I wanna be a surgeon when I grow up! Part 1
I job shadowed a surgeon today.
Dr. Chun's shift began at 7:30am, which meant I needed to wake up at 5, so that I could get to the hospital with enough time to check in at the charge nurse's desk and fill out some preliminary paperwork.
After getting a bit of attitude from the charge nurse, not because of fault of my own, but because Dr. Chun did not notify anyone that he would be followed by pre-med students, I changed into my scrubs and met up with the general surgeon.
He seemed like a great guy. Not full of himself as I had expected given from what I had heard from others who had dealt with him. I followed him into the doctor's lounge where he tried to perk up for his first surgery of the day. Two cups of coffee later I followed him to the OR and watched him scrub in. Since I was mainly observing, I was not allowed to scrub in.
In the OR, the anesthesiologist had already sedated the pt., a surgery RN was ready to assist Dr Chun and the surgery tech gave me the basics of where I should stand to avoid contaminating the sterile field. I was surprised that surgery was a 4-man operation. I had always assumed that more people were needed to get things going.
The anesthesiologist was a hoot! I really liked how "laid-back" his approach to medicine was, and how he seemed to embody everything that I would want in an MD especially an approachable demeanor with a great sense of humor. I felt comfortable speaking with him and he was very willing to answer any question I had and was more than willing to offer information to what he was doing despite me not being there to learn about anesthesiology
The first case was a 61yo male who was getting a laparascopic colectomy. Apparently, he had a large polyp in his colon that was tattooed for ease of finding among the tangles of intestine, which needed to be removed in fear that it might be cancerous. The gastroenterologist had originally charted the polyp was in the lower left quadrant of the pt, but after searching and searching Dr Chun discovered the polyp was actually more medial in the transverse colon area. This was my first exposure to surgery, so I was rather underwhelmed by the process of laparascopic surgery, given the lack of gore I had anticipated. What I viewed on the monitors was nothing different than what the magic of tv presents on shows like House and ER.
Anyway, Dr Chun apparently was having some difficult removing the mesenchyme surrounding the piece of colon to be removed he had his assistant surgeon come in and assist. This is when things got interesting. Of notable mention, I remember how difficult it was to use the laparascopic tools at the ISIS facility at UWSOM, so I was very impressed with the ease Dr Chun maneuvered his way through the gooey mess of innards he had to scavenge through. Anyway, they were having trouble getting a clear shot at the potentially cancerous bowel that they decided to cut open the pt. They made a 4 inch incision in the abdomen with a scalpel, which appeared to only cut through the dermis and then used a cauterizing tool to cut through the pt's large layer of adipose tissue underlying the skin. This was the first time I got smell the lovely stench of burnt flesh. It wasn't pleasant at first, but after a while, it became bearable.
Anyway, they managed to get through into the abdominal cavity, upon which much to my dismay, Dr Chun reached in and yanked the pt's transverse colon out. My jaw hit the floor. There on the pt's stomach laid a heap of pink and yellow goo dripping blood down the unconscious' pt's side. They managed to cut off the piece of colon marked for the polyp with this nifty tool that cuts and cauterizes at the same time. Then, to connect the two separate pieces of colon, rather than connect them end-to-end, they connected side-to-side once again, using that nifty surgical tool. They closed up the patient, did their count of all the gauzes and tools they used to make sure nothing was being left inside the pt and the pt was transferred onto a gourney to be taken to the recovery area. Dr Chun then went on to speak with the pt's wife and let her know everything had gone well, despite the incorrect location originally noted by the gastroenterologist.
One of the cool things I did not know about laparascopic surgery was how they used air to inflate the abdominal cavity to be able to maneuver their through all the crap that's in there. Also, to facility access to what they were working on, they would shift the table to different angles and let gravity help by having all the guts lean to one side or the other.
One of the things that made it apparent that today was going to be a fun day was the fact that Dr Chun kept cursing as he couldn't find the polyp, the anesthesiologist rocking out to music in the background and lastly, Dr Chun saying the gastroenterologists are fuckers for never giving correct locations when it matters.
***
This took longer to write than I anticipated, so I'm going to split it up into four parts, for each procedure done. I'm hoping my memory will be as sharp enough to remember all the gory details.
Dr. Chun's shift began at 7:30am, which meant I needed to wake up at 5, so that I could get to the hospital with enough time to check in at the charge nurse's desk and fill out some preliminary paperwork.
After getting a bit of attitude from the charge nurse, not because of fault of my own, but because Dr. Chun did not notify anyone that he would be followed by pre-med students, I changed into my scrubs and met up with the general surgeon.
He seemed like a great guy. Not full of himself as I had expected given from what I had heard from others who had dealt with him. I followed him into the doctor's lounge where he tried to perk up for his first surgery of the day. Two cups of coffee later I followed him to the OR and watched him scrub in. Since I was mainly observing, I was not allowed to scrub in.
In the OR, the anesthesiologist had already sedated the pt., a surgery RN was ready to assist Dr Chun and the surgery tech gave me the basics of where I should stand to avoid contaminating the sterile field. I was surprised that surgery was a 4-man operation. I had always assumed that more people were needed to get things going.
The anesthesiologist was a hoot! I really liked how "laid-back" his approach to medicine was, and how he seemed to embody everything that I would want in an MD especially an approachable demeanor with a great sense of humor. I felt comfortable speaking with him and he was very willing to answer any question I had and was more than willing to offer information to what he was doing despite me not being there to learn about anesthesiology
The first case was a 61yo male who was getting a laparascopic colectomy. Apparently, he had a large polyp in his colon that was tattooed for ease of finding among the tangles of intestine, which needed to be removed in fear that it might be cancerous. The gastroenterologist had originally charted the polyp was in the lower left quadrant of the pt, but after searching and searching Dr Chun discovered the polyp was actually more medial in the transverse colon area. This was my first exposure to surgery, so I was rather underwhelmed by the process of laparascopic surgery, given the lack of gore I had anticipated. What I viewed on the monitors was nothing different than what the magic of tv presents on shows like House and ER.
Anyway, Dr Chun apparently was having some difficult removing the mesenchyme surrounding the piece of colon to be removed he had his assistant surgeon come in and assist. This is when things got interesting. Of notable mention, I remember how difficult it was to use the laparascopic tools at the ISIS facility at UWSOM, so I was very impressed with the ease Dr Chun maneuvered his way through the gooey mess of innards he had to scavenge through. Anyway, they were having trouble getting a clear shot at the potentially cancerous bowel that they decided to cut open the pt. They made a 4 inch incision in the abdomen with a scalpel, which appeared to only cut through the dermis and then used a cauterizing tool to cut through the pt's large layer of adipose tissue underlying the skin. This was the first time I got smell the lovely stench of burnt flesh. It wasn't pleasant at first, but after a while, it became bearable.
Anyway, they managed to get through into the abdominal cavity, upon which much to my dismay, Dr Chun reached in and yanked the pt's transverse colon out. My jaw hit the floor. There on the pt's stomach laid a heap of pink and yellow goo dripping blood down the unconscious' pt's side. They managed to cut off the piece of colon marked for the polyp with this nifty tool that cuts and cauterizes at the same time. Then, to connect the two separate pieces of colon, rather than connect them end-to-end, they connected side-to-side once again, using that nifty surgical tool. They closed up the patient, did their count of all the gauzes and tools they used to make sure nothing was being left inside the pt and the pt was transferred onto a gourney to be taken to the recovery area. Dr Chun then went on to speak with the pt's wife and let her know everything had gone well, despite the incorrect location originally noted by the gastroenterologist.
One of the cool things I did not know about laparascopic surgery was how they used air to inflate the abdominal cavity to be able to maneuver their through all the crap that's in there. Also, to facility access to what they were working on, they would shift the table to different angles and let gravity help by having all the guts lean to one side or the other.
One of the things that made it apparent that today was going to be a fun day was the fact that Dr Chun kept cursing as he couldn't find the polyp, the anesthesiologist rocking out to music in the background and lastly, Dr Chun saying the gastroenterologists are fuckers for never giving correct locations when it matters.
***
This took longer to write than I anticipated, so I'm going to split it up into four parts, for each procedure done. I'm hoping my memory will be as sharp enough to remember all the gory details.