Face Full of Blood

Hello, hello! Super long time since I updated again, I know. I've been really awful about blogging because I've been on my surgery rotation. And no offense to surgeons, but I'm so not attracted to a surgeon's life. Super early mornings, long hours on your feet, meal breaks equivalent to quickstuffyourfacewithanythingnow, daily wound dressing changes, and when you're not spending long hours in the OR, there will still be long hours in clinic awaiting you. But fortunately, this lifestyle does appeal to certain folks (who are not me) and the world will hopefully always have some excellent, smart, hard-working surgeons (who are not me). I know this to be true because I know about five people, all quite sane and nice human beings, who will be/or is considering going into surgery.

So, for those of you interested in medical school ramblings ... for surgery, resident rounds start around 6-6:30am so for pre-rounds, we should check in even earlier. With long days when I generally leave past 6, I can go for days without seeing daylight because the sun will dawn while I'm in the hospital and set before I leave. Bright side of this? Vampires, too, can be surgeons.

Oh, you want a legit positive? When I drive in super early, it's quite nice because no one is up at 5am and you can go zoom zoom. And have your pick of parking spaces in the lot. Also, everyone can roll out of bed at 4:30am and wear whatever to the hospital because we're going to have to change into scrubs anyway. But after being on obgyn and surgery service back to back ... I missed nice clothes.

For rounds, medical students are generally responsible for carrying a bucket or stuffing their white coat pockets with sterile gauzes, kerlix, saline flushes, and tape. Lots of tape. We then flock after the team up and down stairs to the various patients, presenting the overnight information regarding patients we're following, changing the various patients' dressings and checking their drains. There were a lot of amputation wounds. Many legs to prop up, many oozing wounds to rewrap.

Speaking of amputations, I was scrubbed in to assist the vascular surgeon and resident on a BKA revision (the man is a diabetic whose foot got really infected so he had a guillotine ankle amputation in order to let the wound drain first to make sure the infection gets all taken care of before going back into the OR at a later date for a below the knee stump revision).

During the surgery, the attending hacked away at all the necrotic tissue, trying to roll up the flap into a nice looking stump. Really inappropriate, but it was close to lunch and for a while there, the stump looked like an empanada. A really thick, unwieldy empanada that refused to be wrapped up neatly. Cursing like a rap song, the attending muttered, "Oh, f***, man, this guy's a f****** squirter."

The next I knew, a jet of crimson spurted through the air and caught me right in the face. The attending jerked back, blood just barely grazing the bottom of his mask.

Likely because I was so tired, I just blinked. We all had masks with eye-guards so it wasn't as if the blood had made skin contact ... I hoped. No biggie, so what if there's this ketchupy blob across my vision, I can just peer around it -

The resident on the other side of the table stared at me as he ventured, "Um, maybe she should scrub out ..."

The attending turned his head to me, bovie in hand. "Yes," he decided. "Scrub out and come back."

"Uh ... okay." I turned away from the table and all three nurses in the corner went, "Whoa."

What? What? Did the blood actually manage to sneak past the eye guard? I just pictured a constellation of red on my forehead, forming a neon sign: SOAP PLZ.

One of them rushed forward as I stripped off my gloves, examining my mask closely. "It's okay. It's okay. Nothing got on your skin."

Another nurse laughed as he helped untie the back of my gown, "See now? This is why I said that you should go into dermatology."

When I removed my mask outside, it turned out that the blood had splashed across the mouth and up over the eye guard, ending just right at the upper border. Nice.

Happy New Year!

I hope everyone's been enjoying the holidays and is ready for 2013!

I've been blissfully lazing around during my winter break after wrapping up my ob-gyn clerkship. After seeing all these deliveries and scrubbing in on the C-sections, I have extreme respect for mothers. Mad respect.

As one of the many perks of being a lowly medical student, one of our duties is usually gathering the general history of the patient in triage. So when a woman in labor is busy breathing her way through a contraction and squeezing the threads out of the sheets, hey - you get a medical student hovering over you, asking about your chief complaint ("What do you think? I'm in freaking labor!"), past medical/surgical history, your previous deliveries ("Can't you pull up the information from my medical charts? I've been here before!"), current medications, allergies, STDs, abnormal pap smears ("No, no, no, NO."), etc. Believe me, we're very sorry, but we enjoy the process as much as you enjoy resisting the urge to throw something at our heads.

So ob-gyn was fun, in that mildly traumatizing way.

Anyway, a friend gave me this snow globe for Christmas and at first glance, I was like, "Aw, this is super adorable. It even plays music while I watch the snow fall. I'm going to treasure this forever!"

And then, the other day, I take a closer look:

Be happy, indeed. A bear gleefully prepared to trample a tiny turtle beneath its huge paw. Or caught right in that magical moment before he sends a flying kick at the turtle's head.

Am I to assume this is a subconscious manifestation of my friend's real feelings for me?

Am I a puny turtle, idiotically grinning away, while the shadow of a foot looms over my head?

No.

When the moment comes ...

I shall be the bear.

Sex Therapy

A lecture we had during psychiatry clerkship was on sex therapy.

The lecturer touched upon paraphilias (sexual arousal to objects, situations, or individuals that are not part of normative stimulation, causing distress to the individual or harm to others) for a while and described an experience she had:

One night, the phone rang and she went to pick it up. On the other end, a man breathed harshly before diving into obscene comments and lewd suggestions. Instinctively, she slammed the phone down.

Then, with her hand still on the phone, she thought about this.

The phone rang again and she picked it up. It was the same guy making the same crude remarks and this time, she informed him, "This is an impulse disorder you have, which I imagine would probably cause you a lot of distress. I know where you can get professional help -"

The guy hung up on her before she could finish.

But then, a few minutes later, the phone rang again and when she answered, he asked, "Does the place accept Medicaid?"

"True story!" she stressed as we all laughed in disbelief.


Sorry for being awol. Been really busy lately. I finished my psychiatry and neurology clerkships and I'm now on my pediatrics clerkship. I'm on nursery week and all the babies are so, so adorable - even though a fellow student said that he's since realized all newborns look like Winston Churchill.

Winston Churchill, Master of The Disgruntled Baby Stare-down