Surgery Experience- Week 1

I'm post call right now and have an ENTIRE weekend to sleep, read about my patient (singular) and every other patient on my team's census and possibly even meet up with my family for a few hours!!! I had the first 24 hour call of my hospital's surgical clerkship for the year. I got to see some pretty complicated surgical cases down in the ED and to watch one BS trauma work up, but then I got to watch the residents on call yell at peds nurses, and then sat around reading Surgical Recall from about 2-4:45. I slept for about half an hour and got permission to leave half an hour early since NOTHING was happening in the entirety of the hospital.

As I alluded to a few days ago, I'm discovering that the hospital is a horrible place to learn how to be a doctor. I say this for a number of reasons:
  1. I was given a set of expectations from my clerkship director that apparently only I know about.
  2. My clerkship director's expectations differ from my preceptor's expectations, which differ from my chief resident's expectations, which differ from my intern's expectations, which differ from the expectations on other teams as well as from that of the teaching resident on call. I have approximately 20 bosses and no defined job description!!
  3. The words "educational opportunity" is loosely defined as "get the fuck out of my way and go watch X with Dr.Y in the Z" where X, Y, and Z are unknown variables. By the way, if you have not defined X, Y and Z on your own, you are worthless. Thank you janitor for pointing me to OR10...you saved my self esteem for the next 10 minutes until I was pimped again...by the anesthesiologist.
  4. Trying to get caught up on your work as a surgical intern is a lot like being a dog trying to chase it's own amputated tail. You go around and around and around and around but you'll fall over from exhaustion before you catch it.
  5. I don't want to be an intern...but it's about $180,000 too late for that one. I've been asked exactly 5 times if I'm sure that I still want to be a doctor...how's that for job satisfaction
  6. Being pimped in the OR or on rounds is rather benign because it serves a purpose. Unless you're the intern presenting morning sign out at your 24th hour in the hospital with 6 more hours of catch-up work before you can go home and your chief resident is angry at life.
  7. My feet hurt.
  8. It is possible to wash your hands for 5 minutes straight.
  9. Don't fuck with the pancreas.
  10. Eat, sleep, pee and blog when you can.
I don't want to like surgery, but surprisingly I'm having a good deal of fun on surgery...but the novelty is starting to be tarnished more than a little bit. I've scrubbed on 3 cases and gotten to do some fun stuff on my service, but I've never felt more useless in my life. All I can really do is try to be enthusiastic and work hard enough to live up to the expectations of everyone above me, which again are rather nebulous. I've only been scolded like a child once in the past four days, so I'm doing better than I thought I would.

My plan is to get up to speed this weekend on what I should know for my service and then to actually define my place next week, if I'm not reshuffled onto a different team again by one of the chiefs. For now...my bed is calling


The Lone Coyote said...

Dude, reading that was a trip down memory lane that I am not sure I wanted to remember. You sum up the Surgery rotation pretty well there. At least it is starting off about as well as it could. Do get some sleep when you can... you'll need it. And, remember, if you really don't want to be a true "intern" you can always be a pathologist since I know how much you loved Robbins this past year :)

Resident Anesthesiologist Guy (RAG) said...

Think about this when it comes to surgery: You are a bitch for 2-3 years. It doesn't get significantly better from intern year to PGY-2 and maybe even PGY-3. Intern year is hard, but the hardest intern year is in general surgery. Always.

And what did the anesthesiologist pimp you on? I've had surgeons try to pimp me when on anesthesia rotations and I didn't like it (after all, I'm not on your service), but I've never had the anesthesia person pimp me when on surgery.

Good luck. If you want to know how bad surgery internship can be email me and I can shoot you to a friend's weblog who's in gen surg and getting whooped.

M said...


Sado-masochism aside, we're both roughing it at the moment. Everything is painful and the lights are TOO DAMN BRIGHT!

Bostonian in NY said...

LC- If got paid to know every page of Robbins and could work bankers hours, it might not be so bad.

RAG- he pimped me on rapid sequence induction, the physiology of pre-oxygenation/denitrogenation and several different things.

M- You'll understand when you get here and you have 9 hours a day outside of the hospital to sleep/live/study.