Saturday, July 23, 2016

Take This Job and Shove It Except That It's Not a REAL Job in the Sense That I'm Unpaid Plus I HATE Country Music

Yesterday was a long and rough day at work. It didn't begin with the presage of being unduly lengthy, as the first surgery for which I was to be in attendance wasn't scheduled to begin until 6:30 a.m., which meant I could show up at some point between 5:00 and 5:30, which I did. Matters were not helped by my having picked up a cold at some point during the night, but such is life in the world of medicine. You don't skip surgery for a mere cold. You keep your stinking mask on all day even when you're not in surgery, but you show up and you stay there until you're kicked out of the hospital or surgical center by one of your superiors.Then some lady's fallopian tube exploded, and the surgeon who was to lead the surgery previously scheduled for 6:30 was suddenly out of commission. All of the other surgeries that were scheduled still happened -- just later than they should have started. I finally got away from the hospital at 8:05 p.m. 

I arrived at my condo to find Matthew at home with our living room full of his buddies eating pizza and watching -- of all things -- some ESPN program about how the 2016 NFL draft picks would fare in the upcoming fantasy football season. Jesus fucking Christ! Why doesn't ESPN just televise ants carrying food across kitchen counters? It would be a hell of a lot more relevant and equally entertaining.

I left to get an ice cream cone and briefly texted a friend, but almost as soon as I was handed my ice cream cone in the drive-through lane, I was overcome with violent gastric symptoms. I pulled my car far enough from any other cars in the parking lot so that I could drop the ice cream cone onto the pavement (I'm not usually a litterer, but I made an exception) and could empty the almost nonexistent contents of my stomach in relative peace. I then drove home, plugged my nose so that I wouldn't smell the pizza and beer as I walked though my living room, not that I could have smelled it anyway with the nasal congestion of my cold,  and put two towels at the bottom of my bedroom door so that the smell of the pizza wouldn't pervade my bedroom and make me sicker than I already was.

Work itself was less than delightful. One cannot expect it to be fun when experiencing cold symptoms, but a scratchy throat, headache, and sinus pressure were to be the very least of my troubles. During an exploratory laparotomy, the lead surgeon dropped a clamp. There wasn't another identical clamp on the tray, so he (the lead surgeon) hurled a few choice expletives as one of the nurses quickly hurried to grab another from an already sterilized set of surgical implements. The nurse handed the clamp to the surgical technician [who technically must be the one to hand every instrument, sponge, towel, or whatever piece of equipment is used in a procedure to the surgeon, and then must take it back if it is not something that is to remain inside the patient, because he or she is responsible for accounting for every piece of equipment and for ensuring that nothing is left inside the patient that isn't supposed to be left there], who inadvertantly dropped the second clamp. I was standing slightly behind and between the nurse and the surgical technician but had no physical contact with either, which made it most puzzling when the surgeon hollered, "Goddamn faecal encephalopathic!"

The O.R. tech gave him an ugly look, or as least as much of an ugly look as one person can give another with two-thirds of one's face covered by a surgical mask, and  commented, "You could have just said 'shit for brains.'  Everyone here  knows what faecal encephalopathy means. You weren't impressing anyone or sparing anyone's feelings, not that that you've  been known to spare anyone's feelings before." She paused for a breath, then continued. "And so I dropped a damned clamp. You dropped one before I did. No one felt the need to spout f-bombs when it was your fault."

"I wasn't directing anything at you!"  the lead surgeon retorted.

"So I'm the one with shit for brains?" the nurse who had retrieved the second clamp chimed in. Meanwhile, someone else had grabbed a third clamp and handed it to the O.R. tech, who wordlessly handed it to the lead surgeon, who miraculously managed not to drop it.

"Did I expressly identify you as the faecal encephalopathic among us?" he asked her, looking up briefly from the patient's open abdomen. (Radiological reports were unclear as to precisely what was amiss with the patient's organs, necessitating a full laparotomy as opposed to the less invasive laparoscopic procedure.)

"I handed the clamp to Lisa [the O.R. tech]," the nurse responded. "It fell to the floor. I handed off poorly, or she flat-out dropped it. You seem to be the self-proclaimed official scorer here, not that we've ever needed one before. If you weren't yelling at her, it must have been at me." 

"Try Option 3," the lead surgeon spat out.

"And what might that option be?" asked the assisting surgeon, a  third-year resident, an ordinarily soft-spoken woman.

"That would be Baby Bimbo standing right there between Thing 1 and Thing 2 who couldn't quite keep her hands to herself," the lead surgeon answered. My jaw dropped almost to the floor, though no one could have observed it through the surgical mask.

The O.R. tech and the nurse who handed the clamp to her both began heated responses to the lead surgeon when a voice came over the intercom. 'You have a patient on the table, Dr. ********,"  said what sounded like the voice of God through an intercom, but was actually the voice of the doctor charged with supervising surgical clerkships and residencies.  (Some surgical suites have viewing areas above them, which this one did. Those in the surgical suite cannot hear anything from the observation point unless someone presses the intercom button.  As often as not, the viewing areas are unoccupied, but a relatively  high authority stopped by to observe at a rather timely point in the procedure.)

The surgery proceeded in virtual silence, interrupted only by requests for instruments as needed. As the senior resident was making the final closing sutures, the lead surgeon looked up to ensure that no one was in the viewing area, then looked directly at me. "You cannot tell me, Princess Anorexia," his voice heavily laced with sarcasm, "that you didn't reach for the clamp and cause Ms. Herman [the O.R. tech; though she was known by "Lisa" to everyone in the room, I was, it seemed, unworthy even for a reference by her first name to be directed at me] to drop the clamp?"

As I was pondering the specifics of my answer, Lisa answered for me. "No, she didn't touch the damned clamp. I dropped it, it as you dropped the one before."

'What's this?" the lead surgeon countered.  "She can't speak for herself? Do you even have a voice?"

"Is this really necessary?" the senior resident asked as she made the knot on the final suture. "And by the way, things you've said in here have been precariously close to sexual harassment."

Peronally, I'm not overly concerned with verbal sexual harassment. For the most part, if they keep their hands to themselves, I don't care what questionable things they might say along the lines of sexual innuendo. I draw the line, however, at false accusations of any nature.

"I just want to know if she's capable of speaking," the lead surgeon continued. "I've heard no evidence that she has a voice."

"What do you want me to say?" I asked him, making direct eye contact.

"Anything!" he shrugged.

"Anything,' I responded.

Laughter broke out in the room as the lead surgeon rolled his eyes and muttered, "How intelligent!"

I made it out of the room and out of the scrubs and paraphernalia in record time. I didn't want to talk to anyone. Another surgery, thankfully with another surgeon, was scheduled for less than fifteen minutes from the time I made it out of the partial hysterectomy, and I would need to rush to be  scrubbed and ready in time to be allowed to be present for it.

My next and final surgery for the day -- a thyroidectomy -- went without incident. I just felt sorry for the patient for having to wait so late in the day for the procedure. Few things are more agonizing than waiting as a patient for a surgical procedure. Fortunately, it was short and to the point, everyone inside the O.R. behaved professionally, and the patient came through recovery with minimal discomfort.

So I made it through an especially arduous day, made all the more difficult with the symptoms of a cold, only to be hit with a gastric illness, and, unless someone else who lives in this condo has acted in a most uncharacteristic manner, a messy living room and kitchen with which to deal. Matt will likely pull the martyr act and say that because he is on call for Saturday while I have the weekend off, all the clean-up chores should fall upon me. If I open the door this morning to find the downstairs area not cleaned to my specifications, I will telephone the complex's on-call cleaning crew and arrange to have the entire downstairs area  be made spotless at Matthew's expense. If he doesn't fork over the money willingly, I'll call my dad and rat him out, and the money will be deducted from his next month's spending allotment. It shouldn't be a problem for him, as my grandmother sent him a hefty check for his half-birthday (?!?) last month.

P.S. I received a text message at 1:06 a.m. from my preceptor telling me that I am to meet her at her office at an early time this morning. (She indicated the time, but for security reasons, I can divulge neither the precise time nor the specific location.) She mentioned the importance of punctuality, as others besides her self may possibly be present as well. I didn't see the text at the time it came, but I checked my phone just while ago when it dinged for another reason, and then I saw her message. I've never been asked to meet with her except  regular scheduled-well-in-advance meetings, and certainly never on a Saturday. She's a psychiatrist and almost never works Saturdays.  This cannot possibly be good. I suppose I may as well give up on the idea of sleep for the rest of the night.


  1. Alexis, unless there's something really big that you haven't mentioned, you haven't done anything wrong and nothing bad is going to happen. I haven't any idea why your preceptor feels it's so very urgent to meet with you, but again, you surely are not in trouble.

    Do something that will help you to relax. Call me if you need to talk. Play the piano or violin or cello. Don't worry about the noise disturbing Matt. If the downstairs is too smelly and it makes you feel nauseated, wake Matt up and tell him I said to clean the kitchen and get rid of the pizza boxes and beer bottles NOW. Or wake Matt up just because you need to talk to someone in person. He owes you.

    I would tell you to go to sleep, but I understand that it would be futile. Just TRY to relax.

    I'll be anxiously waiting to hear about just what it was your preceptor felt to be so urgent that she would text you after 1:00 a.m., but it cannot possibly be anything serious that anyone thinks you did. And I cannot stress strongly enough, PLEASE be cautious in publishing information about where and when you are going to be.


    1. This is the best comment that I have ever seen on this blog. I have no doubt at all that your daughter is, by far, the most wonderful woman in the entire world!

  2. By the way, this is awesome writing! You said "This cannot possibly be good." Here is my guess. My guess is it will not be good for the lead surgeon. The preceptor will probably apologize to you for the way the lead surgeon behaved and he may even be disciplined. Even though you were in that room to learn, you learned the wrong way to be a surgeon. Someone probably complained that you were treated abusively. Also the preceptor might know that your father is a doctor and that there are a lot of doctors in your family.

    Either way, let me apologize for the way that you were treated by the lead surgeon. He should not have called you Baby Bimbo, Princess Anorexia or faecal encephalopathic. This could be a Broadway play called Try Option 3.

    The players are the third-year medical student (you), the lead surgeon, the nurses, the surgical technician (also called O.R. tech. or Lisa or Ms. Herman), senior resident, assisting surgeon & others.

    For people like me who do not know the lingo, a laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity, encephalopathy means disorder or disease of the brain, feces or faeces are the solid or semisolid metabolic waste from an animal's digestive tract, discharged through the anus or cloaca during a process called defecation and thyroidectomy is the removal of all or part of your thyroid gland that is located at the base of the neck. False accusations are all over in society and one of the commandments are against them.

  3. Wow... that really sucks. I hope everything's okay. The surgeon who was behaving that way sounds like a real creep. I wouldn't want him operating on me.

    1. Everything's fine for me except I have a stupid cold. I didn't get blamed for anything and even got a week of recovery time for the stress of it (plus I had a fever the next day when I met with muckymucks). They'll try to encourage the surgeon to leave willingly (he's done worse) but will then take steps to get rid of him, which they can do but it will take time. I will not have to work with him again, and he will have no say in anyone's surgery rotation grades.