January 2012 (Part 2)
By Edna Miao, OREXer ’11-12
I was excited to see what I was going to learn today from the OR! I met Dr. Palmar after their morning session. Dr. Palmar is a third year resident with a sarcastically funny sense of humor. The first case was delayed so while we were waiting in the room I got to hear a conversation Dr. Palmar had with a first year resident student. He was correcting her and telling her that she didn’t have to give the impression that she knew everything – it was okay to say that you didn’t know the answer. I thought this was an interesting conversation. When medical students do go to residency, there is a culture in which new residents learn from the older ones, who show them the ropes of the hospital. It was interesting to see this culture played out before me and gave me a picture of what being a new resident might be like.
The first surgery I observed was a gynecological case. A nurse, named Sheena, was very nice and allowed me to observe this surgery. Some vendors were in the room as well because they were selling the physician a new product. I didn’t even know that such job opportunities were possible! It would be cool to have a job to sell products and observe surgeries at the same time! The patient was a 39 year old woman who had fibroids, located in her uterus, that were causing her pain. Dr. Lennox cut through the woman’s stomach and widened this cut using instruments to widen the cut. I was somewhat aghast to see two physicians pulling on a woman’s stomach to widen the opening. I had always imagined surgery to be delicate and refined, and this … was definitely not delicate! Dr. Lennox located a ball of tissue and cut the strands of tissue that suspended the ball of tissue in the cavity. He proceeded with this surgery with great precision and dexterity. I could see just how years of experience has made him an excellent and efficient surgeon. He would alternate between excising and sewing until the ball of tissue was finally taken out completely. It had the shape of a sphere and looked like the size of a softball. I thought: “Wow, that’s a huge fibroid!”
But when I looked at the patient’s charts and read abdominal hysterectomy, I realize that the physician had taken out not the fibroid but the woman’s uterus! I should definitely read the patient’s history first for each case – lesson learned! I couldn’t believe that this was what a uterus actually looked like! This was so different compared to what I saw in the anatomy books. After getting over my initial shock, I went to another operating room.
Next, I saw two portacath placement surgeries. A 58 yo male who was diagnosed with metastatic stage IV nonsmall lung cancer had to have a portacath placed in his body to allow easy injection of chemotherapy drugs. The portacath allows for another way of injecting chemotherapy drugs to reduce irritation and to reduce chance of clogging in veins. This patient has a very poor prognosis and will probably not live for more than a year, according to Dr. Palmar. This statement really made me pause. I wonder what it would be like to be this man – to know that he will not survive for more than a year and that his life will soon come to an end. I cannot even fathom what he must be going through. The next case was 57 yo woman who appeared healthy when I first met her. However, I later learn that she has an adenoma-carcinoma in her colon and will also need a portacath to inject chemo drugs. These cases made me contemplate the fragility of life and the life-giving power of medicine. You hear people say all the time that they want to be doctors to save lives, but it is not until you see patients who are battling and struggling to simply live that you see the depth of this cliche statement. It is truly a privilege to have the gift of health and to pursue a career in medicine.
The last case that I got to see was a total laproscopic hysterectomy. This patient wanted to have permanent sterilization. What was really cool is that the doctor used a camera to see the women’s reproductive organs. He located the fallopian tubes, ovaries, and uterus using this camera. Again, I was just so amazed to see what these reproductive organs actually looked like compared to the textbook images!
Today was a great experience as I got to shift from one OR to another and explore all the different types of surgeries medicine had to offer. It was awesome!