I've been busy.
The General Surgery rotation is now over, and I decided to venture into a Cardio-Thoracic Surgery Elective, not because I'm Wonder Woman and I want to save the lives of those who probably need it the most but because it's about time I take my mini summer vacation, and being the planktons that we are as Med III students, the Attendings would rather excuse us from watching all the operations than having extras bothering them with their useless presence in delicate procedures. Understandable and most Welcome I say!
Looking back at the rotation I spent 6 Weeks on, I must say it's been almost perfect. True I have nothing to compare it to, but being the overzealous medical student who just started her Clinical Years and who wants to learn everything and anything I really enjoyed shadowing our Interns and Residents, learning the ins and outs of the hospital, getting special attention from the Physicians who found our group of students "cute" and worthy of bestowing information upon... Note that we are deemed "cute" because we are about 10 Girls and 2 Guys, a rarity in the medical field and especially in the Surgery Department at AUH where only one Resident is Female (although questionable) and none of the Attendings. So as one other Resident put it: you girls are gonna miss the Surgery Rotation. And if you wonder why, if you wonder how, well because we're probably going to seek that extra attention, never to find it again...
So the Surgery Department was our mini oyster, and we indulged. Does it really matter if on the last day we were dismissed in a hurry? Without the farewells and the waterworks? Does it really matter that it dawned on us that we weren't the first "cute" group to roam the 10th floor at AUH, all smiles and heels? It was good while it lasted. It was about time to move on. Yes it was...
And now you wonder, what kind of a Physician am I growing into? Is the Hospital merely a playground for this unethical, unmotivated Blogger? No. The medical and clinical practices have never felt as gratifying for me as these past few weeks. I was the student who got to the Hospital 15 minutes early to look at the chart and find out what happened overnight, I was the student who took extra shifts to admit new and interesting cases, I was the student who prepared extra talks to learn more about the Child-Pugh scale or IV bags... And I wasn't the only one. Which brings me to the eagerness of Medical Students to become Doctors, we want to learn, we want to be proactive, we want to make a difference... And so enough self gratification, there is something more important on this blogger's mind...
When do you lose this eagerness towards making a difference and replace it with a feeling of extreme and ultimate superiority, even superior to human kind? When do you start overworking yourself not for the greater good but to show off your new techniques (whether followed by complications or not) and to break your own records in the amount and speed of the operations you perform? I see it everyday: Certain Physicians using their unequivocal power to operate on patients, merely for the extra Admission to the Hospital, or the Case Report if the Operation is too risky, or the fact that another Surgeon refused to Operate and they want to prove a Point. This is what Surgery has come down to in certain clinics (and I stress not all), an Abuse of Power and Human Lives without an ounce of Regret or Conscientiousness.
Should I mention the patient whose Ejection Fraction was under 20 percent, meaning he was near a Heart Failure, who Dr. (and I'm even pondering whether I should be mentioning his name here, because he is that powerful, which makes me reflect as to how ideal of a Physician I am being here, getting sucked into the hierarchy to watch my own back...) so who Dr. X (no I will not mention his name for the time being), Dr. X admitted the patient for a symptomatic gallbladder, risking having him never come out of the operating room just because another physician refused to admit him and if the patient were to make it through, it will be recognized that Dr. X has done it again and not that it's merely the poor patient's good fortune. Not that it's become purely a game of luck and statistics with said Dr. X whose many failures are not even properly documented, and a few out of thousands of risky operations are bound to yield a favorable outcome...
So you think the barbarity would end here, that it's already unethical enough. Well you're mistaken. Because Dr. X's Obsessions do not only relate to how many Operations he can do, or how many terminal cases he can get into the Operating Room,
but also and maybe even more importantly: How Fast he can finish said Operation. Yes, Dr. X is obsessed. He will never fail to mention that he can operate on a patient in Seven Minutes, and you listen in awe thinking to yourself, Wow this guy must be good, but then you go into the Operating Room, you see the amount of stress under which he puts everybody around him, and you see him at work. He does have skills I admit, but he is brutal to say the least. And taking that same operation as an example, that critical case that must have been handled with care, I can't help but re-picture him trying to get the Gallbladder out of the incision he had made, and the gallbladder, having stones in it was found to be a bit tricky to pull out, so he kept pulling and pulling and screaming, he managed to move the table and the patient towards him, having the patient at an almost 45 Degrees with the table just by pulling the gallbladder from inside his body... Can you picture the savageness? The trauma? What makes the difference between a surgeon and a cattleman?
And yet it doesn't end here, said Physician managed to have intra-op bleeding because he was in such a hurry to finish the operation, an operation that should have no complications whatsoever, and so to achieve hemostasis he decided (as it has been the norm with him) to carbonize the bleeding part and then some, ending up with a burnt liver. Because as he says anything carbonized doesn't bleed, and yes the liver can regenerate to an extent, but what about the prolonged and sub-optimal healing process post extensive burning? He just does not care because his mission ends on the Operating Table, that is where the Medical Records end too.
I'm done, this was one Case Report from a Medical Student's point of view, from a more humane point of view. I will not mention the extra operations that he convinces patients of, although they don't seem to need it necessarily, like removing the gallbladder to get heartburn relief... This might not be as risky, but it's just as immoral. And so, sometimes I wonder, being the silent observer that I am, maybe, since I am not there when patients discuss their medical issues with the physician before being admitted to the hospital, maybe they tell him things he can pick up on and then they fail to mention them to me on admission, or I am just not as experienced to notice and interpret them. Maybe he is taking the right decision after all... Maybe I am just turning a blind eye like everybody else around me, before me and coming after me. Who knows?
The General Surgery rotation is now over, and I decided to venture into a Cardio-Thoracic Surgery Elective, not because I'm Wonder Woman and I want to save the lives of those who probably need it the most but because it's about time I take my mini summer vacation, and being the planktons that we are as Med III students, the Attendings would rather excuse us from watching all the operations than having extras bothering them with their useless presence in delicate procedures. Understandable and most Welcome I say!
Looking back at the rotation I spent 6 Weeks on, I must say it's been almost perfect. True I have nothing to compare it to, but being the overzealous medical student who just started her Clinical Years and who wants to learn everything and anything I really enjoyed shadowing our Interns and Residents, learning the ins and outs of the hospital, getting special attention from the Physicians who found our group of students "cute" and worthy of bestowing information upon... Note that we are deemed "cute" because we are about 10 Girls and 2 Guys, a rarity in the medical field and especially in the Surgery Department at AUH where only one Resident is Female (although questionable) and none of the Attendings. So as one other Resident put it: you girls are gonna miss the Surgery Rotation. And if you wonder why, if you wonder how, well because we're probably going to seek that extra attention, never to find it again...
So the Surgery Department was our mini oyster, and we indulged. Does it really matter if on the last day we were dismissed in a hurry? Without the farewells and the waterworks? Does it really matter that it dawned on us that we weren't the first "cute" group to roam the 10th floor at AUH, all smiles and heels? It was good while it lasted. It was about time to move on. Yes it was...
And now you wonder, what kind of a Physician am I growing into? Is the Hospital merely a playground for this unethical, unmotivated Blogger? No. The medical and clinical practices have never felt as gratifying for me as these past few weeks. I was the student who got to the Hospital 15 minutes early to look at the chart and find out what happened overnight, I was the student who took extra shifts to admit new and interesting cases, I was the student who prepared extra talks to learn more about the Child-Pugh scale or IV bags... And I wasn't the only one. Which brings me to the eagerness of Medical Students to become Doctors, we want to learn, we want to be proactive, we want to make a difference... And so enough self gratification, there is something more important on this blogger's mind...
When do you lose this eagerness towards making a difference and replace it with a feeling of extreme and ultimate superiority, even superior to human kind? When do you start overworking yourself not for the greater good but to show off your new techniques (whether followed by complications or not) and to break your own records in the amount and speed of the operations you perform? I see it everyday: Certain Physicians using their unequivocal power to operate on patients, merely for the extra Admission to the Hospital, or the Case Report if the Operation is too risky, or the fact that another Surgeon refused to Operate and they want to prove a Point. This is what Surgery has come down to in certain clinics (and I stress not all), an Abuse of Power and Human Lives without an ounce of Regret or Conscientiousness.
Should I mention the patient whose Ejection Fraction was under 20 percent, meaning he was near a Heart Failure, who Dr. (and I'm even pondering whether I should be mentioning his name here, because he is that powerful, which makes me reflect as to how ideal of a Physician I am being here, getting sucked into the hierarchy to watch my own back...) so who Dr. X (no I will not mention his name for the time being), Dr. X admitted the patient for a symptomatic gallbladder, risking having him never come out of the operating room just because another physician refused to admit him and if the patient were to make it through, it will be recognized that Dr. X has done it again and not that it's merely the poor patient's good fortune. Not that it's become purely a game of luck and statistics with said Dr. X whose many failures are not even properly documented, and a few out of thousands of risky operations are bound to yield a favorable outcome...
So you think the barbarity would end here, that it's already unethical enough. Well you're mistaken. Because Dr. X's Obsessions do not only relate to how many Operations he can do, or how many terminal cases he can get into the Operating Room,
but also and maybe even more importantly: How Fast he can finish said Operation. Yes, Dr. X is obsessed. He will never fail to mention that he can operate on a patient in Seven Minutes, and you listen in awe thinking to yourself, Wow this guy must be good, but then you go into the Operating Room, you see the amount of stress under which he puts everybody around him, and you see him at work. He does have skills I admit, but he is brutal to say the least. And taking that same operation as an example, that critical case that must have been handled with care, I can't help but re-picture him trying to get the Gallbladder out of the incision he had made, and the gallbladder, having stones in it was found to be a bit tricky to pull out, so he kept pulling and pulling and screaming, he managed to move the table and the patient towards him, having the patient at an almost 45 Degrees with the table just by pulling the gallbladder from inside his body... Can you picture the savageness? The trauma? What makes the difference between a surgeon and a cattleman?And yet it doesn't end here, said Physician managed to have intra-op bleeding because he was in such a hurry to finish the operation, an operation that should have no complications whatsoever, and so to achieve hemostasis he decided (as it has been the norm with him) to carbonize the bleeding part and then some, ending up with a burnt liver. Because as he says anything carbonized doesn't bleed, and yes the liver can regenerate to an extent, but what about the prolonged and sub-optimal healing process post extensive burning? He just does not care because his mission ends on the Operating Table, that is where the Medical Records end too.
I'm done, this was one Case Report from a Medical Student's point of view, from a more humane point of view. I will not mention the extra operations that he convinces patients of, although they don't seem to need it necessarily, like removing the gallbladder to get heartburn relief... This might not be as risky, but it's just as immoral. And so, sometimes I wonder, being the silent observer that I am, maybe, since I am not there when patients discuss their medical issues with the physician before being admitted to the hospital, maybe they tell him things he can pick up on and then they fail to mention them to me on admission, or I am just not as experienced to notice and interpret them. Maybe he is taking the right decision after all... Maybe I am just turning a blind eye like everybody else around me, before me and coming after me. Who knows?
