Got one under my belt

The feeling of inadequacy is a theme that plagued me in medical school and has followed me to residency...actually, my whole life. I'm always worried that I'm a shitty intern, so I try to log extra hours. Just finished putting in a 33 hour shift, but maybe that just means that I'm an inefficient intern. My biggest concern is that I don't have the hands to be a good surgeon. I have a mild essential tremor that becomes magnified whenever I start stressing about it, then it's a downward spiral from there.

I feel like a huge burden has been lifted. I did my first appendectomy last night from skin to skin, albeit at 3am, on a teenage kid with acute gangrenous appendicitis. Was able to get through the procedure without any big problems...able to lay out suture and tie stuff down without problems. Didn't nick any bowel. Granted it was an easy case, but I feel like I needed that case to realize that it is not impossible for me to become a proficient surgeon and am not just a poser on the wards. Even with my chief breathing down my every movement, I know every time she yelled, it was meant to make me a better doctor/surgeon. Even when she called me out and told me, "you're a urologist. So grow some balls." I realized that sometimes you have to yell and call people out. This is not to be a dick. If your patient needs a CT scan in the middle of the night and the tech is too lazy to do it, you roll your patient up by yourself and make sure it gets done. If your patient has an abscess and the nurse is too lazy to give antibiotics/clarify an order - you call pharmacy, beg, do whatever the fuck it takes to make sure that you take care of your patient. They depend on you to take care of them. If it takes a few asshole phone calls and a visit to the neighborhood radiologist/nursing station/etc. to break some balls, I think I'm alrite with it as long as I can sleep in peace when I get off my shift.

Anyhow, it was another brutal night on call, but I got through it, just like I'll get through the next one. Next on my list is to learn how to dictate a proper operative report. Dictations that start with, um...we started by cutting the belly button with a knife, then we dug around to look for the appendix. Then I cut it off with a knife and then sewed up his stomach....yea, it doesn't hold up so well in a court of law as an official dictation.

time to prep for more cases tomorrow.

-bender