An arm and a leg

So...as of this afternoon, there are eleven patients on the vascular surgery service at UWHC (Univ of WI Hospital & Clinics), and only 55 toes between them. Considering that an anatomically correct count would be 110, we're running a bit short, largely as a result of my own hand, I might add (amputations are an "intern case"). It's amazing how many people neglect and/or abuse themselves to the point where an amputation is the only solution, and quite sad, really. One of my patients last week was only 32...that's barely older than me! She ended up with a TMA (transmetatarsal amputation - basically, you remove the toes and a small portion of the forefoot), which wasn't so bad considering how she'd neglected her health (for those of you in medicine, her Hgb A1c was 16!!!). She will remain very functional with her current amputation, but will no doubt lose more of her limb(s) in the future, since she voiced no intention of getting better control of her diabetes or quitting smoking.

Medicine, for me, is really a battle between trying to win my patients to my way of thinking (i.e., take better care of yourself and things will go better for you), and allowing them to make their own decisions (they're grown people...they know the consequences...they can decide for themselves). I like to think that most people are capable of running their own lives, but everyday I see the consequences of their actions, and oftentimes, they seem ill-prepared for what they've gotten themselves into...as if they didn't see it coming.

At any rate, enough of that business. So, I'm just about to start week four of my surgical residency. My current "rotation-mate", Jason, an intern from the orthopedic surgery service who is spending his first four weeks on vascular surgery with me, will leave at the end of this week. We've gotten along beautifully...he's smart, a hard worker, and a really good guy. It's been really nice to have someone to vent to, not to mention share the workload with. I just had dinner with he and his fiance tonight, and enjoyed it a great deal. Hopefully, we'll keep in touch as we move on to other rotations. It's always nice to have someone to call when you just want to let your hair down for awhile.

Last, but not least, my latest source of dissatisfaction with my life as a surgical resident is my nearly complete inability to do anything even remotely functional in the operating room. Despite the many hours I've spent tying knots at home and nearly everywhere else outside of the OR, it's as if I've never laid eyes on a suture before when I'm handed one during a case. The other day, the vascular fellow waited, seemingly patiently, for at least 15 seconds while I fumbled daftly with a silk tie in a vain attempt to ligate (cut off the flow from) a briskly bleeding artery we had encountered during our dissection. After taking the suture from me and effortlessly tying off the offending vessel, he mumbled something about it being July and not expecting much from the "new crop". I know it's still early, but I can't help but feel as if I'll never get the hang of all of this. As I mentioned before, it's been nice to have Jason around to lament to. He's had a number of similar experiences, and there's something to be said for feeling like you're in the same boat with a peer.

Well, it's getting treacherously close to my witching hour...tomorrow's another day of fun and frolic beginning bright and early at 0600! I hope all is well with everyone and that you're all getting a chance to get out and enjoy the summer. Until next time, I am, as always...

Yours sincerely,
~AC