In the operating room

I spend the better part of my Wednesdays in the operating room. This time of year the residents, interns, graduate nurses and nursing students are still relatively new at their assigned tasks. The operating room remains a bit intimidating to me, a seasoned practitioner. I am sure that these new individuals are terrified. I try to think back to my first day in the operating room on my surgery rotation in medical school.

I had been suturing in the emergency room regularly for almost two years, so I felt a surge of excitement when the resident I ask me to scrub for a case already in progress on my first day. No one explained to me what had happened prior to my arrival. The case was a coronary artery bypass graft requiring the big vein from the leg. While one team of surgeons readied the heart another team harvested the vein from one leg.

I was being asked to scrub so I could help the team suture the incisions in the leg from the vein harvest. There were twelve to fifteen people around the patient. Right after I pulled my gloves on I contaminated myself by going to the wrong spot around the patient. This meant that I would have to begin the process of gowning and gloving again distracting the scrub nurse even longer. She was not happy.

As one of the circulating nurses tied the second gown she whispered, "If that is the worst thing you do, you will be the best medical student we have ever had in this OR." She gave me a knowing look. This has happened before.

I went on to gown and glove a second time with no problems. All my previous suturing experience served me well and I was able to help repair the incisions on the patient's leg. The scrub nurse who had been so angry with me when I had to regown and glove had an improvement in her mood. She taught me the names of all the instruments and how to past them to the surgeons. For the next four weeks, when I was not allowed to help with the actual surgery, she let me stand in her place and pass instruments. Not only could I see what was happening, I felt useful and I never had to study the names of the instruments. I knew them.

The surgery rotation that most in my classmates dreaded, unless they wanted to become surgeons, ended up being one of my best rotations. My attending physician wrote me a wonderful letter of recommendation. Yet, the experience would not have been as rewarding for me, if two operating room nurses did not have the patience to teach me how to function there.

It is good to be reminded that none of us are born with all knowledge. One thing that makes the knowledge that we do acquire better is the ability to share it graciously.

Labor day

Several weeks ago I overheard a conversation between my two teenage sons. My eldest son had a summer job at a local bookstore. One evening after he explained to his brother how tired he was and how much he disliked his job the younger one replied, "Well, duh, that is why they call it work."

Despite the fact that I am often exhausted and despite the fact that there are some unsavory aspects to my job, I would rate my job satisfaction as high. Part of this comes from the fact that practicing medicine is challenging and rarely routine. Yet, much of the fulfillment from my work comes from the approval I receive from my patients. I have found a sincere "Thank you," to be a great reward.

Medicine is not just a series of diseases to overcome though battling disease is a large part of my work and I enjoy the effort involved in making a diagnosis. For me practicing medicine is to participate in healing. Often this is to diagnose diseases and prescribe appropriate treatment. At other times practicing medicine is providing comfort when all the treatments are done.

September dawns

As September arrives I find myself thinking of change. Fall is coming. This is the final quarter of 2007. Who will be migrating as the seasons change? This picture along with many other wonderful watercolors are located at http://www.herondance.org/.