Week 23: dear surgery gal
Surgery gal,
How do you tell people that one of your patients in the ICU coded and died yesterday? That another ICU patient, a sweet grandmother whose walls are covered in colorful construction paper drawings, whose abdominal wound you dressed and packed so delicately, making sure the wet gauze was tucked right between the ridges of her skin, each morning on rounds has decompensated into multiorgan failure and no one on any of her teams knows why? That your new normal is people being hit by cars, that you don’t even bat at eye at the violent aftermath of gunshot wounds and knife fights? That you still think about two patients, a few years younger than yourself, who had just met before coming into the ED with devastating injuries that would change their lives forever?
That sometimes when you’re done with telling a patient their update on rounds, you don’t ask them if they have questions because you know there’s not time to answer them. That you talked to a social worker about plans to conserve a patient you had never met but who needed to be moved off the surgery list. That yesterday your resident made a dark joke about a sad situation and you laughed because it was real, but everyone else in the room (non-surgical specialties) stayed silent and you suddenly felt a flash of shame.
So instead, when people ask about surgery is going, you muster up a smile and say it “It’s going.” And since you’re such an optimist, you add that these last six weeks have been full of growth and excitement and learning, that it's hard and draining but you’re trying to soak it all. It’s tough to contextualize the highs to people outside of this world that’s taken over your life –
But you think about the first time you really operated in the OR. How you used a knife on human skin for the first time and cauterized layers of tissue, how through each step, your hands were steadier than you knew they could be. How your last sutures left a scar so clean. How you can write a whole trauma note in less than ten minutes. How can see a patient on your own for a surgery consult and actually work them up. How now, you just know what needs to be done for the team and how you can churn out tasks in the background without needing anyone’s approval or appreciation. How your skin is thick, your nerves closer to steel than they’ve ever been before. How you stand up for yourself now – answering questions confidently even when you’re wrong, report your findings decisively, correcting your resident who told you that your history took too long when he didn’t make concessions for using a phone interpreter -- which should always double the time spent with your patient. How this surgery rotation has tried you, made demands that you don’t have the time or energy or training to fully address forcing you to prioritize what matters most and make peace with not being able to do it all, and so far, you’ve emerged stronger and fiercer.
In some ways, you’ve changed. Mostly for the better. But so much has stayed the same. You still start every early morning off with energy and a willingness to work. You still look for little moments that matter to patients, whether it’s complimenting their sparkly nails or commiserating about how awful preoperative fasting is or making them feel heard when they need to release the concerns on their chest. You still stop to give people directions around the hospital. You still look for ways to be gracious, to not let others feel inadequate if you can help it. You’re still excited about that immediate moment of connection when you meet a patient for the first time. You love learning about working up trauma and how the pathophysiology maps to management and which anatomical layers are where and how to make sense of real time imaging. You’ve held onto your sense of hope and excitement. Even when no one’s looking, you’re working hard to be the kind of person who does the right thing.
Surgery gal, you’re doing your best. You’re in the final stretch now, starting your fourth quarter of this rotation which any good Georgia football fan knows – is when the magic happens. You’re in the thick of it, but it’s going to be over before you know it. One last twenty four call tomorrow, a few days left of clinic and the OR, one monster shelf - and then it’s time for surgery gal to return those green scrubs, hang up her fanny pack and trauma shears.
The next time someone asks you how the rotation is going, you aren't sure what you'll say but you sure will smile wide.
That sometimes when you’re done with telling a patient their update on rounds, you don’t ask them if they have questions because you know there’s not time to answer them. That you talked to a social worker about plans to conserve a patient you had never met but who needed to be moved off the surgery list. That yesterday your resident made a dark joke about a sad situation and you laughed because it was real, but everyone else in the room (non-surgical specialties) stayed silent and you suddenly felt a flash of shame.
So instead, when people ask about surgery is going, you muster up a smile and say it “It’s going.” And since you’re such an optimist, you add that these last six weeks have been full of growth and excitement and learning, that it's hard and draining but you’re trying to soak it all. It’s tough to contextualize the highs to people outside of this world that’s taken over your life –
But you think about the first time you really operated in the OR. How you used a knife on human skin for the first time and cauterized layers of tissue, how through each step, your hands were steadier than you knew they could be. How your last sutures left a scar so clean. How you can write a whole trauma note in less than ten minutes. How can see a patient on your own for a surgery consult and actually work them up. How now, you just know what needs to be done for the team and how you can churn out tasks in the background without needing anyone’s approval or appreciation. How your skin is thick, your nerves closer to steel than they’ve ever been before. How you stand up for yourself now – answering questions confidently even when you’re wrong, report your findings decisively, correcting your resident who told you that your history took too long when he didn’t make concessions for using a phone interpreter -- which should always double the time spent with your patient. How this surgery rotation has tried you, made demands that you don’t have the time or energy or training to fully address forcing you to prioritize what matters most and make peace with not being able to do it all, and so far, you’ve emerged stronger and fiercer.
In some ways, you’ve changed. Mostly for the better. But so much has stayed the same. You still start every early morning off with energy and a willingness to work. You still look for little moments that matter to patients, whether it’s complimenting their sparkly nails or commiserating about how awful preoperative fasting is or making them feel heard when they need to release the concerns on their chest. You still stop to give people directions around the hospital. You still look for ways to be gracious, to not let others feel inadequate if you can help it. You’re still excited about that immediate moment of connection when you meet a patient for the first time. You love learning about working up trauma and how the pathophysiology maps to management and which anatomical layers are where and how to make sense of real time imaging. You’ve held onto your sense of hope and excitement. Even when no one’s looking, you’re working hard to be the kind of person who does the right thing.
Surgery gal, you’re doing your best. You’re in the final stretch now, starting your fourth quarter of this rotation which any good Georgia football fan knows – is when the magic happens. You’re in the thick of it, but it’s going to be over before you know it. One last twenty four call tomorrow, a few days left of clinic and the OR, one monster shelf - and then it’s time for surgery gal to return those green scrubs, hang up her fanny pack and trauma shears.
The next time someone asks you how the rotation is going, you aren't sure what you'll say but you sure will smile wide.
xoxo
Juhi
Comments
Post a Comment