Sunday, 16 October 2011

The first cut is the deepest

I don't know who said it, but they were wrong. And also kinda right.

This week has been my first week on attached to a surgical firm at St Clabert's and it's been a reminder of what I know and what I don't.

The first point of call was that, until this week, I'd never been further than the anaesthetics room in theatres (other than as a patient). In ward life you know of theatre people and maybe have the occasional tussle in recovery, generally about how you're not taking the patient who is groaning in pain and who's BP is in their boots back to the ward. But I'd never before donned scrubs, clogs and a hat and walked into theatre. It is a strange, controlled, precise place compared to the ward. It was refreshing to experience this change of pace and bear witness to a kind of calm teamwork that I've not seen much of before now.

And the first cut. I realised, when I saw the scalpel go in, that I had never seen this happen before, either. Don't misunderstand, I've assisted in plenty of drain insertions, ascitic taps, biopsies, endoscopies et al, but never seen a person cleaned, draped and then surgically incised. It was amazing. I didn't expect it to be a notable experience, but it left me literally agape (and then when I realised, quickly stoical - I mean, no-one wants to look like a noob in theatre).

This week has quickly taken me out of my comfort zone as anatomy is one of my weaker points and being quizzed about specific muscles and their attachments and insertions and innervations and (god forbid) arterial supply or venous drainage is just awful for me. I've had to claim ignorance and face disapproval more this week than my ego is frankly comfortable with and had to accept I really need to spend more time with Netter if I want to get the most out of this placement.

The high points have (unsurprisingly) been history-taking, clerking, examinations and ward life (both pre-op and post-op). I fully expected this to be the case, given my previous life. I love being on a ward, talking to patients, sitting with them to take a history, busting out the stethoscope, percussing, palpating, the whole nine yards. Which I guess says something about my medical bent.

So far this has been a good placement and I have several weeks to go, so more time to get comfortable in theatre, maybe even scrub in and hold a retractor or two, more time to get my muscles and nerves straight in my head, more time to reinforce the ward skills I have brought with me.

Now if you'll excuse me I have an important meeting with the intrinsic muscles of the hand...

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