Estoy elevando el listón.

What do you remember about your favorite teacher? Or perhaps a specific lesson you learned? How about a random experience you had with a teacher, good or bad?

On nights, a two person team is sometimes not enough. Recognizing when help is needed and eliciting available and appropriate resources is part of the job. So when an open laceration left over from the day team comes to our attention on an already busy night we do just that. Elicit the help of the sub-I doing an overnight rotation in the ICU. Seeing as it is now February, this sub-I has already applied, and interviewed for his surgery residency and is waiting till the fatal day in March when he finds out where the next five years of his life are to be consumed. Looking retrospectly, it was perhaps misplaced, but I had an expectation that someone a few months from their surgery residency would 1) be able to suture a lac and 2) even if they couldn’t, dive right in either way. So when I rattled off the short list of specific steps I was looking for, his hesitation and uncertainty, took me by surprise. Breaking it down, we isolated the specific step that was causing him this hesitation, and therefore we collectively decided he would perform all the steps up to that one, at which time he could text and I would return to demonstrate and assist. When that text came, and I headed back. I was expecting to need to place a stitch, then walk him through the second, and then be able to move on. I entered the room to instead find that nothing was even set up let alone any of the steps actually completed as we had agreed upon prior. I assessed this situation in one look, paused to take a deep breath, then took off my jacket and grabbed a pair of sterile gloves. It was a busy night, and I had no time for this. To be honest, I was disappointed. I worked quickly, explaining what I was seeing, what I was doing about it and why I was doing it. He nervously nodded and followed along as I went. His hesitation remained, and he didn’t actually don his own pair of sterile gloves until I hinted that they should have already been on if he had wanted to get any of the action. Flustered, he pulled on a pair, and hands shaking took the instruments from me. At one point the patient yelped in pain and he about jumped out of his skin, losing his place in the process. It was a slow and unsteady two stitches, but he finally got them with half assistance by myself. And we finally moved on to the next thing on the list for the night leaving behind specific instructions for a dressing and a “well done.”

I wonder the view-point of that sub-I. I walked away well aware that I had just half terrified him. Perhaps I should not have had such expectations. Perhaps it was a bad experience for him, maybe good. But either way, I just pray that he learned something. Time goes quickly, and before he knows it... he’ll be the intern. 

Much Love.