Sunday, April 3, 2011

I've been trying, for the past few weeks, to come up with a way to write about surgery. It's been difficult. The past four weeks have been a more emotional time than I expected, and in the few brief moments of downtime it's hard to reflect on or interpret all of the feelings that bounce around in your head over the course of the 90 hour work-week.

That's basically what I've been up to the past month--I worked for 3 weeks on the general surgery service at a local private hospital, taking call every fourth night. That means that in the average week, I spent one or two 27-30 hour shifts in the hospital, maybe sleeping an average of a couple of hours each time. Some nights are lucky--my last call at this particular hospital we were pretty dead and I got to crash for six hours, but in exchange for that last night on trauma call (we all have to take one night on the trauma team at the local university hospital during our rotation) I stayed for 25 hours and didn't sleep for more than 20 minutes.

I don't particularly enjoy surgery. I expected this coming in--knew that the pace of the OR, the attitudes of the field were not really a good fit for my personality. I've been lucky to work with good residents who have made it more enjoyable than it might have been, but that doesn't make standing still for 6 hours, covered in a hot gown/gloves/mask/hat combo, craning your neck to see something that you will never be allowed to touch all that much better. I also never really want to see another gallbladder in my life.

It's stressful, this feeling of being so totally not cut out for something. I want to do well, to impress my residents and attendings and learn something even if at the same time I want to run away from this rotation as fast as possible once it's over. But I come home at the end of an 11 or 12 hour day, with barely enough time to cook dinner before it's time for bed again and still there is studying that must be done in order to pass the test, still there are things to be done around the house and things that, amazingly, I want to do in my spare time even though there is no time in which to do them. The stress of having to balance all the things that you want and need to do while managing this kind of schedule (especially sleep deprived) is what has made this rotation so difficult. There is no time to rest, no time to sit on the couch at the end of the day and take a breather or think about the day or talk with loved ones for a moment to regain some shred of humanity. That is the toll that surgery is taking on me. Long hours are do-able, boring work is tolerable, even rude or absent team members can be dealt with for a few weeks at a time, but the feeling of running ragged with no chance of ever catching a breath takes a mental toll I wasn't prepared for. (And of course, it doesn't help that I apparently don't do well in hot rooms when my blood sugar drops--add fainting once and having to sit down to prevent fainting another time to the list of stressors--and embarrassment. Woot.) I will be very glad when the next few weeks have passed and I can find myself, can let the tension go and breathe again.

The next 2.5 weeks should be better. I am back at the children's hospital, doing pediatric surgery with people who, while still surgeons, are much more pediatric-minded--more open to teaching, more talkative and friendly, and of course where there are kids and smiles and fewer whiny adults who complain about their need for potato chips the morning after appendectomies. I'm back in my happy place, even if not exactly doing the job that makes me happiest.

But still--April 29th can't come fast enough.