Sunday, January 13, 2008

My first complete week

Ok, it's hard to document everything that happened this week but I'll try to give you the highlights.

I had my first embarassing surgical experience. Something that most people have at least once in the OR. I vagaled. I didn't pass out totally, just got really dizzy and had to excuse myself and sit down on the floor before I lost it. In my defense, the OR was really really hot and the surgeon had asked them to turn the heat down twice before I lost it. When the nurse (not the scrubbed one) helped me off with my mask she noticed that my whole cap was soaked in sweat - it was really hot. Also, I have been in surgery for longer and with grosser surgeries and never vagaled before so I feel like this was an anomaly. Anyway, it happened, everyone was very empathetic and it hasn't happened again and hopefully won't. I learned some good tips for cooling down in surgery though - one of the best is to take off your shoes and stand for a second on the cold floor (easy if you're wearing surgical clogs) and then put them back on. It really helps.

I have learned at least 4 different techniques for inserting a speculum. It's hard to keep straight who does what and who tells you never to do what - if someone's showed you their way once, they expect you to repeat it the next time you're in their clinic. Part of being a clerk is not getting told twice. I think I've picked my favorite so far and i've picked up some good tricks along the way such as, if you see a bit of the cervix in the field and want to bring the rest of it into view, rotate the handle of the speculum towards it and the bottom bill will sweep the cervix into view, then right the speculum before screwing down the hold screw. Very helpful!

Clinics rarely run on time. No matter how fast the doc is, there are always additions and emergent patients to be seen. Go with the flow, bring an energy bar and some water - you're going to need it.

On a similar note, the hospital is VERY DRY. I don't think I peed for the first 2 days of clerkship because I was so dehydrated. Bring water. Take it with you everywhere. Leave it in the fridge in the OR staff room so you have it on breaks. Water is your friend.

This week I discharged my first 4 surgical patients. All of whom I really liked. All of them very different and there for different reasons, some will continue on to need further treatment for cancer and some are cured of their symptoms/diseases by surgery. I realized that I really like continuity of care, I want to know what happens to these people and I want to be a part of it - just one more sign that I was made for family medicine.

Ben and I discussed moving back to Scotland eventually and staying there for a while. So, now I'm trying to figure out what the steps are to getting a license to practice as a GP in Scotland. I know that there is a lot of turmoil in the British system right now and that makes me nervous. Hopefully I can figure out a way to follow my dreams there too.


the little medic said...

I think everyone is allowed one dizzy spell in theatre. I had a similar experience when I was on my elective. I'd never ever felt queasy or faint before but duriing a routine procedure one day in theatre I had to lie on the floor because I felt so strange. It wasn't particularly gross, so I ut it down to the heat.

Sounds like you're enjoying yourself. Glad to hear it.

Xavier Emmanuelle said...

Sounds pretty awesome. Glad you're enjoying yourself, and that your experiences are cementing that family med would be a good fit for you!

ditzydoctor said...

oh my sounds scary. never vagaled before, but i suppose my turn will come!

and it's wonderful you're enjoying yourself! :)

Harry said...

Woah bad luck, can you really take off your shoes in theatre? I mean wouldn't people trip over them, or it be un hygenic, or hard to put back on again??

Calavera said...

Too bad about theatre, but I'm sure that no one thought any less of you or anything - you said yourself that it was way too hot.

Thanks for the handy hints- I'll be back at the hospital next year too!

... and as for the move to Scotland... wow! Were you always planning to move to Scotland?

The Shrink said...

Clinics rarely run on time. No matter how fast the doc is, there are always additions and emergent patients to be seen.
- only in that hospital ;-)

Exciting times. I loved my surgery placement, my first ever clinical attachment. I just didn't love the cutting. Ho hum!

Midwife with a Knife said...

I passed out once, but I was a chief resident at the time. Much more embarassing than when you're a medical student. Nobody will blame you for it, trust me. :)

med school mama said...

Yup, almost passed out during my first OR experience, also while watching an NG tube insertion into an overdosed patient in the ER (but that time was prego so I don't count it as much).
You are going to be a wonderful, attentive doctor.

izzywizzy said...

I've definitely felt dizzy a few times in theatre too! i like your tip about taking off your shoes! I've just finished my obs and gyn placement too and thought it was great though I found speculums a bit tricky at first:) i see your thinking about coming to Scotland to practice-i'm in edinburgh studying and i really enjoy it! if you ever have any questions or whatever don't hesitate to ask! isobel