Surgery Part 2

So much for keeping up with writing things down this year. I had all the best intentions, but free time has come at a premium these days.

Surgery ended about 6 weeks ago now, and I'll be the first to admit that I was very happy to see it go. I learned some valuable things, but I am definitely not going to be a surgeon. On Trauma, we saw patients on the wards from about 5-6ish, and then went to the Trauma Hall in Parkland and waited for patients to come rolling in. We carried a pager with us and it would go off whenever someone was on their way and give us a few key pieces of info to be prepared for. To this day, the sound of that pager gives me chills. I also do not love the whole trauma scene, it is pretty horrific to me but I'm thankful for the people who want to take care of those patients. On my first day of trauma, the first patient that came in ended up dying and it was pretty hard to watch. We have to write short essays at the end of every rotation, and I reflected on that experience...

"On my first day of Trauma call, within the first few hours of the morning, we received a page for a Level 1 trauma. The patient had fallen 20 feet on the job and landed on the concrete below. The paramedics were already performing CPR as the patient rolled in, and the nurses and doctors resumed CPR as they moved him to a trauma bed. The room was packed, it seemed like there were 20 people there and they were rushing around, yet it was surprisingly quiet so everyone could hear instructions. I watched as they performed the ACLS protocol and waited anxiously for some sign of life from the patient. After the protocol had been followed through, one of the doctors in the room said, “What time is it?” My heart sank. She called the time of death at 11:17 am and you could see the energy in the room drop and people started taking off their masks and gowns and walking away. The whole thing must not have lasted more than 10 minutes, but it is an experience that I will not soon forget.

It was strange to me how everyone just sort of dispersed afterward. They didn’t seem to be overly affected by the event. They resumed conversations, talked logistics, even smiled. It was sort of shocking to see people just move on. I couldn’t help but wonder how they could just walk off and leave the man lying there. One of the nurses said that we needed to still do a full evaluation of the patient to document the injuries, so I went with the resident over to the patient. It was so strange to see his face and know that he woke up that morning thinking he was heading to work just like any other day. He probably had a cup of coffee, said goodbye to his wife, and may have told her he’d be home by 5. Then I thought about his family. They were about to find out information that would completely change their lives. There was no warning for them, the patient suffered an accident in an instant that claimed his life. And yet, the rest of the team was back in the hallway talking about discharging the guy in the next room. How could it be that easy for them?

Then I started to realize that they were doing what needed to be done to be a good health care team. If everyone were completely crushed for the rest of the day, then other patients and their own personal lives would suffer. Death is a reality on the Trauma Hall, and the doctors and nurses need to be able to pick up and move on from it. Over the course of the next week, I watched other patients come in and became aware of many others in the SICU who had sustained major injuries and may never recover. I think for me, I need to find a line between processing what is happening around me when it comes to disease, injury, and death, and not dwelling or thinking too deeply into it to where I can’t move forward. I want to always respect life, to not take it lightly or to treat death flippantly, but I see now that all patients are not going to have good outcomes and I am going to have to learn how to deal with that in a healthy way. I don’t think I need to stop feeling sad when people are hurting or when they die, but I recognize that in order to be a good doctor, I’m going to have to do my best to treat the things I am able to and accept the things I can’t change. It will be through a combination of prayer, processing things with others, and talking about it at home that I will continue to learn how to cope."

After Trauma was Emergency General Surgery which was probably the roughest part of Surgery for me. We had to be there at 4am most days and were pretty busy all the time. We drove the camera for the laparoscopic procedures which is not a super easy task in my opinion. Maybe its because I never played video games, but it was tough to navigate those cameras when the surgeons were moving their instruments all over the place. I also learned about working with people who are very difficult to work with which was not fun at the time, but I know it was an important lesson. All in all, I think I took a lot away from the surgery rotation, but I couldn't have been happier when it was over!