The highlights of my surgery rotation at Maricopa Medical Center aka "da copa"

I've been meaning to post this but I always forget!

So for the past year I've kept a little notebook of thoughts/quotes/ideas/tricks that I learn on each rotation. I write down things, not really notes, but things that I learn from and go back to. Whether its a new enema recipe that I hear an old doc talk about that works every time for ileus or constipation(yes this is cool to me), or a moment that I really don't want to forget, or just some funny quotes from patients, I write it down because I want to look back years from now and hopefully bring back some humility. I want to know that even if i gear towards being a "know it all" doc or even somewhat cynical, i still can remind myself that I was not so savy once and to not lose sight of the little things that really matter and where I really started. Ok so anyway, this post is just to share some of those quotes that i wrote down....

In the ER:

Chief complaint- testicular pain/infection
Pt with testicular abscess: "Doc I'm pretty sure one of my hoe's gave me the shit!"
Me: "We're talking about your testicle right?"


Chief complaint- possible small bowel obstruction
Me: "Do you have any history of high blood sugar or do you take insulin?"
Pt who is barely awake: "no, i've never been sick"
Pt's brother: " She's been great, her sugar was a solid 379 this morning, like it always is"
Me: "........."

Chief complaint- rectal bleeding
Me: "has this ever happened to you before?"
Pt who is clearly is too high to remain awake: "oh no, i'm very healthy, not one health problem"
Me: "hmm, what color was the blood?"
Pt, awake again: "oh here, i saved a clot for you so you could see it!!" [shoves tissue with blood clot in my face]
Me: [trying not to vomit] "that's ok, i really don't need to see it....."
[I stepped out after doing her physical and read in her chart that she has HEP C, she's MRSA+, and positive for every illicit drug on the planet almost. Nope, not one health problem!!]


On the Med Surg Floor:

Chief complaint: leg abscess
Pt who made it through the ER fast because she was demanding surgery on her leg abscess: "Hey doc i just need you guys to go in and drain my site, it's infected again, and it's my only site left"
Chief resident: "Site? you mean your shin?"
Pt: "yea if you don't do it tonight I'll go through withdrawals again, that's how I wound up in the ER, and I really don't like shooting up in my neck"
Chief resident: "ok well thanks for your honesty!"

S/P diverting loop colostomy
Me: "how are you doing this morning? how is that colostomy coming along?"
Pt with Stage IV colon cancer: "well, if i have to have to wake up to talk to people about my shit at 5am, I'd rather it be with pretty girls like you, at least I know if this doesn't scare you away, I still have hope"
Me: "It takes more than some shit in a bag to scare me away..."
Pt: "well I've got a lot of shit..."
[he was my favorite patient] :-)


S/P perineal reconstruction with abdominal flap and total proctocolectomy aka a huge operation and she almost died
Pt, 3 days out of surgery: "I'm going to be fine, don't worry"
Me [almost in tears that she is comforting me, came to tell her it was my last day of the rotation and I wouldn't see her again]: "It's my last day with you, but you have the best doctors taking care of you and you're going to do great"
Pt: "thank you for taking care of me, never give up, I love you"
Me: [balling my eyes out like an idiot]


Presentation in weekly Morbidity and Mortality conference [ this is where interns and residents present cases that had a negative outcome due to a preventable reason and they get torn a new one by the attendings, very scary]
Dr. O: [presents a case about a pt who had a tear in his esophagus repaired, and then had to return to the ED because the repair failed and tore open again] "the failure of the repair was due to the patients diet immediately post operatively"
Dr. G (an intern, not the sharpest tool in the shed): "actually, It wasn't Dr. O's fault, it was mine. I gave the pt a sandwich the following morning and asked him if it hurt. He said no, so I thought it was fine."
Attending Physicians: [first silence....then the lions unleashed and attacked poor Dr. G]
Dr. G: "...but it wasn't the whole sandwich, he just had a couple bites!!!"
*note to everyone- if you have a hole in your esophagus and then have it surgically repaired...DON'T EAT A SANDWICH THE NEXT MORNING!!!
*note to self- do not yell back at  your attendings when they are yelling at you during M&M...they WILL kill you. And if they don't, your fellow residents will.


So those are just a few of the quotes/moments from my rotation that I wrote down. It wore me out, made me cry, made me feel like I was dumber than a pre-schooler at times, and made me feel stronger than I ever imagined other times. It really is crazy how far we've come but even more crazy is how much more ground we still have to cover. I don't think it ever ends. Actually, I hope the learning and pushing limits never ends. Oh yea, and saving lives is pretty dang cool too...