Last Hospital Day in Dominica!

Another hospital day over with and my last one! I never really wrote about my previous visit but while I learned a bit - it really didn't compare to today's rotation! This time I had my
anesthesiology rotation. It was great! We were in surgery for about 4 hours in the morning for a partial gastrectomy. The patient had an adenocarcinoma of her LES (cancer of the sphincter between her esophagus and her stomach). Overall, not a good prognosis but in a flash procedures were underway. All together in one case, I saw an epidural, intubation, surgery (obviously), central line, drainage tube and chest tubes all performed.

As soon as the operation started - man - did that surgeon go to town. It all seemed SO rough the way he was doing everything. The point of the surgery was to resect the portion of the stomach (cardia) along with the tumor. All of a sudden we see a spleen go flying - what? why? Don't ask me! We all just looked at each other trying to figure it out. He also cut through nearly the entire greater curvature of the stomach... The best I can come up with is that I noticed the surgeon had to cut out the spleen because of the short gastric arteries that led up to the stomach - and this could have let to a more massive bleed? I feel dumb for not knowing but it's good trivia for me to think of after I write this blog. She did have a large loss of blood, nearly 2 liters I was told. But for a woman of her age, she handled it very well. I hope good things for her. I know when she wakes up she will be in an extraordinary amount of pain. She will require a long recovery and need much extra care.

Working with the anethesiologist was great although we all were bouncing back and forth from the surgeons to anethesiologists the whole time - trying to catch a glimpse of everything. I really enjoyed it but still do not consider either in my future. What bothers me most? The patients are unconscious! I think I feel that I bring alot of my personable qualities to this profession and that I would be wasting them if I spent it in a lab or with patients that I couldn't even speak to and in that way make an impact. I know that is ONE THING I want for myself in my practice.

I did learn alot today however and I think it gave me the kick in the butt I needed to start plowing away at my books... So - here we go! :)