CHAPTER 5: GENERAL SURGERY POSTING.
“How shall I begin my tale?
And many MORE;
I hail thee great Surgeons!
Men and Women of Courage,
Standing tall among Giants,
Daring risks & defying the impossible,
Saving lives against all odds,
Giving your best for the good of all.”
Welcome to the General Surgery department, where lives are saved with the aid of knives.
If you are a fan of surgical caps and masks, surgical scrubs and gowns, scrub shoes and shoe-covers;
If the thought of a serene air-conditioned room with machines beeping in the background is of any appeal to you;
If you can stand the gross sight of blood, the smell of burning flesh, the sawing of limbs, the suturing of skin, the cutting of ligaments and tendons, and many of such intense details, then you’re welcome to join us at the operating theatre.
An operating theatre simply put is a place in the hospital where surgical operations are carried out in a sterile environment.The Operating theatre (OT) team typically consists of: The chief surgeon and assistant(s), the Anesthesiology team, the scrub nurses, the circulating nurses and in some cases surgical technicians.
I’m particularly impressed by the way surgical sets are arranged. The scrub nurses do a great job of keeping the sets in order throughout the surgical procedure.
I also like the general concept of sterility in the OT, although it seems overrated sometimes. But when it comes to the risk of a patient contracting nosocomial or iatrogenic infections, one is better safe than sorry.
Depending on the type of procedure, we spend anything from under an hour to over 3 hours in the operating theatre. All members of the team work systematically to achieve a common goal: get the patient off the surgery table and into the recovery room in stable condition. Thankfully, that is usually the case.
From the time the patient gets draped and the surgical site is prepared with an antiseptic solution, to the first incision the surgeon makes, every action is a hit from back-to-back (pun-intended).
As each procedure draws to an end, and the surgeon puts in closing stitches, he thanks every member of the team. No surgeon can successfully perform such technical procedures without the help of experienced OT staff.
During the course of most procedures, medical students are at the mercy of the surgeon(s) as we are often called upon to identify a nerve or blood vessel, or state the likely complication(s) of a procedure and so forth. It is usually mentally challenging but worth it in the long run. There are days when a member of the team says something funny and we all get a good laugh. OT humor is the best of its kind.
Monday was the delegated day for all elective cases in my team. Emergency surgeries came up as required. On surgery days, we had to be in the hospital as early as 7:00 a.m. and we’d go from the ward to the OT till late afternoon or early evening, depending on the number of cases we had.
Our outpatient clinic was on Tuesdays, where we saw new referrals and followed-up on previous patients. I found the outpatient clinics really challenging. We always seemed to have more than enough patients and standing for some 4 hours or more wasn’t exactly fun. But I was there to learn, so I learnt a lot.
We had ward reviews from Wednesdays to Fridays, often followed by discussions, lab work, bedside procedures or other errands to run on the ward.
Surgery rounds were the best. There was ample opportunity to get involved with the management of the patients. And I had a great rapport with a number of them. I even had favorites. I usually felt pumped each morning as I stepped into the ward. I felt no pressure, sense of intimidation or dread, nor did I feel the need to impress any of my superiors. I was able to learn at my own pace and I did pretty well.
Then I related quite well with my colleagues on the team as well. The 12 weeks allotted for the posting was barely enough.
My Preceptor, an elderly gentleman, Dr. Samuel Hazell, was quite the philosopher. His numerous stories about life and the practice of medicine were a highlight of my posting.
Here are a few I recall:
[THE WORDS OF DR. SAMUEL HAZELL]
-Men should not only walk, they should also lead.
-A man should not just use his head to wear a hat, he should also use it to think.
-The Patient is more than a number (or case), the Patient is a Person (Flesh & Blood, Spirit & Soul), just like the doctors that treat him. Dignity should be accorded to every patient at all times.
-Doctors always profit from the misfortune of their Patients. There is no doctor without a Patient.
-God uses Doctors when he wants to remain anonymous.
(All emphasis mine).
Surgery posting is definitely one to look forward to. It can get a bit messy or malodorous sometimes with things like wound debridement. In the end, you have that sense of fulfillment that you’re making a positive difference in your patient’s healthcare.
I don’t think I can conceive the idea of practicing as a surgeon though. My stamina would probably not carry me for the first hour of a procedure…lol.
Nosocomial Infections- Hospital-acquired infections caused by viral, bacterial or fungal pathogens.
Iatrogenic Infections– Disease induced by medical treatment or diagnostic procedure.
Thanks for reading.