[Disclaimer: Medical terminology and surgeries are described here. No "graphic violence" or descriptions about how bloody it was or bodily juices, but relevant surgical terms are used]
Ok, where to start...[ponders]
Gynecology - the branch of medical science that deals with the health maintenance and diseases of women, esp. of the reproductive organs. (definition from here)
Oncology - the branch of medical science dealing with tumors, including the origin, development, diagnosis, and treatment of malignant neoplasms. (definition from here)
July 7th, 4:30 AM I met with my classmates in a dark parking garage. We walked to the hospital and changed into scrubs nervously. We learned.
That early in the morning we wake up old ladies and ask them whether their pain is controlled. Whether they are feeling nausea or have vomited overnight. Did they have any bowel movements or did they pass any gas (I always want to say fart but I have to sound proper even though the patients can say whatever they want). One lady talked about popping a kid off on July 4th and another mentioned she'd let rip a big fart just the past night. We proceed on with our exam.
The exam isn't anything horrific. I just listen to lungs to make sure there's no fluid buildup and listen to the heart. This is where I start practicing listening to normal stuff and might hear abnormal stuff time to time. Then I check the abdomen. There's a variety of abdomens. Some are pale and doughy, others are pinker and more rigid. I always get nervous poking near the site of the wound.
After all that, we sit and write our progress notes. Basically a distillation of all we learned from the patient and writing down all the pertinent lab information from the computer and from the nurses' vitals' sheets. We try to finish before the residents come in--I still find this morning deadline challenging. The residents then repeat everything we did except they go much faster and they have an idea about what treatments to follow for the day. The Attending doctor arrives at some point and we proceed to summarize all the patients for him (or her) and then go to each patient as a large horde. We talk to each patient and sometimes re-examine them telling them what we have planned for them and listening to their concerns.
One day a week I have clinic. This is akin to a doctors office and deals mainly with pregnant women coming in for regular checkups or post-operative patients coming in for 3 or 6 week followups. Women seeking contraceptive help can also come into the clinic. Here I brush up on interviewing skills and practice my physical exams steps of listening to heart/lungs, and checking the abdomen as well.
I have to dress up for this day. I still find jeans and a t-shirt more comfortable.
Outside of that routine, we get to scrub into surgeries our doctors perform. My first surgery was a 3 hour hysterectomy and bilateral salpingo-oopherectomy. Those are fancy words for "We took her ovaries, tubes, and uterus out of her." It was a surreal experience putting my hands inside her belly. I've been following her since her surgery and she's been doing alright. We're waiting for her to have a bowel movement. Yup, surgery is grand!
I enjoyed laprascopic surgery. I play video games. Controlling the camera felt quite natural. I was also controlling the lady's uterus so it stayed up and out of our way. The tension in my arms from these two actions used a lot of oxygen. I almost fainted. I'm glad I spoke up and sat down at that time. Falling down on a sterile field is definitely frowned upon in surgery.
Yesterday's surgery was to investigate a pelvic mass in a dear old lady who wasn't able to keep anything down. This was a neat surgery because as we delved down into her bowels, it was clear why she couldn't eat anything. A huge cyst had adhered to her intestines and then grew big enough to pressure the gut to close. We took out the cyst--it quivered as it came into the cold OR. It was black and blue and slowly dying (the cyst, not the lady). We're hoping she'll heal just fine now!
Today I will go to bed two hours ago. I will wake up tomorrow dark and early to go back to the hospital!
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