Third Week of Internship (Cont'd)

Optimism is described as having a happy and content outlook on life no matter the circumstances. This is exactly what any surgeon has to entail. One cannot be pessimistic that the surgery can go wrong or focus solely on the level of error. Every surgeon that I have seen comes into the OR with a smile planted, fully ready for the obstacles that lie ahead.

On Wednesday I was able to observe Dr. Brian Jewett the Assistant Professor for Otolaryngology. He performed a scar removal and fixation. Apparently this patient had had a previous surgery in which the stitches were not properly done and most likely caused an abnormal scar. The procedure was a careful excision of the scar and stitching the dermis and then epidermis with precision and care.

However, Dr. Jewett explained to me that technical factors are only some of the effects of bad scarring. He began a conversation, being the professor he is, about teaching yourself to learn as if your brain was a filing cabinet. In that file cabinet each file is marked with something specific such as the scarring in this surgery. Pull out that file and there several sub-categories like “technical factors,” “patient history and genetics,” and “optimized healing.” When we are younger, memorization is often easier to harness than this method. But our memory weakens as we age so this method makes the answering process much simpler. Dr. Jewett stated that he wished he would have learned about this during high school and undergraduate studies because studying would have not been so cumbersome. I immediately thought that this could be something I could in my prospective future as a college student and beyond. Anything that makes the studying process more efficient is vital to survival in school.

Later, I was lucky enough to enter a special procedure that is rarely done in Sylvester. In fact this was the first time the hospital was going to do a hysterectomy, which is a removal of polyps that formed in the walls of the uterus. The endoscopes were extremely handy in this case because it would not make sense to cut into the uterus when it can be done noninvasively. The tiny camera was placed through the vagina and clamps were used in conjunction to literally scoop out the masses of uterine tissue. Dr. Carlos Medina, Director of the Division of Female Pelvic Medicine and Reconstructive Surgery, did the case. It was an overall interesting to see the endoscopes used for something other than noses and ears. It shows how versatile and useful any piece of technology is.

Finally, on Thursday I observed Dr. Donald Weed, the Resident Program Director for the Department of Otolaryngology. He is really funny and sarcastic and finds humor in anything. That is why I was going for in the beginning when I mentioned the importance of optimism. You should enjoy what you are doing and have to a certain level fun in the OR. I got to watch him perform a thyroidectomy, a removal of the thyroid. The surgery lasted about three hours and was similar to one from earlier this week with the parathyroids except much easier because a thyroid is larger.

While this procedure was not that exciting as some of the others I have seen, it was made engaging by Dr. Weed. He explained each section carefully from the moment of incision to the stitch. Part of medical studies is teaching and having that facility allows knowledge to pass from one generation to the next. We will have future thyroidectomies and will need to have surgeons on task with what they have to do from “A” to “Z.” I found the teaching aspect of medicine to be a noble cause and should be made regulatory for all hospitals to have students scrubbing in or watching how doctors speak to patients of potentially fatal disease. Dr. Weed and others like him are definitely making a difference for the future.