feel. whenever i talk to a patient, wether it is someone i am following post-op or a new consult, they value everything i am doing and most importantly, they appreciate me. they value my time and thank me graciously. thats a damn good feeling.
during an axillary node dissection on tuesday, i stood over the patient looking at dr.B make sure to find the axillary n,a, and v as to avoid them at all costs.[he pressed on the nerve and made her arm jump when i asked how he knew that was it...] when he was pointing out the structures, i realized how much damage he could do with a single small stroke in the wrong direction. one slip and this women would not be able to move her arm again. i kinda told myself right there that i dont think i would want to have that on my hands everyday of my life. though surgery would be a blast to do, realistically, it is more anxiety that i would rather take on. i am sure once you get enough practice with it, it is easier. but there are still times when you can cut the wrong thing, accidently nick the bowel, etc. i just dont think i want to deal with that. but, no final decisions have been made. what i do know, is that going into ER seems a lot more fitting because i know i can get good at procedures and i think under pressure, i will be able to handle things. yes, i can still do damage in the ER and make lifelong effects, but i dont think the stakes are as high as in surgery.
i am not done with my work week yet [worked 60 hours so far i think...which isnt as bad as i thought it would be actually] because i have to work saturday and sunday also. though that sucks, im kinda ok with it. its not like i am just doing admissions all day like my last couple rotations. i get to see the patients we have operated on, see potential pre-op patients and then there is always the chance that someone will come in and need an operation right away. thats kinda fun for me. :) today i rounded on 17 patients myself because the PA was at school today. i was able to handle it. tomorrow there will be less because some were discharged. either way, this entire experience has been an amazing opportunity to see how far i have grown and how much i have learned in the last 3 years, esp this year in clerkships. i am self sufficient, efficient, and though i may not be the smartest person in our class, i think i can make up for that in other ways.
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