[Album: We Are Young Money]
Brief Explanation by Request:
Crates: the tangible facts and figures we are supposed to learn in Medical School.
Hippos: the intangible memories and experiences that we inadvertently pick up in Medical School.
"And now we murderers. Because we kill time."
Officially past the halfway point of this two-month rotation in OB/GYN.
Time is flyin', almost as if it's just dyin'. Fortunately, most of the time was spent smilin'.
Medical School has, amongst its greatest powers, the ability to warp time. Each year seems to go faster than the last. Sometimes it's welcome, as with the first 2 years of school, we couldn't wait to get into the hospitals and at least pretend to be doctors -- well we all but blinked and suddenly we're here. Then there are other times when time steals away priceless moments from right under our feet as is, unfortunately, the case with celebrations and farewells.
"I like the way you walkin' if you walkin' my way.
I'm that red bull, now let's fly away."
crate --
}}} Robot-Assisted Surgery
I have spent the past week with the Gynecology service and had my first exposure to the Da Vinci surgical robot. Change and progress is almost always welcome but I couldn't say if the benefits of a metal octopus (as the robot so effectively makes me think of) are worth it. Regardless of anything, however, the Da Vinci is impressive without a doubt.
"Pressin' me like button downs on a Friday night."
The robot itself is controlled entirely from a separate console and has been described as something close to a video game. Button presses and lever movements are translated to the quiver-less movements of each robotic arm. Those of us not controlling the robot are able to see all the action from multiple monitors that output directly from the robot's camera. It honestly looks like Call of Duty...except with tiny arms for guns and pesky fascia as your main enemy.
The primary idea behind the Da Vinci robot is that it is 'minimally-invasive', which might be the hottest trend in surgery since sliced flesh. It does this through the use of multiple arms, cameras, and interchangeable tools that enter the body using incisions that are no bigger than an inch or so. It's quite ingenious. Especially when you find out the system makes use of CO2 gas to inflate body cavities in order for the arms to have enough room to function. Very clever.
I had the opportunity to assist with two major surgeries involving the Da Vinci: a myomectomy and a total hysterectomy -- both of which were performed as a definitive treatment for Menorrhagia secondary to Uterine Fibroids.
How far surgical Crates have come. Instead of a wide open scimitar-like gash the Patient enters recovery with 3-5 baby stitches. Improved recovery time is supposed to be the biggest advantage and I've heard of Patients going home the same day or the the day after major surgeries that used to require a much longer hospital stay.
Each procedure approached 5 hours, which to some may sound reasonable, until you realize that the conventional 'open' versions of these procedures may only take 2 hours or less. Debating all the factors that go into Robot vs. Conventional are Crates I am entirely unfamiliar with, but as far as I can tell it's a constant tug-of-war between better Patient Comfort/Recovery and Cost of the Robot/Surgeon.
Is the Change worth it?
"I'll let you be the judge. And I'm the case."
}}} The Residents ended their Rotation Yesterday.
It's not only Medical Students that are shuffled from Rotation to Rotation but Resident Physicians as well. Admittedly I did not realize this until this past week even though it makes complete sense.
"That's when we disappear, you need GPS to find her."
It's a logistical Crate and the only way to make sure Students and Residents are allowed the opportunity to gain the knowledge and experience to become fully-fledged Physicians.
It was a bittersweet moment, but it was part of the natural order of things in the world of a Teaching Hospital. We are always happy to accomplish something and to have gained not only the knowledge but the memories from time that has transpired. In the end, it ultimately serves as a reminder that time is one of the most fleeting things in existence. Too fleeting in this case.
They were amazing Residents.
hippo --
}}} Our Residents ended their Rotation Yesterday.
We have our First Hospitals. We meet our First Patients.
And seeing us through all of this are our First Residents.
It's an overused joke that July is the worst month to get sick and go to the hospital. Just like Zedd's Clarity, however, there is a reason popular music is constantly replayed on the radio and a reason why sayings become cliche. There is truth in the saying....and sometimes solid lyrics with a good beat.
First Year Residents/Interns historically start on July First along with 3rd Year Medical Students. Everything is new. Everything Changes. Everyone is trying to learn and adjust to different challenges, temperaments, and environments. The few Attendings and the handful of Veteran Residents are stretched thin in their HippoCratic obligation to their Patients and their dedication to Teaching.
As a Medical Student the sentiment is made very clear -- that we should not be in the way, learn all that we can, and should not be in the way. We hear horror stories of getting less-than-courteous superiors and of the ceaseless 'pimping' that goes on to simultaneously show us gaps in our knowledge while shattering any remnants of self-esteem.
I'm not sure if it is an anomaly but none of that really happened. It wasn't smooth and easy by any means. There were definitely more than a handful of times when the red hot spotlight was focused on us and the only escape was the dreaded sign of defeat, confessing: 'I don't know.'
We have our First Hospitals. We meet our First Patients.
And seeing us through all of this are our First Residents.
It's an overused joke that July is the worst month to get sick and go to the hospital. Just like Zedd's Clarity, however, there is a reason popular music is constantly replayed on the radio and a reason why sayings become cliche. There is truth in the saying....and sometimes solid lyrics with a good beat.
First Year Residents/Interns historically start on July First along with 3rd Year Medical Students. Everything is new. Everything Changes. Everyone is trying to learn and adjust to different challenges, temperaments, and environments. The few Attendings and the handful of Veteran Residents are stretched thin in their HippoCratic obligation to their Patients and their dedication to Teaching.
As a Medical Student the sentiment is made very clear -- that we should not be in the way, learn all that we can, and should not be in the way. We hear horror stories of getting less-than-courteous superiors and of the ceaseless 'pimping' that goes on to simultaneously show us gaps in our knowledge while shattering any remnants of self-esteem.
I'm not sure if it is an anomaly but none of that really happened. It wasn't smooth and easy by any means. There were definitely more than a handful of times when the red hot spotlight was focused on us and the only escape was the dreaded sign of defeat, confessing: 'I don't know.'
"Don't stop you the bestest.
And I be coming off the top as-bestos."
We didn't dodge the usual rites of passage...where we fully realize our position at the bottom of the totem pole. We were told we were wrong. We were relegated to the furthest corners of operating rooms. We were interrogated about extensive lists of differential diagnoses and medication dosages. It was tough, but it was constructive. Tough-structive, if you will.
It seemed like our Residents knew exactly what we were going through and what was going through our minds. Of course when I think about it I give myself a mental slap in the face because for most, if not all, Residents they literally were in our position at least sometime in the last 5 years or so -- of course they knew. (Duh).
"Running back and forth -- soccer team."
As such, there was never a moment where we felt dumb or deficient. When one is 'pimped' and you don't know the answer it's a law of the universe that you never get that question wrong again. Now.
That law is fulfilled in one of two ways:
That law is fulfilled in one of two ways:
1.One.
You feel guilty and inadequate so you learn the answer to escape negative thoughts/feelings.
2.Two.
You are disappointed. You let your Attending/Resident down.
You want to make them proud and there is no way you're going to let that happen again.
You are, in a way, inspired. Driven.
It seemed like more of #2. One month. Our very First month as 3rd Year Medical Students and our First foray into the wards and clinics as pseudo-professionals...it could not have been better -- learning has been running on encouragement instead of being driven by guilt and that is without a single doubt the best way.
As far as Hippos go, encouragement is a much better fuel.
Hungry, hungry Hippos could never get enough.
I hope it doesn't come to pass that this experience truly was an anomaly. Regardless, whether this is normal or not, I know that our Residents made it this way. They were the First to start shaping the blank slate of our clinical acumen. Undoubtedly we will encounter a countless number of Residents in our career but none of us will ever have another set of First Residents.
These weren't just Residents or the Residents. These were Our Residents.
"I'm too loyal, and too focused.
To be losing, and be hopeless."
Really gonna miss them.
}}} The Double-Edge of Emotion
In discussing the sentimental repercussions of our Residents leaving, a colleague lightly joked that it is our duty to not get too emotionally attached -- that any Emotion in our profession is a bad idea. This is especially the case for our Patients, so as to not erode our objectivity and clinical judgement.
I agree.
(But that comes with a sharp pang of resistance.)
"Okay, I get it. Let me think. I guess it's my turn."
Because -- I don't agree that there should be zero Emotion.
At that point we are just as good as the Da Vinci robot. Sure we may be a tad more precise, and we will be less shaky. We will move with greater surety and deliberation. But without anyone or anything at the controls we are useless.
Who drives the robot but the human at the Da Vinci controls?
And what drives us but the Passion for our work and genuine Empathy for our Patients?
Emotion is the human fuel. Without it we have no explanations for what we do. No motivations for what we do. Medicine is an Art as well as a Science? A Hippo as well as a Crate?
Then we'd only be fulfilling half of our obligation. We would be practicing half-Medicine if we deny that part of us that makes us perfectly imperfect. There is such a thing as too much Emotion, there is no denying that, but to be devoid of it is just as bad if not worse. (At least Emotion provides Purpose).
Why do we care for terminally ill Patients?
Why do Children's Hospitals look different from conventional ones?
Why haven't Da Vinci robots taken over?
Why, despite the constant and accelerating pace of change in Medicine,
has the role of Healer generally stayed the same for thousands of years?
Because we are Human. Only we could possibly come close to understanding what we are each going through. In the end, Change is generally good. Our Residents are moving on to master a new set of skills and circumstances. We, as Medical Students, will learn a fresh new set of Patient approaches and clinical techniques from the next set of Residents.
But, I can't deny that I'll miss Our First Residents.
I'll leave the emotion-less circuits and calibrations to the robots.
Hippos don't run on electricity.
"Cold as a winter's day. Hot as a summer's eve."
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