Sunday, August 07, 2011

halfway through plastics

2nd week better than 1rst week. isn't that how it's supposed to be? and my formative eval half way through said "doing well. pleasure to work with." BOO-YAH! granted, it was just one opinion out of 4 that i should get, but can't beat that!

one of the things that i've been learning about during residency is how to navigate through the politics. i'm still just the lowly intern, not expected to know anything or do stuff right, and i'm shielded from a lot of the politicking, but i can still feel the effects from time to time. i just do my best to stay above it and not get sucked in...and that actually for me is not too hard. maybe it's my southern roots, but i'm used to "playing the game", ha! and as a med student i got really good at "hearing without listening". if that makes any sense.

alright, on to the good stuff! things i learned and worked on this week:
  • how to properly use the bovie to remove large chunks of flesh! and the importance of not plowing through as to not miss the big vessels that will bleed and obscure your view. (i definitely learned that one quickly!)
  • suturing! got to close tons of skin for 2 breast reduction cases. and there was that panniculectomy that i did a ton of sewing on too.
  • taught my med student how to do 2-handed ties...apparently not all surgery rotations are the same, and where she rotated at last didn't show her how to tie with two hands! the travesty! but now she's a pro, and that's what matters. (note to all med students: as a 3rd year at least, NEVER USE A ONE HAND TIE IN THE OR, especially in front of an attending. two hand ties only until you are proven worthy enough for the one hand tie.)
  • did my first I&D...incision and drainage to all the non-med people. it was quite a big one and under a fair amount of tension too. aspirated about 20cc worth of fluid first before making the cut, and then there was still so much in there. very satisfying. mostly seroma, but there was purulence too. i think the patient is going to feel so much better.
  • cut off some NUBBINS! ok, extra digits, but i think nubbins is so much more accurate. had a baby with bilateral postaxial polydactyly. tied off the nubbins, snip snip, and bam! nubbin free! (and yes, it was so weird to be holding a little nubbin with a fingernail on it post snippage! and my attending thought i was hilarious since i was getting grossed out. i know, surgeon getting grossed out, who would have thought...)
ok, and i'll leave y'all with that. on call again tonight, blah! at least we don't have any OR cases tomorrow so i won't be missing out on the fun!

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