Assorted anecdotes from surgery day 1

This entry brought to you courtesy of "the ex knife set."

No comments. Too tired to comment. Just stories.

First patient of the day. 64ish year old man, hospitalized for renal failure. During his hospital stay, the internal medicine staff began to suspect that he perhaps had some sort of psychiatric issues of an unspecified nature. They ordered a psych consult. Psychiatrist ruled that the patient posed no threat to himself or others and sent him back to the ward. A few hours later, he went missing from his bed. He was found shortly thereafter at the triage desk of the ER complaining of "chest pain." The cause of this chest pain?
A scalpel protruding from his right ventricle. Apparently he wandered into the hallway, grabbed the sharpest object he could find in the ward, and stuck it into his heart.

This prompted one of my favorite student-attending dialogues of all time:

Student: What is the prognosis after being stabbed in the right ventricle?
Doctor: About the same as being stabbed in the left ventricle.
::Walks away::

Patient two 30sish. Admitted due to multiple stab wounds to the . . . guess. .. yup! Right ventricle. The best part of his medical records: "Medical history significant for inspiring multiple homicide attempts." I did not realize until today that people wanting to kill you was a medical condition.

This was in fact, not the first time he had been stabbed in the heart. Handled it like a pro too. He was nearly discharged the day after surgery for stealing cigarettes from the nurses and smoking in his bed. With his oxygen connected and flowing.

The rest of the day was mostly spent taking out staples and sutures in the outpatient clinic. One of the good things about learning medicine in Israel is that there is much less bureaucracy surrounding what medical students can and cannot do. We've been sticking needles, fingers, and catheters in and taking blood, urine, and poo (<--technical medical term) out of patients since we first started on the wards. If the attending is comfortable with us and we're super confident we do just about any procedure we're moved to.

There's something amazing about the fact that the first time I take a scalpel or needle and thread to a person's skin will leave a mark that they'll carry around with them for the rest of their life.

That's inspiration to practice, I suppose. Off I go.



Tomorrow: A short news story and ramble on the ethics of medical education.