A Bloody Mess Called Surgery

It was a pretty routine surgery. It was me, my partner, and Prof Gorey who scrubbed in on the case. The first incision was made. 4cm across the crease of the neck. My eyes were fixed on the patient. I have recurring nightmares where the patient jumps out screaming in pain. Thankfully the anaesthetist was in top form.

I have a fear of blood. Correction. I have a fear of squirting blood.

The patient's thyroid was enlarged and overly vascular. Prof Gorey wasn't too happy. It wasn't going to be as routine as expected. Blood vessels were enlarged, and in places where it shouldn't be.

A quarter of an hour into the surgery, my partner looked quesy. I knew what was coming next.

“Professor, I think I'm going to faint,”

Immediately she was taken off the case. It was only me and the Professor.

An hour into surgery, the first bleeder 'erupted'. As the Prof was exposing the platysma, he hit a bood vessel. The vessel squirted out blood which sprayed all over my gown.

Then he hit another one. This time I had to hold the suction to clear the area so he could cauterize the bleed.

Blood was squirting all over the place.

“Not as elegant as I hoped it would be,” said Prof Gorey.

Surprisingly, I did not even remember that I had a fear of blood. Maybe it was the adrenaline.

The C-section

Dermott had just finished giving us a tutorial on the gastrointestinal system.

“Which one of yous would be disappointed if yous got a C grade?” he asked.

Few familiar faces raised their hands. Hermione included.

I resisted the tempation and looked to see what the point to this was.

“This isn't secondary school. Most of of yous are used to being on top in class,”

At this point my eyes were on Hermione.

“Well wake up. The days of getting straight A's are over,”

“A person who can answer all the questions without making a single mistake would qualify for a B,”

“A 'C' grade is what most of you will get. And that would qualify you for an honours grade in your final degree. So suck it up and accept that you are no longer in your small town competing with a bunch of duds. You're in the big leagues now,”

He was right. As of now, the elusive 'A' seems like a far cry from the days of high school back home. Clinical years have a totally different assesment system in where a passing is already a huge achievement.

“The most important thing is to GET THROUGH your exams, and become a doctor!”

He was brutally honest wasn't he?

Scrubs

Scrubbing in for surgery was indeed exciting.

Inscribed on one of the walls up in the MATER :

You put your right hand in

You put your right hand out

Touch another patient

And you spread the bugs about

I don’t even need to get into the hoo-haa involved in infection control in hospitals. It’s absurd at times. I spent 5 minutes scrubbing up only to be asked to scrub all over again because I touched (more like brushed my hand against) an unsterile surface. Nice. All for the greater good I guess.

Burn Baby Burn.

I was positioned in front of the Registrar, with the patient on my right totally unconscious (I hope!).

The first cut was made underneath the areolar crease, approximately 2-3cm wide. The diathermy was then used for the rest of the procedure to both cauterize and coagulate ‘bleeders’. The smell was awful.

You know the feeling one gets when a putrid smell is basically implanted in your brain? The smell of rotting burnt flesh has probably permanently manifested itself in my olfactory bulbs. Yeap. Burning flesh.

....

Surgery isn’t all bad.

No other profession involves people actually begging you to stick a knife in ‘em. Then they pay you loads for it.

Another good reason to become a surgeon :

CROCS!!!

I snapped a photo of my bright green crocs

Cest la vie

I’ve always been biased toward medicine rather than surgery. Then again the door isn’t closed shut. I might just give surgery a chance. At least for the next two weeks.

Maggot of a Man

“I’ll kidnap you, drag you up to Killarney Hill, gag you up and leave you there,”

The dressing nurse remained calm. She seemed unabated by the threats of the horrid man.

Maggot man, as I call him, has leg ulcers which have necrotized deep into his tissues. A curative approached would have been amputation of both his legs. He obviously didn’t want that.

If he was cured, Maggot Man would be liable to a court date for selling heroine. In other words, he was jail-bound barring definitive treatment of his leg ulcers.

Dr Swear-a-lot (remember him) decided to try a relatively ‘alternative’ treatment by ordering MAGGOTS imported from Wales in order to remove the necrotic tissue surrounding the borders of the ulcer.

Yup. Maggots eating away at dead tissue. And I had the wonderful opportunity of holding ‘em baby maggots as they positioned the sachets as to cover every inch of the foot ulcer. I’m not being sarcastic. It was exciting!

Sad Goodbyes

After three weeks in St Micheal’s, it was finally time to leave. What started out as a pretty mundane setting turned into one of the most educational experiences for me, and I’m sure, the rest of my group mates. The laid-back atmosphere of the whole set-up allowed more time for the doctors to hang around and actually teach us a thing or two. So adios and on to the MATER for my final rotation. Enter SURGERY.

Bowels in Motion

I looked over the new time sheet that was given out.

Gastroenterology Rotation

Reg : Dr JLC

SHO : DR CG

I went up to meet the team. My partner, blondie (her car sticker reads : Danger-Blond driver) was absent.

McDreamy...

“He’s gorgeous,”

“Such a peach,”

"Love the hair,"

It’s unfortunate that in real life, not all doctors look as hot as the ones in Grey's Anatomy or even House. He was the exception. He was in fact of movie star quality. And they(the girls) do love him up in the wards.

With my manhood being challenged by such a good-looking SHO, I was determined to see what the deal with the guy was. To my inherent surprise, I do actually like him. He is a very pleasant and charming young fellow, who isn’t at all snobbish or stuck up. In fact, he goes out of his way to teach us baby-doctors everything he knows. Thumbs up to my very own version of Dr Mcdreamy.

Small freaking world

On to the Registrar, who was Chinese by the looks of it.

“Where are you from?” he asked. His pronunciation was pristine.

“Muh layh shia” I answered in the most legible way possible. Malaysia isn’t the most well known country amongst the Irish.

“Ah, me too. Whereabouts in Malaysia,” he answered to my surprise.

This was going well.

“Err, somewhere near KL, have you heard of Subang Jaya?” again trying not to be overly specific.

“Really? I’m from Subang as well. I used to go to Seafield. I assume you’re from SMSJ or SMSU?"

“SMSJ,” I answered, trying to contain my excitement.

“We’ll get on very well then,” Dr JLC smiled.

Small world it is.

Up yours!

The Gastro team does weekly endoscopies involving the GI tract. Patients are usually sent for either a colonoscopy or a gastroscopy to check for any underlying pathology that might’ve caused their symptoms.

A colonoscopy involves sticking a camera up the patient’s ass anus all the way into up the large bowels leading to the caecum. Suffice to say, it isn’t a pleasant procedure for the patient.

Far-t-ales

The room where they perform the procedure is pretty small. There’d basically be a consultant, the registrar, one or two nurses, and a maximum of two students. Anything more than that would make it very difficult to manoeuvre.

I’ve recently altered my eating habits to a healthier diet (I’ll explain more as we go along). I’ve also developed a liking for ‘prawn salad’ that costs only 2 quid in the Tesco opposite the hospital. The increased amounts of fruit and vegetables have caused, for the time being, hyper-flatulence. To put it simply, I’ve been farting a whole lot.

It had to happen in the endoscopy room. Of all the small, cramped, poorly ventilated places....

I felt the bowels move and immediately knew what was coming. I couldn’t get out as I was stuck in the corner beside the patient. I looked around. The window was closed.

It felt warm as I clenched my ‘cheeks’ to prevent it from being released. My brain was racing, trying to devise a way out of the mess I was in.

Then it hit me.

“The anal patency is reduced when the patient is in a sedated state,” explained the consultant.

Perfect.

As they inserted the camera up the patient’s anus, I knew that this was the moment.

It did smell like prawns.

Not even a bat of the eyelid. Everyone was too polite and assumed it came from the patient.

“The anal patency is reduced when the patient in a sedated state”

I had picked the perfect moment. Good save, huh?

Moral of the story:

Smile, and the world smiles with you.

Fart, and you’ll be the only one smiling.

Bus-capades

It was a bad start to an already crappy morning. I had woken up late. And it was RAINING!

I decided to go “Irish” and skip my daily shower. Deodorant and Brylcream would suffice.

I wasn’t sure if my bus card was still valid. I didn’t want to risk it. So I made my way to the nearest shop to get a new card. As I was threading through the rain, I saw a yellow flash.

The bus had arrived. I made a u-turn and ran across to the bus stop. I made it just in time.

Thankfully, my bus card had one day left in it. Close one!

Each day, I take two buses in order to arrive in Dun Laghoire. The first bus stops in Stillorgan, which is the last station. I then have to hop on the 46a which goes directly to St Micheal’s.

I make it a habit to revise a bit on the bus.

“We have to be proactive!” Hermione’s voice echoed in my head while I was turning the pages of my beloved clinical handbook.

The bus had slowed down. I looked left and right and realized I wasn’t in familiar territory. And I was the only one left on the bus.

“Where are you heading?” She asked

“Stillorgan, I thought it was the last stop?”

“Well it is, and we’ve gone past it,”

I tried not to swear. I got off and made my way back to the Stillorgan stop. It wasn’t that far. But it was RAINING.

About 50 metres from the stop, the 46a had arrived. “Not again,” I muttered as I made another hopeful dash towards it

I arrived (out of breath) and hopped on.

“I’m sorry, the bus is full,” said the driver.

My mouth was half open. “Wh-whhat?”

Then I looked around. It was half empty.

The driver was chuckling now. He got me.

Well, at least I put a smile on someone’s face today. The look on my face must’ve been priceless. He smiled all the way to Dun Laghoire.

Hunger Pains

Please observe protected mealtimes from 12pm-1pm.

I didn’t really understand the meaning of the sign until today. As the german giant (my consultant) was doing rounds, the clock struck twelve. Immediately from left to right, carts carrying food suddenly appeared from the doors leading to the alleyway in the corridors to be flooded. The smell was mouth watering. I thought I smelt steak.

The german giant was still in Mrs GH’s room. And he took his time. A lady carrying a tray of food barged in.

“LUNCH TIME!” she cried.

The giant was taken aback. He ignored the lady and continued to examine the patient.

When he left the room, he was confronted with whom I presume to be the “manager”. She was small. But she still stood tall in facing the giant.

“We have a clear policy about mealtimes, doctor. Patients are NOT allowed to be disturbed during lunch hour. It has always been that way. They need to have their meals” she said without flinching.

“Well I understand and am all for that. BUT,”

I realized how intimidating the german giant can be.

“When I am in the middle of examining a patient, I would at least expect SOME degree of RESPECT. What your lady did back there was plain RUDE. She SHOULD have just let me finish with the patient,” he argued.

The heated argument continued for the next quarter of an hour. Neither gave in.

The moral of the story : DON’T mess with meal times. Patients need to eat.

The Never-ending Drama

First in, last out

Every class has a miss-know-it-all. It just happens that my partner is the typical Hermione Granger sorta character. There are pros and cons to say the least.

Coming in an hour or two earlier than scheduled has been the norm. The feeling of inadequacy beside a student of such high caliber can be at times depressing.

"Here take this, you can have my job," joked the consultant when my Hermione answered a really difficult question.

On the plus side, my Hermione often keeps me on my toes, as my ego can only take so much of a battering day in day out.

“We have to be proactive!!” she says.

It’s not that I’m lazy. In fact, many would consider me to be hardworking. But compared to my own little Hermione, I’m definitely a slob.

“We have A & E rounds at 11 tomorrow. So I’d say that we should come in at around 9 and see if we can catch them on the respiratory ward round. If not we could just scout around and get a history or two. What do you reckon?” asked Hermione in her usual excited tone.

“Of course we could do that. But em, if the resp round is off, I think we should just hang out and do nothing at all. What do you reckon?” I answered with a relatively straight face.

Peter had burst out laughing in the background.

“Good man, I like the way you think” he said along with his signature wink.

Smile dearie

“All smiles now, no long face,” exclaimed the old lady we passed by in the wards.

It is something that I do have to get used to. Smile for the patients!!!

Drama

“We’ve tried all the antibiotic regiments, but she doesn’t seem to be responding as well as we had hoped,” explained Deegan to the worried looking husband.

“At this moment, I’m afraid there’s nothing we can do for your wife. On the up side, we’ll now try to make things as comfortable as possible; she won’t have to suffer from any pain or discomfort. I’m really sorry Mr JD,” continued Deegan, now with a hand on the poor man’s shoulder.

“I understand doctor, you’ve done the best possible...” he couldn’t finish his sentence. He had already broken down in tears.

Though not entirely unexpected, Mr JD had to finally accept that his wife wouldn’t be there much longer. Deegan had knocked the breath out of him. It was the closure that he needed. He was shattered.

“H-how long does she have left?” he asked amidst the sniffles.

“We can’t really say, MR D. But I assure you that she will be cared for to the best of our abilities to ensure that she does not go through any sort of pain,” Deegan again reiterating their commitment to alleviate her suffering.

As we left the ward, our SHO had taken out a booklet entitled, “Care Pathway of the Dying Patient”

That really summed up the scene.

It’s surprising how grossly inaccurate textbooks can be in “Dealing with grief”. Nothing comes close to describing the heartfelt emotions that go through patients and doctors alike. In such a real scenario, one cannot even hope to get any sort of ‘answer’ just by reading textbooks or attending lectures. It’s as real as it gets.

Time and again I remind myself as to why the medical profession requires more than just brains. Getting through medical school will test your determination, guts and willpower. All the stuff they taught in countless lectures, seminars and courses can only prepare you to a limited extent.

The drama is definitely REAL.