Tag Archives: third year

by the way, it’s sunday

I think was feeling a bit nostalgic tonight. I got out of work early and for the first time in what feels like 9 months, it was still light out for my walk home.  I also may have hallucinated the smell of spring in the air.  Not entirely sure what day it was or what to do with a whole extra one hour of free time, I decided to read through some of my old posts and I– as I have said to myself many times before– realized I need to write more.  I have so many stories from this year.  Some are disturbing, some are sad, most of them are just dumbly entertaining.

As I try to get my act together, allow me to refer you to a post I wrote almost exactly two years ago about what was, in retrospect, maybe one of my favorite days of medical school.

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Filed under emergency medicine, intern year, med school, medical school, medical student

oh hello, uterus

We were scrubbed and gowned, standing in the OR around a pregnant, sterilized belly.

My attending said to the resident, “you’ve done enough of these, right?  Right.  Okay, then let the med student take a turn.”

My pulse rate doubled.  Shit. And so I reluctantly turned to the scrub nurse, “Scalpel, please.”

Scalpel in hand I sliced through the skin and into the fascia, trying to hold my hand steady and maneuver a straight line.  At first I was too shy, “Come on, med student, CUT.”  But as I neared midline I had the hang of it.  Not bad, I thought, and found myself secretly hoping the procedure called for another incision.  A number of steps later we’re through the rectus sheath, pulling in either direction on the rectus muscle, and there it was, the uterus.  Inside that ball of a compartment is a tiny little human being.  The resident made the cut through the uterus, fluid gushed and spurted, and we saw the head.  Well, I guess they saw the head.  I saw fluid and smooth surfaces, shiny surfaces, dark surfaces and blood.

Extracting the head out of the uterus took some muscle.  I applied fundal pressure on the upper abdomen while the resident pulled.  And finally, a baby. I was so wrapped up in things I forgot to notice whether it was a boy or a girl.

I was sweaty and tired and ready to de-gown but looked up and realized the abdomen was still wide open.  Oh right, not finished.  We pulled out the uterus and plopped it on her abdomen.  Oh hello, uterus.  Wait, what? Really? This is how we do this? Through the blood we stitched it back together and shoved it back inside so we could could start putting her back together, layer by layer.  When we got to the rectus sheath, the only part of the procedure in which the sutures are proven to make a difference, the attending handed me the needle and pick-ups.  Shit.  Okay, I guess I’m gonna sew this up.

Once again, my hands were shaking, my mask was foggy, and by this time I was wondering if they would make fun of me for sweating through my gown.  I was taking my sweet old time (because that’s all I’m capable of at this point) and everyone in the room (scrub nurse, circulating nurse, anesthesiologist, attending, resident) was willing me to hurry-the-f-up with their pissed-off glares.  Sorry guys, I know it’s 2am, did I mention I have never done this before?

But I did it.  I cut her up and sewed her up.  And she got a little baby girl.

To the scrub nurse: “Suture scissors, please.” The resident cut suture 1cm above the knot. “Needle down.”

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just another day at school

I walked into the building wearing my scrubs, not really sure where I was supposed to go.  There was a room on the right with a lot of scary looking dudes in it… that definitely has potential, I thought to myself.  I lurked over toward the door and peeked in when some really big dude walked up to me and blocked the entire doorway with his body,

“Can I help you?”.

“Uhm, I’m looking for SWAT team training?”

“Yeah, well, we’re building bombs in here. Try the door down on the right.”

Right.  Well, I found my classroom.  If you are going to pick a day to be late, make sure it’s on a day when you get to walk in into a room and have 100 scary looking testosterone-filled eyes immediately stop watching the video of a man being shot down in the field and turn to stare at you, the sole, really out-of-place-looking, tall, blonde, awkward girl.  I took a seat in the back and listened as my mentor taught the men about wound packing, the proper defensive positioning when attending to a man in the field, applying tourniquets 3 inches above the wound, and needle decompressions.  As the time passed I think the guys got used to my presence.  I could tell because they stopped glancing at me nervously every time there was a “tea-bag” or “donkey punch” reference.  I was surprised when one of them even spoke to me, “Can I borrow a highlighter? I’ll trade you a bullet…”

Next thing I know I’m in the medic vehicle, Van Halen is blasting, the sun is shining, the windows are wide open and we are tailing a cop car down some back roads at an uncomfortably fast speed.  We pull into a hidden cove and find the sniper team getting ready to drill.  They want to know if I’ve ever shot a gun before.  Ha.  “Nope, never.” Then they want to know if I’m some kind of liberal. I give a hardy laugh to dodge the question.

Now I’m standing to the right of two men wearing camo pants tucked into their army boots, black SWAT shirts, buzz cuts, goatees, and guns around their waists.  In front of me is a metal silhouette, my target.  A third guy just a few steps away from me tosses a Flash Bang on the ground.  BOOM! Um, it’s smoky and I can’t see what the hell is going on.  Though I am holding an extremely large gun the green scrubs and pony tail kind of negate any hope of looking intimidating.

“You realize I’m going to need a little extra instruction, right?”

“Just grab it with your left hand and put your arm through here.  Good.  Now this part goes where your bra strap lies.”

Um, what is going on here. “Okay, like this?”

“Oh my god you look incredibly awkward.”

Sorry this is the first time I’ve ever held a gun, much less a semi-automatic machine gun. No big deal.

“So… this gun is really heavy.”

“You are such a girl. Put your finger on the trigger, aim the red dot at the head, and shoot.”

BANG. I look around.  No, you did not make that noise, you haven’t even shot the gun yet.  BANG! This time I actually did pull the trigger, not much of a kickback and I hit the metal target. BANG! Hit it again.

“Stick your butt out! This isn’t like those other exercises you do! Bend your knees and stick your butt out!”

And what other exercises are you speaking of, Steaky?

BANGBANGBANGBANGBANG!

This is kind of fun.

An hour later I am hiding behind a door on the second floor of an abandoned building.  I have a grenade (that they promised me was dead) in my hand.  I hear them yelling from below, “Alright men, listen up! There are three bad guys wearing green pajamas hiding in the building.  GO!”

One part of the team snuck up the stairs and came in on the second floor, the other team came from the floor above.  As soon as a man went down my job was to jump out of my hiding place, scream really loud, and throw my grenade at them.  Fifteen scary men are approaching with guns.  I am hiding behind a door.  A man goes down.  They are frantically putting pressure on the fake wound and fumbling with the bandage and I’m supposed to jump out from behind a door, scream, and throw a five pound grenade at them? You’ve got to be kidding me.  Luckily they saw me (oops) and fake shot me before I had to chuck the bomb at some big scary guy’s nose.

“Hey doc, you coming back next time?”  Are they talking to me? I think the enormous men are talking to me.

I could be scutting around the hospital, chasing down labs, preforming rectal exams, writing notes, getting my attendings coffee, or doing this…

“See you in two weeks, boys.”

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bad things

A colleague came up to me with a pained look on his face, “Something kind of bad just happened…”

I had NO idea where this was going.  Did you break up with your girlfriend? You missed your patient’s hypokalemia and she started having chest pain? You put a note in the wrong chart? A nurse yelled at you again?

“My stethoscope just fell into the toilet.”

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Filed under clerkships, jokes, med school, medical school, medical student, Medicine

a joke

Yesterday a patient told me a joke:

What’s the difference between a surgeon and God?

God knows he is not a surgeon.

Funny only because it is so true.

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stinky

If I am going to be your bitch for the next six weeks, at the very least could you stop boxing me out of the circle during morning rounds? Or maybe say hello once in a while?

I understand the heirarchy.  I’m used to and okay with being treated like crap as a medical student.  I am at the bottom of the totem poll and I know what comes along with that.

For example, on my first day in the operating room at this particular site, my attending made me sing. “She’s Always a Woman,” by Billy Joel. Well, at least I knew the words.  You get used to mortification pretty quickly on your surgery rotation.  You also get used to nastiness.  If there is a gangrenous, purulent ulcer that extends from a man’s upper thigh and erodes through posterior to his testicles, guess who’s gonna pack it? Yes, me.  If someone needs vitals, a pen, a granola bar, gauze, or even coffee… I’m the gopher. If someone does something wrong, it is always the med student’s fault.  Once an attending asked me,

  • Do you know the four ways a medical student can cut a stitch?
  • No, sir, I do not.
  • 1) Too short; 2) Too long; 3) Too fucking short; and 4) Too fucking long.

I am okay with the scut work.  I’ve learned to take things less personally.  It’s all part of the process.  But I am not okay with any of this if I’m not learning.  It’s only worth it if you are learning.  Last week I began the last six weeks of my rotation at a new site and I hate it.  Traditionally it’s the residents who do the teaching on the surgery rotation.  You spend the most time with them, you are part of the their team, and they teach as they go. Our residents, on the other hand, don’t speak to us.  Actually, they don’t even look at us.  Seriously.  It’s kind of weird and creepy how they can actually act like we do not exist for the full 14+ hours a day we are at the hospital with them.

I am just disappointed.  I loved my two weeks on the trauma team so much so that I am now (crazily and perhaps transiently) considering going into surgery.  But I’m starting to reconsider, this sucks.

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tired

About two weeks ago my uncle sent me an email telling me he was tired of opening to the word Turd everyday.  Today over the phone my mother begged and pleaded with me to put up a new post.  I suppose it’s time to update.

I might not be awake but I’m alive.  It’s now week 4 of my surgery rotation. I spent the first two weeks in the trauma bay and loved  everything about it. My new site is another story entirely.

There you have it, no more turd headlines.

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