Estoy cuidando los bebes.

There is a baby girl at the hospital right now. She's two years old so more of the toddler age, but I still call her my baby. I see her every morning.  I see her because she's had two liver transplants in the past, and that's the thing about transplant services.  They follow their patient's until they go home, and then they keep following them. My baby's belly wasn't feeling too good and that's why we started considering surgical intervention once again. I was against it, and when they told me to book her for surgery when I was among friends again I protested. Proclaimed that I would refuse to scrub in on her surgery. But the night before, when my chief asked me what surgery I wanted to do the following day...  I couldn't let someone else take her.  If she had to go to surgery, I was going to be there with her.

Much Love.

Estoy mirando tiempos melancólicos

A patient dying in the Medical ICU was taken to the OR the other day by my Attendings.  yes, (s) as in plural.  All my Attendings.  Surgeons can be funny creatures sometimes.  I was all set to scrub in on this case, but one after another the Attendings poked their heads into the OR and invited themselves to scrub in.  In the end there were three Attendings, one Fellow and one Chief Resident all scrubbed in for the case. So alas, I was bumped. But I was not about to leave.  The OR was packed because we all wanted to know what was in the belly. Would we find dead bowel? or simply a belly full of blood?  Either way something was making the patient sick, sick enough they could die on the table. Time was of the essence.

That scene has happened a couple of times the past two weeks since my return to WMC. And it makes me smile how giddy everyone gets in anticipation. Even residents that aren't scrubbed in will stop by the OR periodically to see if they can catch a glimpse of the action.

Last week was my turn to provide the education for our weekly resident "education hours".  Topic assigned to me was the esophagus.  I, of course, prepared the day prior and sent the powerpoint to the Attending assigned to work with me at 11:30pm the night before the presentation. He hasn't let me forget it yet... and I have a feeling he doesn't plan on letting me forget it either.

In one of the hallways of the children's hospital there is a doll collection encased on shelves that line the walls. On occasion I take a two second pause in passing to see if I can pick out a favorite.  I think they may have mixed these two up. Just maybe.

Still no favorites though.


Much Love,

Estoy durmiendo.

I think I fell asleep while walking the other day. A nearby doorframe noticed and was kind enough to do me the favor of waking me up.

BAM. Ok! Ok! I'm awake. Yup wide awake!

Owwwwwwwwww...

Estoy enseñando.

The days go up, and then they go down. Way way up and then down down down. It's like a roller coaster. You just have to hold on for the peaks and the troughs to turn.

The other day I can't even tell you if we were headed up or down, because whichever direction it was... it was fast. It started with a trauma activation calling me out of the OR. And before we could get through that trauma another was coming in, and so it continued. A few medical students had responded to the initial trauma page as well, and then when things proved to be picking up had stayed with me in the ED. By the end of the day they confessed that it was, "The best day of medical school ever!" It really makes a part of me smile to see them so excited. There is a part of me that likes the teaching aspect.

Nowadays scrubbing into a surgery or procedure is as easy as dressing myself. A while ago, I had turned to a medical student and asked him to scrub himself in.  He didn't know how. In the OR you have a scrub tech help you to scrub in, but if there's no one to help you have to scrub yourself in. It took me aback that he didn't know how.  I wondered, how did I learn. Sure enough it was medical school. And I realized that this is his impromptu course. This is his learning how to scrub himself in, and I get to be the teacher.

Here's a few pictures from a beautiful Connecticut sunset a few weeks ago!  I'm just posting them now simply because I kept forgetting before. :)

Much Love.

Estoy solamente parte de la historia.

With any story, there are multiple view points. Different angles from which a story can be told. And depending on the audience the same narrator may not always be appropriate.

I've been thinking about that a lot this week. Particularly because I've been hearing a story, a common everyday story for me, but this time it's being told from a completely opposite point of view.

When an individual goes into surgery they have to let go of any control they hold over a situation. They become completely reliant on the hands of someone else to follow through. That side of the story is what I get to help be a part of everyday. I'm learning and growing, my ability to tell this part of the story improving with time. I'm seeing lines where before none existed. Quicker using both hands when the left hand was so awkward at first. Becoming comfortable with what is safe versus what needs caution. And it makes me wonder sometimes.  I've cut in places where I'm told to cut when everything in me squirms that a higher level of caution is needed. I confess this... I cut, not because I want to trust the Surgeon telling me to do so, but because I have to trust him. Because if I don't cut, the instruments will be taken away from me, and then how would I learn.  Mistakes often the best way to learn. (Don't worry, thankfully so far there have been no such mistakes).  But hearing a story from a different view point makes me think again about the what is entrusted to the hands of a surgeon. Clean and smooth. Perfection is hoped for, prayed for. And I have seen it, it does exist. The hands of a Surgeon creating art. Surgery so beautiful it makes my fingers tingle.  I've seen the opposite as well. Blindly dissecting were there shouldn't be a problem, but it's not clean... it's not safe. And I've concluded that fast is not always a good thing.  I've seen a surgeon so quick because he can recognize anatomy by touch, with his eyes closed. His expertise allowing him to smoothly and quickly perform.  I've also seen quick, because a surgeon simply didn't take the time to recognize anatomy. It is a side of the story that will never be told. I certainly would never tell it.

Much Love.

Estoy solicitando una posición.

I wrote a blogpost this morning. It was a personal message to myself.  I finished the message, but instead of clicking publish I clicked save.  I left the screen open just like that, saved, and went for a run. I needed to think.  The run was slow making sure to allow ample time. Upon returning I copied that message to myself, pasted it into a word document and changed it into a personal statement.

It is the shortest PS I have ever composed. It's the first time I haven't dwelt on any part of my past. Haven't tried to explain where I've come from or where I've been. Was that wise? Hard to tell as my past is the reason for who I am. At the same time, it's therefore probably the most direct I've ever been in a PS. Some may say, about time. But either way, God's timing is perfect.

It's still rough draft. Have to send it off now for red ink editing, so who knows how it will turn out in the end. ;)

Much Love.

Estoy traumatizada.

Life at Bridgeport as a 2nd year surgery resident

That 6am early morning trauma.  It starts the whole day off 5 steps behind, and you spend that subsequent day trying to catch up. Never really succeeding, and you therefore find yourself so anxiously awaiting the minutes to tick 6pm just so you can finally stop receiving work to do and get about actually doing work. And then at 5:54pm your pager goes off yet again.  I mean you started the day with a trauma... might as well finish the same right?!

You do finally make it out of the hospital that night.  All of your patients packaged up. Bow's even tied on top. You sit down in your room and realize the interns are already asleep in their rooms upstairs. You used to try to go to bed reasonably too... habit long lost.

Trauma activations at St. Vincent's are so annoying. Take today for example. Old man had been bending over to pull a weed, and then just kept going forward right on his noggin. His daughter drove him to the hospital.  He walked into the hospital where they sat him in a wheelchair.  And then they learned he takes Coumadin at home. Automatic trauma activation!!! The alert goes out!!.  That's not the bad part.  You want to activate a trauma fine...  but then actually activate it.  It's hard to explain, but for example, just like law is "innocent until proven guilty," trauma is "everything is broken until proven otherwise." A trauma needs to be flat, in a c collar and systematically checked head to toe. It's quick and it assures nothing is missed.  But no, not at St. Vincent's.  This guy, now officially a trauma activation,  stands up from his wheelchair to get on the ED stretcher himself, he has no spine protection whatsoever. Or another horrible example: I get a trauma activation and respond to the appropriate trauma bay...it's empty.  I see a guy outside the trauma bay sitting upright in a stretcher with a poor attempt at a c collar.  Perhaps he's the trauma patient I think, but there's no nurse around, no XRay, not even an ED doc. And sure enough they finally role that patient into the trauma bay. But it's just the EMS guys and myself. I was so flabbergasted at the lack of responsibility being exhibited by the ED that the trauma patient looked up at me and asked what was wrong, why I looked so confused?! Whoops, cue the quick recovery.

If you activate a trauma.  Own the activation!

This unfortunately is not something that I foresee happening in the near future of St. V's.  Or distant future for that matter. Sigh. C'est la vie.

Sigh. I just want to go operate.

Much Love.