Today was a good day. Woke up, late as usual. Safrina made some crepes for dessert last night so I took one for breakfast and walked to work. I was only about 7 minutes late but I always feel bad strolling in after they’ve started. So I took a seat in the back and intently listened.
A lot of interesting cases- really too many to even write about so I’ll focus on the few I was involved with. First, there was a 23 year old transfer from an outside hospital for a huge ovarian mass, almost up to her xyphoid process (her chest bone). There was an interesting discussion on whether this was neoplastic or benign but the plan was made for a unilateral salpingoopherectomy today (remove the ovary and tube on that side). I love when there are oncology cases during morning report, so educational!
The next patient was a patient with a molar pregnancy at age 55 but it was so fascinating the way she presented. It’s like you were reading a text book. In any case- plan was made for TAH/BS (abdominal hysterectomy and removal of the Fallopian tubes) as she was done with child bearing and the concern for neoplasia.
So Eliziphan (sp?) and Gilbert scrubbed in. They’re both 4th year residents. I asked if I could assist, Gilbert said sure. That essentially meant I was scrub tech (there are none here!!) which was slightly demoralizing since I was the same level of training as them but there was no way I was doing this hysterectomy without an attending. As a general rule of thumb- I don’t do anything here that I wouldn’t do at home. So I assisted and weighed in a lot. “Wait, why are you doing that like that?” “Why did you do it one way and Gilbert do it another way?” There was nothing textbook about this hysterectomy. And it was very difficult so my hats off to them. It was not beautiful by any means but this patient needed this surgery and it was safely performed today and in a timely fashion (also while I swatted flies off the surgical field!). As usual, I was impressed. In the labor ward today was Aimee. The 3rd and final female resident here. There was only 1 patient on the ward and she was an induction for an IUFD (intrauterine fetal demise). So there was a lot of time to chat. “So are you married?” One of the first questions Aimee asked me. “Nope, no ring on this finger!” Aimee is recently married and about the same age as me. I had to thoroughly defend my martial status. She asks a lot of personal questions, but then again, so do I. She is great.
For the first time today I met a resident from a different specialty. Quel suprise! I cannot remember his name and I tried so hard to read his ID badge, but it was dangling off his hip and you can only stare so long below the waist before people start to question your intentions. He was a 4th year anesthesia resident and we chatted for what seems like hours. He is brilliant and always 3 steps ahead. His general medicine knowledge is impressive. First off he was the anesthesiologist on the two cases discussed above and he had many concerns. Thyroid storm, metastasis, the difficulty of the case. I’m telling you- these physicians have PTSD here! Every patients is a time bomb and it’s up to them to beat the explosion. When things go right, they are in disbelief and continue to wait for the tables to turn. In any case, Gilbert and Aimee were dealing with the IUFD so I literally bedside rounded with him. Explained the Gynecological portions and why the surgery was warranted while listening to his concerns and validating his opinions. We decided we would have blood available for both cases and discussed the treatment of thyroid storm since the patient with the molar pregnancy presented with elevated thyroid hormone levels. Afterwards the patient got very agitated and I suggested he check her glucose and it was extremely low. After that, we were tight. After things quieted down we talked about his path to anesthesia and how he is also doing critical care and plans to do a fellowship. We also talked about my home and how “everyone just wants to make money there!” LOL. I find it so interesting other people in the worlds perceptions of Americans. I swear, they think we’re monsters! In any case, it was interesting collaborating with him today and to have 3 chief residents struggle in a difficult hysterectomy.
After work, I went to my favorite hang out spot in town. You may laugh, but it’s the Marriott!! (I’m so American but whatever) It’s conveniently located on the way home from CHUK and I can grab some wine and snacks before heading home. They also have WiFi and TV so I catch up on my CNN. Super clutch. I had the same waitress as usual- Neema. I always tip her well so she follows me to my seat whenever I walk in.