Many of you guys are much younger than me; just getting married, or in phase two, creating new children. I thought I would post something about the other end (phase 4?). I always believed that communication is the basis of good parenting, because you can't do much if you don't know what is going on. To communicate well, you can't be too judgmental and you have to walk that fine line between being a parent and being a friend, especially as the children get older. I was a single parent for many years (maybe more so after I got married again) and my relationship with my daughter is very close. I know more about her than any father should know and I feel blessed that she turned out to be who she is.
My daughter is 25 now and in medical school. The third year starts with clinical rotations and she is doing surgery right now. She writes a little broadcast email to keep the family up to date which I thought I would share - for what it is worth:
"You're pretty. I love you."
Quote from my 5-year-old patient Thursday before last.
My ENT week went amazing. The surgeries are shorter than a lot of general surgeries, and then office hours were really fun. I did an entire day of pediatric ENT the Thursday before last, which was super awesome - I saw some 35 kids, and got REALLY good at looking in their ears, nose and mouths. Some little babies only a few days old, some 18, 19 and 20 year olds, and everyone in between. I also learned some great tricks for getting kids to let you look in their ears. Most, in turns out, are pretty okay with it (if they don't have an infection), but some really, REALLY don't like it and need some convincing. Of course, being myself, I was always sure to tell the kids that if they absolutely didn't want me to look in their ears, I wouldn't. For some reason I feel the need to help kids (and parents) understand that "no" is a powerful word that deserves respect. Even if I don't go into ENT it was a really great experience.
This week was full of office hours rather than operating. I had call on Sunday night, which included an emergent appendectomy on a 2-year-old boy and placing a chest tube in a man with a pneumothorax. A man also came in bleeding from every orifice, he had meningococcemia, a rapidly fatal disease that is airborne (the same microbe that causes meningitis in young adults.) It's not a super rare disease, but not too common either. We have drugs to protect against it, but they only have a 60% success rate after symptoms begin. (Hey everyone, get your meningitis vaccine!) I've seen it once before, and it was similarly sad - a previously healthy 34 year old man goes from okay but sorta sick feeling to dead within a day.
Monday was pediatric surgery office hours, which were fun because I like peds, but tiring because I was post call. I got lucky and got to take the afternoon off.
Tuesday I saw probably the coolest surgery ever, a radical neck dissection. The patient had squamous cell carcinoma in his neck. Any surgery that has the word "radical" in it promises to be huge and fascinating. A radical neck dissection literally isolates all of the key structures of the neck - nerves, arteries, veins, muscles, fascia, glands - and takes out the involved ones while preserving the others. If you mess up, you can leave someone without a voice, or with a deadly leak of lymph into their neck, or bleeding out from major arteries and veins, or unable to lift their arms above 90 degrees, or, you know, dead. Getting to see all those structures out in the open and the careful dissection of them was absolutely mind-blowing. It really put into perspective just how amazing the human body is, and especially the face and neck.
Wednesday and Thursday I had office hours with the colorectal surgeon. I finally got that rectal exam checked off! Man, I saw so many buttholes, I can't even. It was just one after the other. Most of them were totally fine, but some were very sick buttholes. It was surprisingly not weird, though - people think of that as a really dirty and unpleasant area, but it really just seemed like another part of people's bodies to me. Even the sick ones - you know, pus smells bad no matter where it comes from. Frankly after this week I'd rather see a sick butthole than sick teeth. Gum disease is SUPER GROSS.
I got to be artsy this week - the colorectal surgeon asked me to draw him, so I did. It was... okay. It only sort of looks like him (photos attached.) I did much better on Friday during the chairman's breakfast, when I got bored and decided to draw one of my chief residents who was sitting surprisingly still. I gave him the picture after and he was quite shocked and happy to see it! I think he was flattered, maybe? I don't know.
A number of my favorite residents are leaving for a month-long rotation in Newark today. I'm really sad to see them go; I finally felt like I was starting to build a report and become a member of the team. Several of the ones I like are staying, though, and some are coming back who left last month. Things are just constantly changing this year, so I guess that's the game. Find a niche quickly, learn to fit in with people easily.
Other things that are happening: getting research off the ground (finally) with one of my residents, starting to feel more confident answering questions about surgery. Things are coming together, which is lucky because I only have 2 more working weeks left. One step at a time...