Yes...I'm still alive

For those of you who were wondering if I gave up and went home or suffered some other horrible misfortune rendering me unable to type, I am actually doing well and still able to post to my blog (although you wouldn't know it from the number of updates I've put up during the past few months). Everyone realizes I'm busy and it's really a cop-out to use a cliched phrase like that anyway. Truth is, I just haven't taken the time to write. Nevertheless, I'm writing now and I've got a good deal to cover, so here goes.


Currently, I'm on Pediatric Surgery at the American Family (yes, the insurance company...first our magazines, then our stadiums, and now our hospitals...is nothing safe from the ever-tightening grip of corporate America?) Children's Hospital, the new children's hospital attached to the main UW Hospital. It's a well-equipped hospital in my opinion; although, those with more experience with Pediatric Surgery tell me the program here is really somewhat inadequate. We have only two Peds surgeons, both of whom are good surgeons and teachers. But with only two, our service volume is arguably small. This is nice from an intern standpoint (i.e., my workload is much more manageable than it has been on past rotations), but might leave something to be desired in the way of exposure to Peds Surgery. All in all, I'm enjoying myself. I don't have much interest in a career in Peds Surgery, but kids are fun to take care of in that they are very resilient and almost always get better, often in spite of what we do to/for them. Also, the team is currently led by a terrific chief resident, Ben Mandel. He has led a rather interesting life, the details of which I'll hopefully relate in a subsequent post.

I've also had a whole host of interesting experiences away from my work at the hospital. I'm fortunate to get along very well with all of the other five members of my intern class, as well as the other interns from outside specialties (e.g., Anesthesia, Ortho, Neurosurgery, Plastics, ENT) and General Surgery residents in the program. Particular activities of interest over the past few months include: 2 UW Badger football games (one in the student section [I'm getting too old for that craziness] and one in the "good seats"), one Green Bay Packers game at Lambeau Field (just this past weekend...a great time), the Madison Symphony, several 30+ mile bike rides through the Wisconsin countryside in the fall (usually failing at desperate attempts to keep up with my riding partners...more about them later also...for now, all I need to describe them is one word - triathletes), and a number of recent attempts at improving my luck at cross-country skiing. All of this has helped keep me somewhat sane despite the mounting demands of residency, and I'm obviously thankful for that.

I also was fortunate to get a week of vacation around the Thanksgiving holiday, which allowed me to make the trip out to CA to spend time with my family. My grandmother has a home in Morgan Hill, a couple of hours south of San Francisco, and my folks and sister (and her family) made the trip out as well. It was great to see everyone and I benefited enormously from the break. I spent the first couple of days traveling up north into the Redwoods and camping out with my dad. It was an excellent time, despite some rain.

Regarding the other rotations I've completed since my last post, I've rotated through both Orange and Blue Surgery. These are two of the busiest rotation and are considered the "core General Surgery rotations" during the intern year. Orange is the colorectal and minimally invasive service, which largely entails operating on various parts of the gastrointestinal tract, often through small incisions with the aid of a laparoscope. This was an extremely busy rotation, as our census (with me as the only intern) was often in the mid to upper 30s (meaning we were caring for 30 or more patients in the hospital). The cases were largely bread-and-butter General Surgery, which was nice. However, the amount of paperwork and daily chores on the floor were often overwhelming and led to a significant amount of stress. Furthermore, operating became something to be dreaded rather than eagerly anticipated since all of the floor work (by the way, when I say "floor" I'm referring to the inpatient hospital unit(s) where all of our hospitalized patients are residing and being cared for. This is in contrast to the ICU ["the unit"], the recovery room [PACU, pronounced pack-you], operating room [OR], etc.) was waiting for me after my time in the OR (i.e., there was no one else to do my work for me, so operating made the days very hectic and long). All told, it was a good rotation and I increased my comfort level and surgical knowledge base a great deal.

After Orange came Blue, the hepatobiliary, pancreas, endocrine, and surgical oncology service (translation: liver, bile ducts/gallbladder, pancreas, thyroid/parathyroid/adrenal glands, and cancer surgery service...probably not much of a translation for the non-clinical members in the crowd, I realize). All of that aside, the important thing about the Blue service is that it is "The Chairman's Service", meaning that all of the politically important people in the residency program are part of it (e.g., the Chairman of the Dept. of Surgery, the Residency Program Director, the Chief of Surgery at the Veterans Admin. Hospital). Needless to say, this was another stressful rotation, albeit for different reasons. This was a less busy service, but the patients were considerably more ill as a general rule, and the pressure to perform at my peak often felt crushing. A particularly anxiety-provoking aspect of this rotation was the conference held each Tuesday morning after rounds. Basically, the faculty assembled in a shallow arc of high-backed wooden chairs at the end of a long hallway on the 6th floor with a gigantic plate-glass window behind them (and remember, this group included the Department's movers and shakers). We, the lowly residents and medical students, gathered in small chairs before them, facing the giant window. The real kicker here was that the window faced east and inevitably, the sun seemed to be perpetually rising behind the the assembled faculty blinding us and adding to our sense of ineptitude and anxiety. I won't bore you with the painful details. In short, every week the faculty expected us to have a better command of the topic being discussed than we actually did. It was a stout weekly brow-beating, but I will say this: I learned a lot during that conference, anxiety or not. Again, overall it was a good rotation and one during which I got into the operating room a fair amount, mostly on Friday mornings to do parathyroidectomies with Dr. Chen, the Chief of Endocrine Surgery.

At any rate, this is getting ridiculous and I've spent over an hour at this point. Note to self: write more often and it won't be as painful. With that, I hope life is treating all of you well and that you're looking forward to a great Holiday Season. I'll try and write again soon. Until then here's wishing you, as always...

All the best,
AC