My first day of my pediatric surgery elective – my real first day of third year – was exactly what I hoped for as the first day of my “real” medical education.
I rounded on every inpatient on the surgery service – forty-six in all, ages one month to seventeen years, with dozens of different problems or different presentations of similar problems. My feet hurt, and I have a lot of acronyms to decipher.
I got to do two procedures, which is two more than I thought I would get to do on my first day. I inserted a Foley (bladder) catheter, one of the standard “by the end of your third year” procedures, in the OR. So I’m on my way.
I removed a suture. Only one, because the thirteen-year-old boy was very skittish (just old enough to know what to expect from hospitals), and said he was “a bit afraid to have a beginner do it.” After all the sutures were out without any trouble, my one and the intern’s two with four more for later, the boy softly told me, “you can do them all tomorrow.”
And there were children…
A little four-week-old fussed a bit each time we adjusted his abdominal repair, until the nurses dipped his pacifier in sugar solution.
A six-year-old brought Buzz Lightyear into the operating room with him, with plans for Buzz to have a gastrointestinal tube placed as well, so they would both have one.
A previously hostile teenager with an abdominal complaint giggled like a baby when the examining surgeon felt her abdomen, now painless and ticklish.
Kids of all ages rode around the hospital corridors and up and down the elevators in pushed or foot-powered wagons and cars of brightly colored plastic.
And I met a teenager who was dying of cancer. He lay pale and exhausted in his hospital bed, clutching his patient-controlled anesthesia (a button that triggers delivery of pain medicine as needed). He allowed me to examine his abdomen, which I could barely indent: every bit of it was like a layer of skin over rock, all tumor, and thudded dully when I tapped on it. His mother cried quietly as the surgeon discussed what measures would best preserve his quality of life as its quantity ran out. After we left the room, he pulled out the operating room schedule and picked out a few surgeries I should consider seeing, but his voice broke and paused.
So, in my thirteen-and-a-half-hour day in the hospital, I was exposed to the joys and the sorrows of pediatric medicine, I watched and I listened and I even contributed a little bit to patient care, I met a dozen new kind and encouraging teachers, and I feel like I learned more about medicine than I have in months’ worth of my preclinical years. I know it won’t always be this positive or energizing or successful, but I wanted to write down right now as much as I could of my first day as a third year, because I know for certain that by the end of the year my life will have changed dramatically…
