Look Ma - an appendectomy!
My attending surgeon told me to call my Mom.
We were in the process of finishing up a gynecologic surgery (and by "we" I mean the attending and the resident - I was mostly just standing there) when we came across the appendix. That graceful, slender, unnecessary appendage, protruding like a dainty pink finger from the cecum. Vermiform appendix. From the latin vermis, or worm.
I am currently doing a mini-rotation in Gynecologic Oncolgy (Gyn Onc), which deals with the treatment of cancer of the lady parts. Ovarian cancer, cervical cancer, endometrial cancer, as well as numerous vaginal and vulvar cancers and pre-cancerous lesions whose removal makes me cringe with sharp pangs of sympathy. While the subject matter is a wee bit gloomy, this rotation is exciting to me because it is 100% surgery. The best way of getting rid of these tumors is to cut them out, and this provides the medical student with an intimate tour of gynecologic anatomy. The uterus is cool. It really is.
But the uterus is close to other things. The bladder. The bowel. Important vessels. Things you don't want to cut open accidentally. So working with the uterus in surgery means man-handling these other parts, pushing them out of the way, carefully, holding them back. And this is the perfect job for a student. "Put your hand down here, Fiona." "Retract this for me." And then your hands are in. Nestled in soft warm bowel, feeling the strong pulse of the external iliac. "Suction in the hole please." You get good with suction as a student.
But I digress. The appendix. The phone call to Mother. We came across the appendix. And it is often customary, when one stumbles upon this little organ, to take it out. Appendicitis is relatively common, and can be quite dangerous, as well as very expensive. You are already in there, the theory goes, so why not just get rid of the risk? Especially since the act of being in there can leave behind scar tissue that can pre-dispose to appendicieal trouble.
So the surgeon turns to me and says, "Do you want to do an appendectomy?" Ummm... yes please. He guided me through, step by step, where to clamp, when to cut, what to tie off. "Clamp closer to the base." "Don't pull up so hard on the mesentary." "Nice tie." And then I was holding the appendix in my hand, passing it off to the scrub nurse and saying, "specimen."
Then he told me to go home that night and call my mom and tell her that I did an appendectomy today. So I did.
Congratulations! I can't believe you are cutting into live bodies... that is amazing.
(I'm guessing you didn't leave a stitch in?) :)
I did infact leave a stitch. I left many. ON PURPOSE. Stitches are good for you, you whiney baby. ZING!
This post is awesome! Congratulations. Will you cut out my appendix?
Mine, too, excise please! Just knowing it's in there, waiting to become infected, is a constant source of anxiety.
Also, I really like the profession's tradition of addressing other potential problems since you're already "in there." My auto mechanic uses similar logic, though I think his motives are different.
Great Mother's Day present...you made your Mom proud!
OH SHIT! I am so proud of you, fiona!! You are really on your way, and I mean ALL the way! You are the best doctor and I can't wait for you to cut out MY appendix. I wish I had been there to cheer for you, except I would probably have puked. P.s. call me sometime, we played phone tag for awhile and then stopped. Let's keep playing phone tag!
I forgot about mother's day! Looks like you got your present already, mom.
And due to popular demand, I will be offering an appendectomy clinic this thursday evening. I will be taking out appendices from 8:30-11pm in the van in the parking lot behind Harpoon Larry’s, located off exit 67b from I-5, next to the Schmitty’s, across the street from Mall 205. Bring $183.75. Cash only.
And thursday night is LADIES night behind the Harpoon Larry's! Half off oyster-snooters once you wake up from the anesthesia!
I just happened to stumble upon your little med school journal, and I have to say it's really great. You're an excellent writer. I'm one year behind you in med school, and I really like the way you put the medical school adventure into words. I'll keep following your journey from here on (and probably reading back through your past memories). I'm sure you'll be graduating soon enough. Good luck in everything else that you do!
HI Fionna,
As I read your stories, its difficult to remember you as that somewhat frightened LC student I drove to the ferry for that PCT experience. Congratulations on year 4. Hope to see you this month.
B.
hi, congratulations. I'm also in med school here in the Philippines. I hope my attending will give me an opportunity like you had...
Hello! I love this online journal of your experiences at med school. I hope you can take a moment to answer a 2 quick questions. 1) after removing the appendix from the intestine the caceam(I am not a medical professional) how many sutures did it require to close the site? 2) Did you use a stapling device or sutures? Thanks! I hope you answer me! I know you'r well beyond this b now. Good lck in your future endeavors.