November 7, 2007

• The size of a cantaloupe

  Today was crazy good.

  Still waking up feeling pretty refreshed, so I think my sleep schedule has finally reset itself to this 5am routine i have going for me. Got to the hospital, wrote my surgical notes, and then just started scrubbing on cases. First one was a breast biopsy. Pretty standard procedure, but done quick, efficiently, and more importantly, I got to tie the sutures

  Next case was another lap chole. I hope i never get bored of driving the camera around. Now this particular patient was, how do you say, a big girl. So there was not a lot of room to maneuver in her abdomen. Nonetheless we perservered and removed a ginourmous gallbladder. How ginourmous was it? Well, the attending had to actually widen the initial incision just to pull it out. Twice. We were all like, damn, even yo organs are fat, sucka. I got to suture again, and the resident told me that not only did i do a good job approximating and tying the wound, but he was impressed that i could switch hands when i needed to with no loss of dexterity. (if you are tired of me bragging about my ambidextrousness, you should probably not read any more of my surgery posts)

  At that point it was about 3pm. Yes two surgeries and I had already been at the hospital for 10 hours. Can you imagine what residency would be like? So while my resident had said i was free to go, I opted to wander the hall briefly and see if there were any interesting cases. And on my way to the door, lo and behold, what appeared to my eyes but a patient on the table with a facial mass. Mass being the operative word. (haha a double pun! get it? mass? operative? i kill me!)

  To get an idea of the size of the facial mass, I want you to hold up your hand and make a fist. Good. Now take your other hand and cover your fist. Okay. Now take those two hands together and place them right smack dab against your cheek, with your thumb touching your face. That is how large the growth on this man’s face was.

  Now you know me, i can’t just walk away from something like that. So into the OR i went and asked the surgeon if i could observe the case. He said no. He then followed it with, if you want to watch this case, go scrub in. Score! The case ended up being A squamous cell carcinoma of the face
  
  yes i know that is a foot, but you needed to have an idea of the general apperance of the cancer since you know the size (fist to head!)

  The basic idea was the surgeon cut through a large portion of the persons chest. Then he dissected off this cantaloupe sized mass (we called it mort. no, seriously) The final step was to pull all the loose skin we initially carved from the chest, up and over his face where we had cut the mass out. Then staple it to his head. That’s right. Skin that used to be near this man’s nipples is now part of his cheek. Skin grafts are fun. Dont worry though it does not look like a botox job gone horribly wrong. SKin around a lot of the areas was loosened so it could be approximated well. Aside from the fact he looked like an elderly frankensteins monster after all the skin staples, once those come out he will heal up nicely

  As if that wasnt cool enough, I got to learn a ton about anatomy from what basically ended up being a neck dissection. And at the end of the 3.5 hour case, the surgeon even bought everyone on the case dinner! So I am sitting here typing this with a mouth full of egg foo young. yum.

  And the icing on the cake of the whole day. Two products have come to my attention

  the first is this
  http://www.feer.com/tales/?p=749
  I am putting the link b/c i really really want you to click it. And i promise it is not rick roll or any other internet prank, it is just portable happiness. And a great stocking stuffer.

  and speaking of great stocking stuffers,
  Cadbury Ornament Creme Eggs. The exact same thing as the Easter
  version, only with red packaging for Christmas. Now they come out twice
  a year! Just like Jesus!

  No chapter of the story today. I am tired and going to bed. tomorrow i will continue

  • 9:57 pm
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