The Little Shop of Horrors

It is funny how you gain perspective quickly when you start to compare other people's circumstance with your own and then you quit wanting to be such a crybaby. So I think my life is misery that I have no sleep, no respect, my skin is peeling off and I think I am allergic to surgical scrub or the hospital because I have developed a bad rash all over my body, am constipated for being chronically dehydrated because I am either stuck in the OR and can't drink, or I am out running around like a mad chicken and don't drink? This is what I thought as millions of children lay hungry and people are dying for no reason?

That is until I met up with someone I will call Fettucini because I relate everything to food.

Ms Fettucini had the unfortunate circumstance of meeting up with OB/GYN, the Birthing-cum-Vagina doctors, who said she needed to have her whole female plumping permanently removed from her system, which will make her incapable of having any children so she wouldn't contribute to the amassing amounts of hungry children in the world. Three weeks later, she developed an infection which led to abscesses that formed on her insides, in her abdomen. Abscesses are like giant zits and like giant zits, they have to be popped or they won't go away. She gets admitted into the hospital, because giant zits in the abdomen are awful painful, and comes see the surgeons.

The surgeons say, as is a typical response you would expect from a surgeon,:
"That's why people who have only 3 years of training in the OR are not qualified to operate on people."
Surgeons suffer 5 years, plus some, of agony while Vag Docs get to do it for only 3 years before they are allowed to hang a shingle on their window and open their Little Shop of Horrors.
They decide to manage it conservatively and sent her to the Interventional Radiologists.
IR people wanna be surgeons but, unlike surgeons, they also want to play golf, own a million dollar mansion, go on extended vacations in Tuscany, drive their nice high-end series BMWs and Benzes, work 9-5, and never take call. They think they are more superb than the surgeons because they get to study about physics and atoms and use big xray machines to help them place drains and lines and stuff like that into people.

IR gets called in to help drain Ms Fettucini's abscess. They think there may be a pocket in her lower back they can get to with their big xray and they stick a drain into her abdomen from behind. Three days later, Ms Fettucini is still in pain and she is spiking a little fever and her drain is draining something looking like poop. We take her back to the Xray men who take a picture of her abdomen and find now that the abscess cavitiy has bored a hole through the small intestines and she is draining pus into her gut.

The surgeons want to try to treat this but not cut into her uneccessarily (can you beat that, a righteous surgeon?!). Two days later they take another picture of her abdomen and now, there are tiny abscesses everywhere in her abdomen.

So back to the OR she goes, nice little tattooed Fettucini whose greatest concerns were: 1) we don't screw up her tattoo she has around her belly button, and 2) no one sees her without her dentures. She is thirty-three, with no spleen and front teeth because her boyfriend had the shit beaten out of her, she has no uterus and ovary because she had such bad HPV infection her OB/GYNs had to remove them and she has HIV, which someone gave to her when she was 22.

So we open this woman and the first thing the surgeons said was this:
"What the fuck is this?" as he surveys the angry abdomen with intestines bunched up in a knot, pus pockets littered everywhere.
It is always comforting to know that even the surgeons can't tell the difference between pulverized flesh and minced meat.
"Is this the colon? What hole is this?"
Fettucini is a jig-saw we are trying to put together. The right side of her colon was stuck to her abdominal wall where it was presumed that when the Vag Docs went in to take out her uterus and ovaries, they had "bagged" the colon with a stitch as they were closing her up.
After what seems like hours, we flush out every abscess we find, clean her out, and then we went fishing for the drain the Xray men put into her that was draining something looking like poop.

When we finally find it, we find it hiding in her small intestines and it was draining out what was looking like poop, instead of pus, because it was poop that was draining out of the drain. We had to take the drain out and fix the hole that the drain had made so poop doesn't drain into her abdomen.

And as we were closing, we find an ovary with an angry fallopian tube that had to come out. (Wait, wasn't it supposed to be out already?)

So now, Fettucini is spleenless, uterus-ovary-less, with holes in her intestines, has HIV, is toothless and she is 33. However, we made sure her tattoo around her belly-button looked as symmetrical as the day she acquired it.

What is my little rash compared to that?

By the way Polk and associates in Waterbury.....stay away from them.

My Pet Stoma

Mrs C, like 75% of the general population who has chosen to eat processed food and grainless bread and pastas, whose concept of fruit is something like Sunny D orange juice, and whose idea of vegetables is canned peas and baby corn, has diverticula disease. This is The disease of the modern world. A world that can afford to grind their grain down to nothing and where pizza is a main food group, with olives standing in for roughage. It is basically a pooping problem, or an accumulation of years of straining to poop until the eyeballs pop out of the socket. Over the years, the ass settles into the couch until there is a dent and the stomach shelves out so there is a place to put that favorite can of soda. Over the years, the colon is subjected to constant forces as Macdonald's and KFC make their way out of the digestive system with more difficulty than they would desire. And little by little, the walls weaken where blood vessels enter. And eventually, they start to bulge outwards into the abdominal cavity where bits of what once were Whoppers and Bacon Double cheeseburgers get caught in these blind pouches, which can number into the hundreds, and erode a blood vessel or worse yet, get stuck permanently and give you the wickedest stomache known to man. Such attacks come and go as the body takes care of the local infection but what can happen is that occassionally, an eroded blood vessel doesn't want to stop bleeding or the pouch gets so heavy that it bursts, spilling remnant Chilli Cheese Fries and Chicken Fried Steaks into the inside of your abdomen. This is really bad doo doo (in more ways than one) and can land you in a hospital, very very sick.

Mrs C had one too many of those wickedest stomaches known to man with bleeding that won't stop and developed a bad infection so we went in and whacked out the left side of her colon. However, it wasn't safe to put her colon back together so a hole was made on the side of her abdomen and a bit of her colon was pulled through to the outside. This is a colostomy, we affectionately also call a "stoma", and a bag that goes on the outside of that is a colostomy bag.

I had the utter pleasure of changing this bag today. Fortunately for me, it was empty.

As the old bag came off and the new one put on, Mrs C glanced at her stoma, naked for the first time, and eeked!
"It's so strange looking," she said, starring at the beefy red mouth at the side of her tummy. "How bizarre."
And very thoughtfully she added:"The implications of having a colostomy bag just hit me."
For a brief moment, she looked sad.

"I know what you can do," I said, trying to think of a quick way to distract her.
"You can give it a name."
"What a great idea!"
She then looked at me trepidatiously.
"You won't be offended if I named it after you, would you?"
"You want to name your stoma Edna?"
Seriously now. I was thinking more on the lines of "Squirt", which would have been far more appropriate.
"Why not, since you're the first to change the bag."
Well, blimme.

As we rounded with the attending and the chief resident that day, I hear the usual attending speak; congratulatory tone; about how we will watch and see how things are and how good Mrs C is doing after her operation and how well she looks.
"We'll have to wait," he said. "Hopefully, Edna will open up and things will start moving along."

I've been known to be full of shit and have bouts of verbal diarrhea once in a while but this pet stoma is putting it a little too literally.

Stupid is as Stupid Does

It's Friday at 6:30 pm. I have been awake and on my feet since 3 in the morning. All I want to do is to go home, put my feet up, eat my dinner and watch brainless TV. I go to my locker, where I have my bag and in it lies my car keys that would take me home, away from the psycho madness of this surgery rotation, where you get yelled at for every which reason and you are never right.

I push open the door, look at my locker. I look at my locker again.
Was there a lock on it this morning that I wasn't aware of?
Did I put the means of my way out of this nightmare into a locker with a lock on it I had no clue how to open?

No. I swear there was no lock on this locker at 3 o'clock in the morning. There was talk of a lock to be installed but no one told me they were going to install a lock like today.

Oh oh. It's 6:30 and on the brink of the weekend and there is not a soul in sight except the rustle that the hurried make as they shimey out of a place they don't want to be because it is work. And my car keys are locked behind a locker that has a 1000 different numerical combinations that would open it. Some one help.

No one is around and when I find the night surgical nurse, I try to explain to her the situation and ask her to call the supervisor in charge of the lockers who had the lock installed to see if she possibly had the combination to the lock that is preventing me from going home.

"It's the weekend and no one is around and this isn't an emergency," she said.
Bitch, I said, since I cannot get to my car keys, which is locked behind this locker, keys that will take me home and even if I were to walk home, I would have gotten mugged or killed, judging from the superb neighborhood I live in and besides, my house keys are in the car, which is locked, whose keys are in the locker, which also is locked, which makes this A BLOODY EMERGENCY!

"We can call security and maybe they can cut the lock," she continued.
How can they cut this lock when it is not cuttable since it is attached to the door of the locker?
She shoots a are-you-stupid look my way and mouths out these words, painfully slowly, as if English was not my first language:
"They take a bolt cutter and they cut the lock."
Are you stupid? Have I not just explained to you why a bolt cutter will not work on this lock? I give up because it is futile to explain to stupid people how stupid they are.

So security comes with a bolt cutter and enters the women's locker room.
He takes one look at the lock and says:
"Oh no, I can't cut this lock."
No shit, Sherlock, I said. I tried to explain to stupid but stupid insisted that she knew what she was talking about, she being a nurse and all.
"I'll have to see if maybe we have a key to this lock or a combination otherwise I'd have to cut a hole through this locker."
Security gets in touch with his supervisor who asks:
"Are you sure she is the owner of this locker, does she have some kind of ID?"
I would have nothing else better to do, on a Friday night, at 6:30 pm, after having been on me feet for the past 18 hours, then to fuck around with you because I would like to steal a pair of ass ugly purple scrubs from a locker and for your infomation my ID is in my bag right next to my car keys which are being held hostage behind a locked locker.
"Are you sure there wasn't a lock on it in the morning?"
Jesusmothermaryjoseph, Fuck me.

So finally stupid gets on the phone and gets in touch with the other stupid who authorized the lock be put on the locker and did not bother to notify the occupant of the locker whose car keys are in the locked locker and who would have loved to eradicate all the stupid nur...people in the world with several sticks of dynamite since they don't have any use for their brains anyway.

The other stupid says: "Oh, the combination to the lock is in my office on the desk." In her office, on a desk which happens to be behind a locked door. Just like that; like I was superman and had xray vision and could see behind concrete walls or better yet, like I was elastic woman and could squeeze into her locked office to retreive the precious, secret combination, or bestest yet, like it was just extremely ok that she put a lock on a locker and not bothered to notify anyone except her expanding behind and then acted like nothing happened.

Sercurity had to be called again and they finally get the combination and I finally unlock the locked locker. By this time it is 8:30. Precious TV watching time has been intruded upon, thanks to stupid people.

By the way the combination is 5-41-39. Don't fucking forget it.

Two days later, I pass by the office of the other stupid who authorized the lock to be installed.
"Did you get the combination?" She yells at me as I whizz past.
Yes, stupid, two days too late and no apology. What sort of fucking shit is that and I paid for a chance to come here and subject myself to crap and abuse like that?

Who is the stupid one?

Mad World

I actually enjoy surgery clinic. People are in and out of there so quick and their problems are so easy to solve. Right upper quadrant pain after a fatty meal? Ok, your gall bladder needs to be out. Lump in your breast? See, we have to get a sample of it and if it is not looking good, the lump needs to come out. Bulge in your groin when you cough? Well, we'll have to go in and stuff your intestines back into your abdomen and make you a new inguinal canal. Red, hard lump in your armpit that looks like a giant zit? Well, we'll have to pop it like a zit. No shit like when did the cough start; what time of day does it happen most often; what type of job do you/did you/have you ever done in your lifetime; do you have a family member that has, ever before, is now currently smoking? Has anyone in your family died of cancer?

Time consuming inquisition that sometimes leads to nowhere because the vast majority of regular folk have no clue about their family history or the current condition of their health. You're the doctor, they say, go figure it out. Most aren't even aware that 3/4 of the infomation that is needed for their care comes from them knowing how long they have been coughing, or if an uncle had cancer and what type of cancer it is. We are supposed to magically come up with an answer and just because we can't sometimes because of lack of infomation, people are quick to send us to the gallows and question what all that education was for. It's a two-way street, people.

I digress. So, I am in surgery clinic and loving it because it is so problem and solution oriented most days, whipping people in an out like in five minutes. As I am getting ready to book someone I saw for inguinal hernia repair, my chief says to me:

"You will die in internal medicine, I can see that."
Not looking up from my writing I said:
"Are you trying to tell me that I should be a surgeon?"
She says: "Yes."
"Is it because of my personality?"
She says: "Yes and I don't have to tell you that; you know it."

I smile but inside, I am SCREAMING until my eyes pop from the inside.
BUT I HATE SURGEONS!!, I said in my head, how is it that one of them recognizes that I am one of them when clearly, I have no problems yelling at people when they don't perform or have no patience when they are stupid and bring in a family member from another patient's room to interpret for our spanish speaking patient? How is it possible that I can have no regard for other people's beliefs especially if it interferes with taking care of the patient or that my ego is so big, I flop over myself and get pissy when things don't go my way? How is that possible?

I am in a philosophical quandry; on the one hand I am such a rebel, wanting and thinking I can always give a fresh spin to things and constantly challenging the way things are done, on the other hand, I find the better aspects of surgery challenging, rewarding and on some level satisfying like the time I got to sew a 18 inch facial gash shut on a drunk cyclist who colided with an SUV. Psych! I hope I didn't sew his eyeball to his eyelid.

But wasn't that what I said about medicine, about anesthesia, about psychiatry.......?
Is there something I will do that will make me happy?
Will I ever be satisfied?
Is the grass always greener on the other side?

Damn it, someone give me a crystal ball. I have half a mind to visit a psychic.
And I hate surgeons so how can I hate myself?

Stardate Log 787357

Surgery Core Day 23

Today I fell asleep for a second while holding the retractor in my hand as the surgeons masserate this man who needed to have his appendix out. I had only 2 hours of sleep for the past 24 hours.

Next thing I know, I am told that the Chief resident (Big Kahuna, me little plankton) was terribly irate because short little middle eastern surgeon, whose head is way too big for his body and who probably has Penis Envy, said that he had an asian female student fall asleep at the table. Gee, since I am the only Asian and the only Female student at this rotation, I wonder who he could be referring to?

I am told I am fortunate he didn't throw me out of the OR suite, which I would have been more than thankful for and would have promised God I'd go to church for the next 5 sundays for.

Retractor No Name

Stardate Log 541221

Surgery Core Day 22

There is now no more skin on my hands. I think I have been yelled at for various things that I have become oblivious to what it is that I have now done wrong. For example:

Another wonderful day in the OR where the attending never ackowledges your existence and you might as well be another piece of furniture. In fact I have conveniently, for their benefit, renamed myself Retractor No Name.

We are doing thyroid surgery. Cut, separate the fascia....."What muscle is this, Retractor No Name?"
"That would be the Platysma."
"Very good." I have been elevated now to living, breathing creature, thank god.

Locate the Strap muscles, separate them and viola Thyroid pops out.

"Retractor No name hold this." A retractor named after someone I would care less of knowing gets shoved in my hands.
"Doctor Resident hold this." Thyroid is shoved into the resident's hand.

Now is the ballet of right angle, tie, scissors, cut as they isolate every freaking blood vessel this humongous thyroid has.

Right angle, tie, scissors, cut.
Hold this!
Move this!
Move this!
You! You didn't have breakfast this morning?

You who? Doctor Resident you or Retractor No Name you?!? Move, hold what?! Thyroid or retractor named after someone I have no desire of getting to know probably because he is dead?

Of course it was Retractor No Name Almighty Attending Surgeon, whose time is too precious to waste and who thinks his shit don't stink, was referring to.

And it was my fault that the surgery had to pause like a split millisecond because I didn't have Wheaties for breakfast and I didn't understand the Arabic that Almighty Attending Surgeon was telepathically transmitting to me.

I, The Sucker

Stardate Log 271311
Surgery Core Day 1

After fuddling with thoroughly scrubbing my hands raw, I enter the surgery suit with my elbows raised, dripping soap and water. The room is surrounded by women, whom I shall here on now call Bitches, with their claws retracted and the hair at the back of their necks standing on end. Had I known this beforehand or had anyone forewarned me, I would have adorned full body armor, including spit proof face mask to ward off acid saliva that would melt the better half of my face.

Unsuspecting, I smile and curtsied, practiced good manners my mother taught me and before I knew it:
“Watch your hands! Keep them at the level of the nipple!”

I jump out of my skin and thought I had murdered a lamb.
Trauma Primary survey: 6-inch gash across the face with claws that were sharpened with glee.

The day moves on….I am trying not to contaminate myself by picking my nose or scratching my ass, so I put my befuddled hands on the draped patient and freeze.

“Don’t lean on the patient or put any weight on him!” Meanwhile, surgery instruments are placed on his face, the surgeon has his weight thrown over the man.

I am trying to be helpful now because she-who-hands-the-surgeon-his-tools-Bitch is not paying attention and jabbering away like no one’s business. So I hand the surgeon his pair of Adson’s. The day is saved and surgery moves on without a hitch or so I thought when this comes:

“I HAND THE SURGEON HIS TOOLS!”

After that, my life was hell.

Bitch took back the suction, which had been my tool in the OR, I the glorified sucker, who pays the institution for the opportunity to suck fumes and blood and shit out of the sterile field, and have, additionally, paid these people to rip me a new one any chance they get because their little menial lives are too pathetic to even comment upon whose sole importance in life is to hand the surgeon his tools just so they can say they participated in surgery, saved a man's life, and pointedly illustrated to me how she, Bitch, is the Queen of the OR suit. Nothing was ever said. Instead, when I asked for the scissors to cut suture after the incision has been closed, another one of my senseless “jobs”, Bitch ignored me and handed them to the surgeon, another little pointed message meant at fully maiming me.

And like that, Surgery scrub-in day 1 ended.
Trauma Secondary survey: My left eye has been gorged out, my tongue is nowhere to be found and I have lost both my arms.
Imagine…….I have 12 more weeks of this shit.