Subaqua Sternal Rubs

The smell of acrid smoke just hung in the air for hours. Despite repeated exposure, the noxious odor of burning flesh is something I never really can get used to. So maybe this surgery thing really isn't for me, and I should stick to Emergency Medicine. Well, that and I was having real difficulty (pain) with my back after standing for 4 hours straight. (Chronic issue after lifting too many obese patients on the ambulance/in the hospital.) Oh well, it was worth it because we got to see 3 surgeries instead of just one.

Unfortunately, the original surgery we were scheduled to see was cancelled because more invasive imaging showed that further intervention would not bring benefits that outweighed the risks. I feel really bad for the guy, and he is going to the US for further treatment, but I really doubt that there is anything more that they can do there at this point.

When we walked in the the O.T. (Operating Theatre, a.k.a. OR), the surgeon was just finishing up with a hernia repair on a 4-yo. Unfortunately, we were about 45 minutes late. Who knew there could be 45-minutes worth of traffic on a small Caribbean island? Anyways, not much to see there, but we were invited to observe one of the major cases of the day, a radical prostatectomy.

However, this case was pushed back on the schedule for an emergency C-section. That was kind of cool, since 1) you could see everything, and 2) despite being on an ambulance of 7 years and in a hospital ED for 8 years, I've never seen a birth. I can't tell you how relieved I was when, after a few seconds of silence, the newborn started screaming. Almost immediately thereafter, the baby was removed from the OR, so I really didn't get to follow-up on him/her (I really didn't check, for some reason.) After the newborn was delivered, the placenta was removed, and the Fallopian tubes were ligated. I guess this woman had enough of this pregnancy thing.

Finally, the gentleman with the prostatectomy was on the table. He had originally presented a year ago and had a PSA of 11. Upon returning a year later (he was a sailor and spent long periods away from home), his PSA had risen to 22. Biopsies of the prostate showed a relatively aggressive cancer, and the decision was made to remove the prostate. It is a rather delicate operation, because there are numerous blood vessels and nerves that attach or pass close by, not to mention that the urethra passes right through the middle, and cutting one of these can lead to incontinence and/or erectile dysfunction. The surgery went pretty well, even though it was kind of hard to see, since there were 4 surgeons around the patient and a deep field. All in all, the morning was rather educational.

Alright, I need to get back to studying… Two weeks to go until the first exams…

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