Highlights and Lowlights

- i saw the coolest surgery ever last week- WARNING, GRAPHIC MATERIAL AHEAD...a long time smoker had developed a mouth cancer and nerve tumor that had spread all over his neck, jaw, throat, and tongue. the Ears, Nose, Throat (ENT) surgeon did a 14 hr surgery on him (14 hours!!) that involved reflecting the skin on his jaw/face up and the skin on his neck down, tying off his jugular vein, and dissecting out all the tumor, cautiously picking through and avoiding other major vessels and nerves. to get all the tumors and their margins, they had to take most of his tongue, severed his jaw in half and took much of his inner cheek, soft palate, etc. it was incredible to see. i went in an checked it out in between cases. it was an amazing anatomy lesson. and i had actually met this patient in pre-op, and he was very full of faith and kept smiling and talking about how God had gotten him through this far, so knew He would stay w/ him for this....so as i watched the surgery in awe, i just kept praying over him- asking for God's protection and hand in this. i kind of thought that's what the patient would want. the next day i went and saw him in the surgical ICU, and other than the fact that he was breathing through a tracheotomy in his neck, fed through a feeding tube, and had a howdy doody looking line of sutures down his chin and around his jaw, his head was entirely put back together and he looked like himself. his recovery will be long and his long-term prognosis is still shaky. he will have to learn to speak again w/ a finger-width of tongue left...but this might have saved his life from an incredibly invasive and hard to reach cancer. so cool.

-i requested that my chief PA schedule me for as many laparoscopic cases as i could get this week, so that i could become proficient with using the long instruments and manipulating them inside the belly, using monitors to gage my actions. i did a few gall bladders in this way, which went really well....the whole thing is pretty counterintuitive, but i'm learning. i'm learning.

-so...on thursday, i was with a good 'ol boy surgeon who i'd never worked w/ before... a genuine cowboy. loud and crass and over the top. goes unpunished for telling horrible off-color jokes about race and sexuality, etc, etc. generally, the kind of dude i try to avoid. and we were doing a tricky hernia repair laparoscopically. so, as i was attempting to manipulate the hernia mesh patch w/ my instrument while using the monitor and 'feel' as a guide, it wasn't going well. (like i said, i'm learning. i'm learning). he, the lasso-wielding surgeon, the PA who was with me, and all the nurses in the room laughed hysterically at me. like tears-in-their-eyes, funniest thing they've ever seen, laughed. so that was fun. needless to say, i was a little jarred after that and so then bumbled around, contaminating myself, breaking a glove, even my sewing was not so hot...but the case eventually ended. thank God.

-friday, they let me scrub by myself for four cases w/ a surgeon. and overall, they went really well. that helped re-build my little shaky self esteem a little bit.

-also, apparently, i'm a legend. i ran into the chief of surgery in the hallway the other day. he had been fond of me when i was a student there last year- i think he was instrumental in getting me hired. anyway, if you've been reading my blog all along, you might remember a particular story about when i made an ass out of myself (i'll clarify- i know that doesn't help) when i asked for the "bent retractor" instead of the "Bennett retractor" during an ortho case. he told me that i'm remembered for this and that now the whole orthopedics department refers to it as the "bent retractor." fan-friggin-tastic. :) i guess infamy is better than no-famy, eh?

-what else? my weekends are becoming more and more important to me. and we've got busy ones back-to-back for the next few months. i'm taking advantage of the fact that i don't have to take call yet. this particular weekend, we went to a traveling broadway show called "avenue q" which is sort of a raunchy, hilarious musical puppet show w/ such favorite numbers as "the internet is for porn." good times were had by all.