I Will Cut You.

i'm not sure if the general public is aware of this, but there's a sort of rivalry/respect game thing between surgery and medical folks. it's something like the surgeons think they're rock stars that cut and dig and sew things back together to save lives and the medicine docs think they understand pathophysiology, diagnostics, and treatments of life threatening conditions better, so that they can more sophisticatedly and less boorishly save lives. surgeons stereotypically are very skilled with their hands, seeing what they do as a fine craft, and want to make the problem in front of them go away, and then move on to the next....they tend to view time outside of the OR as boring...and aren't notorious for their excellent bedside manner. medicine docs, stereotypically, conduct long interviews with their patients, don't do much hands on examining/ treating, but will follow their patients' hypertension, heart disease, diabetes, etc over their lifetimes. there's definitely a difference between the two philosophies and everyone is subconsciously aware of it. as far as how i look at things, i'm somewhere in the middle. i like medicine- i like taking the time to think through a spiked temp about all the possible culprits that could be causing it...and I LOVE mannering at the bedside, but i also like actually examining, opening up and taking out the problem. and it's not like i won't be practicing medicine as a surgery PA- i will follow patients post-operatively and do admissions pre-operatively for them...

...but i guess i do kind of like the incising and draining of a cyst and figuring out the appropriate antibiotic coverage more than pontificating about what underlying autoimmune disorder might be causing the patient to be more susceptible to cysts and speculating as to whether it will recur.

but that's the great thing about my training- PA school is such a complete, general education that i do have, in the back of my mind, an idea of the big picture of what might be happening with a patient, even though i'm just cutting or squeezing on something.

it's been eye-opening, though, over the last few days that when i tell people at the hospital (all internal medicine people) that i took a surgical job, i hear a lot of, "oh, well. that should be fun" or "even though you're not going into medicine...let's talk about heart failure...you should know a little something about it..." as if they expect that when i start surgery, i'll turn my brain off and forget everything i know. i assure you, that won't be the case. i won't worry just about the incision site and whether or not the patient is moving his bowels, i'll consider all his ailments and meds and how they might be playing a role in his presentation. i will. i really will. and if i forget everything i know and instead occupy my brain with the names of the ligaments of the knee or the 13 types of forceps, i can always consult medicine. :)

booya.


by the way- a friend asked just what a PA does in surgery: here's what i told her, in case you're wondering the same thing...

what PA's do in surgery is assist the surgeons. but not like the nurses or techs or anesthesiologists assist the surgeons, but actually scrubbed in, across the table from the surgeon, cutting, holding, sewing, suctioning, cauterizing, etc along with the surgeon. if it's a laparoscopic surgery- we move the internal camera so the doc can identify and cut out whatever he's taking- gall bladder, appendix, or sewing up a hernia hole, etc. so i'll be used in this capacity for any surgeries that require 2 people (this is wide ranging- abdominal surgeries, vascular, cardiovascular (some open heart), neuro (spine/some brain), gyn (hysterectomies mostly), plastic (boob jobs, face/tummy tucks, etc), ortho (hip/knee/shoulder replacements, amputations, etc)). and then i'll follow patients post-operatively as they heal in a hospital room, taking care of their wounds and pain, diet, and all that.

there you have it. :)