Today is the end of my surgery cycle, which marks the beginning of many-things-to-study-internal medicine cycle.
We have successfully covered several topics in this three weeks duration cycle,which include:
*Peripheral arterial disease
*Deep Vein Thrombosis
*Fistula in ano
*Inflammatory Bowel Disease
*Thyroid gland diseases-neoplasms,hypo and hyperthyroidism.
It seems a lot, but trust me I did not have enough of surgery. Some diseases which are not listed here were supposed to be covered during last semester, but unfortunately we got a surgeon who didn’t teach, and all that we did was to watch the barely able to see kind of surgery for the whole one month duration!
Luckily we get Denis Sergeevich Ledaev for this semester, who stimulates and gives us topic to study, guides us with differential diagnosis for diseases and shows many X-Ray and CT scan films to us.
Everyday we discuss the topics given, see the patients and watch operation, be it from video or live performance by our surgeons. The operations that we had watched for this semester were:
*Inguinal Hernia repair
The most memorable moment during this cycle was I got the opportunity to assist in orthopedic surgery twice. It happened in one fine day when we were watching almost-nothing-you-can-see-partial nephrectomy, one nurse from another operation theatre called someone for help in orthopedic surgery. At first I thought she was talking to the nurse or surgeon in charge. But after being sure that she was frantically searching for a student, I offered myself without much hesitation.
Then she asked me whether I ever assisted in any operations before, and I just nodded yes and explained to her that I assisted during my third year, which was three years ago and my function that time was to pull the retractor and made one suture only. I was nervous if the surgeon expected too much from me since I’m now a final year student, hence the clarity was given.
After thoroughly washing my hand according to standard procedure, the nurses helped me to put on the sterile gown and gloves, and there I was, being the second assistant for knee joint replacement surgery. That time my role was still the same, to pull the retractor and suck the blood.
I was really thrilled with that kind of surgery because I had never seen any live orthopedic surgery last year during whole orthopedic cycle. And somehow it brought back my old sweet memories of living skill lesson. I mean with the knocking hammer sound and blood splashed into my face after bone drilling (I’m not joking) was really cool. It’s really different from what I usually see in other types of operation-with only incising the skin, muscle, suturing here and there, closing back, that’s all. Definitely not so fast and furious as orthopedic surgery is.
If you ever thought that pulling the retractor and sucking the blood has a minor role here, let me make it clear that it actually serves a paramount importance in any surgery. Surgery team is a real team where if you put one zero inside, the result will obviously be zero! If you follow Japanese series Team Medical Dragon, you will understand how everyone in a surgery team cooperates and plays an important role.
Any delay in my action would delay the surgeon’s action as well, for example if I didn’t widen the operative field by pulling the retractor, the surgeon would have difficult time in viewing the organs. It’s the same if I didn’t suck the accumulated blood from the bleeding site, it will hinder the surgeon’s view as well. I had to catch up really fast with the faster surgeon. Being an amateur there, I realized how every nanosecond was so vital for the outcome of the surgery.
And after that time I also realized how 3 hours of standing to perform a surgery is not tiring at all, compared to 30 minutes of watching i-have-no-idea-what-the-surgeon-is-doing-surgery. It’s because once we stand near the operative table, we bear such a huge responsibility and stay focus all the time, until we reach one point where we don’t notice the clock is ticking.
On the next day, Ledaev called me and my friend to the operation theatre all of a sudden after clerking a patient. We had no idea why only two of us were being called. Apparently the orthopedic surgeon still wanted a student to assist him for another knee joint replacement surgery. That time I gave my friend the chance because I already had the experience, but since they needed 2 students, I didn’t give a second thought.
This time was much harder since it’s performed on an obese patient. To keep the knee flexed was not an easy task. Try to imagine how manpower (us plus the first assistant that made us 3 altogether) still can’t manage to keep the heavy limb in a proper flexed position. And that time the surgeon was so angry with us (including his first assistant) for not able to support the knee. Haha, it didn’t infuriate me at all because I did understand enough how the slightest mistake may cause the patient unable to walk later on.
For me, being an orthopedic surgeon doesn’t only need you to be skillful, but the most important thing is to be accurate and meticulous. The slightest mistake in nailing a screw would cause a great catastrophe to a patient. The slight diverted angle for inserting the prosthetic joint may cause them to be malfunction. Maybe I should consider being an orthopedist? Em, I wonder! It still can’t surpass my passion in neurology. Hehe.
On another hand, I think anesthesiologist is the coolest person in the operation theatre. Since I was a second year student where I watch the first surgery, I never saw any anesthesiologist making a stern looking face, unlike some nurses. And they are not cocky like some surgeons, I may add. But I’m not interested in doing their job, because I prefer to diagnose a disease over narcotizing a patient. =p
In short, I really enjoyed this cycle and learned a lot compared to last semester. Hopefully this spirit and momentum will last till the end of the semester.=]