Cut Up

Literally. In the Surgical kind of way. Haha.

I made a decision to go into Theatre bright and early on a Monday morning, simply because I had not gotten many chances to witness many big operations during Gen Surg last year, and hey, this is what a surgical rotation is supposed to be about right? Lots and lots of theatre and cutting.

Well not me cutting of course.

Turned up at 8.30 in Theatre on Monday, and was slightly shocked to see that no other student had beaten me to it, and that the Reg and SHO were not even there yet. So I hung around in the Anaesthetics room where the Anaesthetists ignored me, not that I cared much of course. I just read the patient's notes and kept myself busy till the surgeons came along. After that, CK explained to me that there was a code in the room where silence was maintained simply because they didn't want to agitate the patient any further / cause unnecessary nervousness before the big procedue. God knows, I would be SO nervous if I was going into an operating theatre, so I guess that makes sense.

Mr. T let me scrub in, and the Reg was the same one whom I had had from the Colorectal team in Georges last year, so all was quite good. Except for the SHO who ignored me, they talked me through the Anterior Resection and said I could scrub in. Although I felt later on that it was SUCH a waste of NHS resources etc, because all I did was scrub up to stand there like some kind of model. Touched the retractor for like 2 seconds, and the Diathermy pen for another 2 seconds to prevent it from slipping down, and the suction for another 3 seconds. I even felt sorry for the SHO whose job was just to hold retractors and snip suture. But I guess that's what being a Junior is all about in Surgery huh? You never quite get to actually do anything until you're a Reg probably.

Bar the initial excitement of scrubbing up and wondering HOW I could have screwed up my OSCE station in Gloving & Gowning last year, I eventually started wondering, throughout the duration of the 5 hours, what my purpose was as a medical student here in theatre. Was I supposed to gather anything by watching them do the surgery? It wasn't like I would be able to know what to do later on anyway. Sure, I knew that the patient had a Mid Rectal Tumour that was pretty large (Felt it on PR exam), and that they do Anterior Resections for these, and they do a temporary Ileostomy after to divert the flow of contents through the bowel just to let the anastamosed area heal for a while after surgery since the small bowel contents were the more 'nasty' stuff.

This was the amazing piece of technology that I found so fascinating - which they used to anastamose the remnants of the descending colon and the rectum. I was wondering for a moment, how they would have done it in the past without this Stapler, seeing as the lower rectum was all the way down in the pelvis and out of sight, and there was no way they could have sutured without being able to see. Then I realised they probably wouldn't have done Anterior Resections in the past, they would have just gone with AP Resections totally.

After a whole 5 hours of standing on a platform and talking through a mask, though, I got pretty tired.

Thank goodness for CK's pep talk outside her flat while walking back after dinner. I was just telling her how afraid I had become of surgeons in general, after getting yelled at by the CT Surgeon, experiencing mood swings in some others, and although Mr. T was probably the nicest surgeon I had met so far - I was still a little apprehensive. And I was tired. What was I supposed to gather by watching surgeries in theatre? Was I supposed to become any smarter and any better in surgery after this?

I don't overstep my boundaries as a medical student, and get out of their way whenever they are having mood swings, and they might think that I lack initiative. And if I do? I would just get told off anyway. And there are only so many times I can get told off.

So there's never anything you can really do right as a medical student, really. Damned if you do, damned if you don't.

I guess I am being a bit of a Drama Queen here. Don't get me wrong, I really do like Colorectal Surgery. Colorectal Pathology is this easy, you see. There are only so many things that can go wrong in your colon and your rectum. And the reason I like surgery is because everything is systematic, and broken down into bullet points. And there is a chronological system of categorising and thinking.

Reflecting retrospectively, I don't think that my experiences with Surgery have all been entirely horrible, and I really shouldn't be whinging about my team right now, seeing as they have actually been quite keen about teaching, but I guess I am the sort to lose focus easily and be affected by things.

I am lost in translation, but I guess it's just a matter of time before I get myself back.