Up-to-date on the past couple of months

I've been really lazy about blogging as of late. Here a quick update on the past few months.



My brother finally got married to his gal. So Chris and Christine finally tied the knot. It was a gorgeous outdoor wedding at the Palo Alto Hills Country Club. Great food, views, people...the whole nine yards. The maid of honor and I were taking shots of Petron left and right and the night ended with a lot of dancing and shameless debauchery in front of the family. Good times were had by all.




Here's a pic of me on the last day of my AI down in LA. Prior to starting the rotation, I had a lot of apprehension about it. I had to memorize 35 pages of anatomy pimp questions and I heard horror stories about the rotation from other surgical residents who had done the rotation prior to myself.

My thoughts:

It's true what they say. It's the roughest rotation that I have ever done. It's 4am to 9-10pm every day. You round on 25 patients in the morning by yourself. There is no EMR, so you have to get everything from the charts. The nursing staff isn't always on top of things, so there is a lot of adding on your part. You present all of the patients as you round with 4-5 attendings every morning. You present all of your cases in front of the team by memory. There are huge cases every day...roughly 8 hours in the OR every day. You get pimped skin to skin. If you mess up, you may get yelled at. You learn to get by when you're sleepy/hungry/need to take a shit/etc. Then you go home and read about the cases for the next day so that you know what's going to occur skin to skin, in addition to prepping talks for grand rounds, all injected with humor of course.

Really, it wasn't that bad. The residents/faculty/surgical staff there was awesome. They took me under their wing and I really had a blast. The nursing staff made sure that there was food waiting for me at the end of the case. I know my surgical anatomy cold down to every auxillary nerve/vein/artery within the abdominal and pelvic cavity. I made a lot of mistakes, but I as long as I owned up to it and made sure not to repeat my mistakes, I was treated fairly. It's a rough rotation, and I've gotta say there was a fair amount of drinking involved to make it through the month.


The awesome part. As a junior, you start scrubbing in on the big cases. By the time you get out, you're a damn good surgeon. Things that I was really attracted to: LA county hospital. This place really is a war zone. It's like taking student run clinic patients, multiplying them by the thousands, then giving them crazy disease. If you don't know what I'm talking about, it's a mostly spanish speaking population. There aren't enough translators/rooms/supplies to go around. You improvize and make do with what you've got. It's easy for patients to be forgotten, so you damn well better take it on yourself to make sure that they have follow-up and get the tests and treatment that they need. The onus is on you. It seems like a draining place, but it's a real chance to make a difference. These patients have not seem a doctor in ages and they come in really sick. I mean, tumors that you only get to read about in case reports. Screw the work hour limit. You take care of your patients until they're ok.

This next part is pure gripe and bitching. I apologize. My gripe on work hour limits. I agree that work hour limits are a good thing. When you're tired, you make stupid mistakes. It can harm patients and patient care is the most important thing, period. What pisses me off is the mentality that can often follow the work hour limit. After getting consulted in the middle of the night, we'll return the call only to hear that the previous resident did a shitty job of signing out and doesn't want to be bothered since his shift is up. The patient needs care. That's f-ing bullshit. In general, I have nothing but love and respect for the medicine guys. They know their shit and they put up with a lot of crap to care for their patients. My gripe is with residents who are weenies. Don't be that guy. Examples: I had a resident call us for a patient who was oliguric. Did he try fluids? Lasix? No? Wtf? He tried those, and the patient started peeing again. Still he is worried about obstruction. What are the labs. Did he get a FENA? Did he get an ultrasound? What?....you don't know what a FENA is? Seriously, don't consult people unless you have tried/ordered tests. The pet peeve of urologists is dumb foley consults. Medicine residents kept consulting us to put foleys in. The worst part is, they hadn't even tried to put it in themselves? Wtf? It's 3 am? We just rolled into bed a couple of hours ago and will be in at 4am. Try to put the damn foley in yourself. It literally took me 3 seconds to put that shit in. Pull the foreskin back, pop the foley in the hole. It's that easy. Your foley did not go in because you were trying to ram it between the glans and the foreskin. Seriously, don't be a weenie resident who I have no respect for. Read, know what you're dealing with and take care of your patients. Please.

Anyhow, the picture above is a pic of "the boss" He is a world famous old school surgeon. Everyone who rotates through takes a picture in front of him. I don't know why, but it's a rite of passage. Anyhow, interview season is starting. I'll keep updating as interview season rolls on.

-bender