Since my first taste of the OR, I have been busy getting to do more procedures and assisting with various other surgery perks.
These include EGDs, colonoscopies, rectal exams, excision of masses on a man’s thigh and on a woman’s face, lidocaine injections, sutures, and the always fun yet never perfect patient histories.
The thigh mass was, per my surgeon’s words, a “simple in-office, quick procedure.” For me, it was all but that! It was an exciting opportunity to practice injections, learn how living tissue feels under a scalpel (for the record, it is VERY different than cadaver skin…), and work on my cautery skills. We started by injecting Lidocaine. My surgeon handed me the syringe and I stood holding it, expecting him to take it from me when he was ready. When he asked “hello? are you going to numb up our patient?” I was shocked, confused, and giddy with excitement. I had never done a real injection before! And he trusted me! It was difficult to get the depth correct, but once I did, it was amazing. Being able to take someone’s pain away with the push of a little bit of liquid is a pretty powerful feeling. No wonder surgeons are sometimes regarded as gods. After the injection, we cut through epidermis. Here again, I was handed the scalpel and stood, waiting for further instruction, when my surgeon gently encouraged me to make the first cut, instructing me as to the proper angle and pressure to apply. It takes more pressure than you would think! Our skin is pretty thick. So don’t worry, future patients of mine. I’m apparently too gentle with a scalpel (which I don’t believe is a bad problem to have!). The excision was beautiful, the mass was excised in one piece because it was encapsulated, and we sent it off to pathology with the impression that it was a benign lipoma. He let me suture him up and I got to practice and improve my instrument tie suturing (which we didn’t learn- we only learned 1 and 2 handed ties! Luckily I read my supplemental surgical rotation book that has pictures…)
The second procedure we did I was a bit more confident… until I realized it was on a woman’s FACE. He again helped me deliver the Lidocaine, but I was a bit shaky when making the incision. He ended up having to take over because this mass was not subcutaneous, but subdermal- i.e. really deep and really bloody. And the mass wasn’t capsulated so we had to snip out bit by bit until it was all out. All while her face was draped with a small cloth and she was awake and speaking to us. Did I mention it was bloody? Needless to say, the procedure from start to end had me sweating bullets, but we successfully completed it, changing this woman’s life by giving her back her self confidence. THAT was a good feeling!
Since then, we have done some venous ablation, imaging studies, scheduled some exciting surgeries for later this week and next week (sadly, my last on surgery rotation!), and I’ve been spending some time with another general surgeon who specializes in bariatric surgery, which is a huge new field (pardon the pun… Ok, ok, it was on purpose).
I started this surgery rotation thinking “oh great, rectal exams and standing in the corner of an operating room. This should be interesting.” But that hasn’t been my experience at all. Not. At. All! The procedures I have seen and assisted with have all been thought-provoking. The rectal exams I have done have also been educational- they aren’t the plastic models we practiced on during second year: they are real people with real concerns about real cancers and scary family histories- and my simple exam is one way to calm their fears and rule out some of the terrifying possibilities. I don’t care how gross it may sound, but THAT is a humbling and wonderful opportunity. And I’ve decided to approach the rest of my rotations with this same attitude.
It may seem like a meaningless, “going through the motions” procedure or exam, but you truly can learn something from everyone. And who knows? In the process you just might change a life for the better.