Estoy disfrutando aprender cosas nuevas.

Did you know that there are eight layers to the eyelid? I learned that this past week. I learned it in preparation for a surgery in which I dissected through one layer at a time to arrive at a dermoid cyst at the corner of a boy's eye. I'm sure I completed the surgery much slower than necessary, but doing delicate surgery with your Attending watching your every more saying, "Don't mess it up! Don't mess it up!  Don't pop the cyst!" (Of course, not in such politically correct terms ;) Well, I imagine that would slow anyone down.
I've never really liked working so close to the eye before, always felt like a wrong twitch the patient made, or I made and we'd somehow end up with a needle in the eyeball. But I learned that it doesn't have to be like that. If you understand the tissue you are working with, and respect the tissue you are working with, then it will return the favor to you.

I had a really good case lined up for this past Thursday. I had just gotten into bed Wednesday night when the long range plastics pager went off. I groaned to see that it was the ED. I was soooo tired, had close to zero desire to go in to work. But I knew there was no way around it. A kid had cut through all of the extensor tendons of his hand with a machete. Perhaps not an emergency, but at the same time unable to be ignored, and so I got dressed and went in. Cleaned the kid up and put him in a splint which kept his hand in extension and then scheduled him for the following day for tendon repair. Having crossed all the T's and dotted all the I's I headed home again and finally got some sleep excited for a nice case the following day. Unfortunately we start our day to discover our patient had walked out at 2am!!! Nooooooo! We tried calling the patient and his parents but without luck. He has every right to walk out against medical advice, but I just want to know why?! A couple theory's could be that he was coming due for his next fix, or perhaps he already knew another surgeon he preferred. But for whatever reason, I do hope that he gets some sort of help... before he permanently looses function of his hand.

Much Love.