To be honest, my surgery rotation has been a heck of a distraction. I'm certainly not bored, let me tell you. I am sick to death of bowels and poo, though. Blech. Surgery is SO not me. One of the hardest things is seeing people who thought they just had a stomachache, and discovering that they in fact have a huge tumour. Watching someone's life turn upside down in seconds like that is really tough.
That said, I've enjoyed the rotation more than I thought I would. Turns out that even though I don't want to be a surgeon, looking at guts is cool sometimes - and if nothing else, at my school where anatomy education is largely "self-directed" (my fiance manages to make that sound dirty, but really it's not, it just means that students at my school tend to be a little rusty about anatomy!)...anyways, surgery has been a good way to brush up on anatomy. Nothing like seeing it "in the flesh," so to speak.
I wish I could tell you some of the tales of things I've seen. Damn privacy laws. I will say that it is absolutely amazing how much will fit up one person's bum. It's even more amazing what people will put up there. Ouch.
I will tell you about one patient, though. He was one of those patients that for some reason resonates with me. He came into the ER with this vague history of abdominal pain, loss of appetite, weight loss, and intermittent fevers over the past few months.
The man is very, very Irish, and had this very Irish way of speaking -- a manner with which I am intimately familiar, because my whole damn family talks like that - they never answer a question directly, but instead dance around the question and tell all sorts of side stories until you're totally lost - at which point they finally give you a very indirect answer to your original question. In any other group of people, it would be called circumlocution. In the Irish (or at least the ones I know), it's utterly normal. I understand this. Unfortunately, the residents with whom I was working did NOT understand, and thus got a very poor history from the man. Fortunately, med students tend to have time that residents do not - so I went back and talked to he and his wife for almost an hour, and got the whole story - pretty much as described above, although I also found out an awful lot about him that had nothing to do with his medical problems in the process!
The whole conversation sort of built a connection. I "get" this man - we speak the same language, if you will. I could see that his nonchalant attitude that others were interpreting as a lack of understanding of the situation was in fact stoicism covering utter terror. He understood the situation all too well.
A CT scan was done, and it showed a big, scary-looking mass that no one could specifically identify, but that everyone agreed was cancer.
The poor man has stayed in hospital two weeks (and counting) while everyone tries to sort out what the tumour is, how to biopsy it, and how (and if) it should be treated. He's a man who has worked hard his whole life and only recently retired - the forced "rest" at the hospital is driivng him crazy. He wanders the halls all day, pushing his IV pole. I always make a point to stop and talk to him for a few seconds, because I know that he's lonely. That Irish craving for socialization is something I know very well.
He nearly broke my heart one morning when we stopped to see him on rounds and one of the residents commented that he was "looking very good." "Aye," he replied, "too good to die." It was heart-wrenching, because all any of us could think was that he was probably right - he was dying.
He also gave me a good belly laugh late one night when I was heading off toward my on-call room for a few hours' sleep. I ran into him a couple of wards away from the one where he is staying. As usually, he was walking the halls, pushing his IV pole. I joked that he was fairly far afield from his usual turf. "Aye," he replied, "I'm just gettin' my exercise. Thought I might as well do the Terry Fox Run while I'm here." He grinned.
Last week, someone decided to repeat his CT, presumably to make some sort of decision about treatment and prognosis. Imagine our shock when the "tumour" was half its original size! It turns out that he has diverticulitis (a condition that's more of a pain in the butt (literally) than an actual threat to life) and the "tumour" is in fact a huge lymph node that got inflamed from this ongoing diverticulitis that was causing crazy inflammation in his abdomen. How the diverticulitis was missed the first time, I do not know. But when I found out about the second CT, it made my whole day. I haven't seen him yet, because I've been at another hospital for the past few days, but I'm hoping to go visit him tomorrow. It's cases like these that make all the poo and bowels and sad stories worthwhile.