March 14, 2008

• Resi-dos and Resi-don’ts

  I realize this is not something I mention a lot, but as a medical student you come across both good residents and bad residents. Interactions with both help to shape what kind of doctor you will be as much or more than your interactions with patients and personality.

  Right now I am working with several good residents and one VERY bad one. Bad as in, this resident has walked into patient rooms and just begun the vaginal exam without so much as a how do you do to the patient. Now correct me if i am wrong, but i am guessing most women would prefer at least a , Hello, i need to perform a vaginal exam as opposed to a “open your legs. dolor dolor? no dolor? good.” And aside from her terrible bedside manner, her surgery is downright terrifying.

  The resident had begun the initial incision for a ovarian cystectomy when the tech asked if the patient had a foley in (a foley is a catheter or tube that goes into your bladder to make sure if you have to pee any urine drains into the bag while doing pelvic surgery. aside from not being sprayed with uring during a procedure, if you are doing surgery near a bladder, you dont want said bladder to have fluid inside it.)

  So the resident had to stop the initial incision to go back and put in a foley. The attending commented sarcasticlly, i will forgive you since you are only a third year resident (most residencies are 3-5 years, so this is a mistake that you should have stopped making LONG ago)

  Now the surgery was supposed to be laparoscopic, which i have described before on my surgery rotation entries. Due to the incompetence of correctly placing the trochar which the laparoscope goes through , not once but three times, the surgery had to be converted to an open laparatomy. So instead of a small scar just beneath her bellybutton, this patient will have a large scar down the center of her abdomen.

  As the debacle continued, the resident proceeded to make some curved incisions while widenig the initial rather than straight, and cutting while the ATTENDING’S fingers were still in the way rather than waiting for the retractor, prompting the attending to threaten to take the knife away from the resident and make them go stand in a corner. I wish he had.

  Most of the rest of the surgery went uneventfully after that until the resident was beginning to suture closed the fascia. She was rushing her sutures, despite the attending telling her several times to slow down, and as a result, managed to poke through her gloves and stick her finger with the suture needle. This of course means that an HIV, Hepatitis B and C panel needed to be sent and the resident would have to go to the er following the surgery, and begin takign the HIV prophylaxis drugs for several months until two hiv tests could be done on the patient.

  It was geninuenly the worst surgery i have ever seen, and practically the picture of incompetence if not malpractice.

  Now i watched this resident interact with a different attending, an attending who is know for being a huge misogynist, and jerk in general, but a darn fine surgeon and incredibly competent ob/gyn. Although i admit ob is a strange place for a misogynist to be. The resident kept trying to be cute..oh dr x dont you like me, why dont we work together more, do you have something against me, dont you like me?

  The attending straight up told her…why would I like you? and returned to the procedure. Later on during the same surgery, when the foley catheter was removed and dripping water and urine he proceeded to shake it out at her, spraying the resident with urine.

  There are definetly some characters in gynecology and while again, these make for interesting stories, i would be just as happy if i continued to have more uneventful days where i do my work, see my patients and post about random links or comics.

  That said, the the boy band i am, 98 kids on the back sync, in returns for our 3rd and final performance this year which will be posted on both youtube and this site within a week or so. Til then, happy saint patty’s day, and if you live in chicago, go out to watch them dye the river green at 9:45 tomorrow morning…i will be there, and drunk!

   

  • 12:25 pm
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