Like a Surgeon. Not!

Hi,

Hank here. Well, Mike's a little out of it. He wanted a little bit of a breather. Instead, he got to start his surgery clerkship. I woke up early with him just to see how he'd do on his first day, and it was worth it. (Penguins don't usually have to wake up with the sun - we can wake up whenever, hit the beach, eat some fish, then go back to sleep again. Other than that, waking up at 3:00 in the morning - really - it's just not right). During orientation, Mikey was given a name to contact so he could figure out where he needed to be on his first day. The contact, a PGY3 orthopedic surgery resident, never called back (this happens a lot to Mikey), so Mikey had no idea where to go, only that he had to show up somewhere by 4:45 AM. He did better. He got to the clinic at 4:30 in the morning, and waited around for an hour and a half before a resident came by and then informed him that they moved rounds to 6AM that morning. Unfazed, Mikey didn't let shed any tears over the 90 minutes of sleep that he lost. Not on the outside, anyway.

The orthopedics residents are great. Always trying to get Mikey to see the most interesting things. So they threw him into a pair of scrubs and he was in the operating room - the "OR" - by 7:30 that morning. Mikey has to pray in front of this rectangular-shaped altar for his scrubs. Then he hits one of four buttons, all of which have had their labels scraped off over the years. Presumably, each button corresponds to one of four sizes - S, M, L, and XL. Mikey closed his eyes and hit one of the buttons and the Scrub Dispenser started to spin. Where it stops, Nobody Knows! I pray to the Great Penguin God in the Sky that the dispenser spits out small scrubs at the guy. Alas, he guessed right. Normal-sized scrubs. I guess Mikey's luck is taking a turn for the better.

Mikey scrubs in for the next case, an internal fixation of a fractured fibula. He scrubs in and manages to not break sterility. One of the keys to maintaining sterility is making sure that one's hands never leave the region of this imaginary box extending from the shoulders down to the waist. Basically, one's arms are flexed for the duration of the operation, an especially exhausting position if your a medical student and you're just watching the entire time. Mikey was rewarded for his efforts by being allowed to help put the patient's lower leg in a cast. Basically, all he had to do was hold the patient's leg up while the orthopedist applied bandages and plaster in what seemed like super-slow motion. Of course, this would have been much easier had his arms not been sore from maintaining the sterile position (I love how that sounds) and the fact that the patient had a BMI of like 60. I think Mikey dropped about 3 liters of sweat holding that leg up. "You doing okay there?" the orthopedics resident asked. "No problem!" Mike wheezed.

The next patient was more complex. This patient had contractures in his feet, bunions on both great toes, a heel that needed a calcaneal ostectomy, and an Achilles tendon that needed to be lengthened. This operation lasted over three hours. During that time, Mikey wished that:

1. He'd worn more comfortable shoes, and
   
2. That he had eaten something that day.

The stories of medical students fainting in operating rooms are many. It's usually not due to the sight of cadavers or blood - these people made it through Gross Anatomy already. No, it's because they're usually not smart enough to eat before scrubbing in. At about 2pm, Mikey had been in the OR for almost 6 hours, he still hadn't eaten anything all day, trying to make it through on 3 hours of sleep. Then I saw it. His eyes started to blink uncontrollably. His head started to bob as he tried to keep from sleeping while standing. I quickly made bets with the Anesthesiology crew that Mikey was going to crash face first into the operating table, thoroughly contaminating the sterile field. Several minutes later, his body started to lean backward, and - ohh!! He caught himself from falling. Dammit! Weebles wobble but they don't fall down! Sadly, I handed the anesthesiologist the ten dollars he won from me. Jerk - it's not like he needs it.¹

The rest of the operation went by without further entertainment. Mikey managed to cut a few sutures without stabbing anyone, but that's about it. He finally went home around 8 pm, a nice 16-hour day, ready to do it all again. Except next time without the penguin. I'm sleeping in.


¹ Some of this narrative is fictional and/or exaggerated. Like the part about praying to the Scrub Dispenser. And also the bit about the Hank making bets with the anesthesiologist. Okay, the fibular fracture patient did not have a BMI of 60. It was more like 50 - point being, the poor fibula just couldn't take it anymore.