Sunday, July 10, 2011

The Art of an Operating Room

For whatever reason, I missed out on a general surgery rotation in my third year of medical school. It was replaced by random surgical specialties which were educational, but did not cover the basics of surgery. Now that I am rotating with anesthesia, I am seeing a larger variety of surgery than I could have imagined.

Effects of Cold Steel

In only a week's time I have observed surgeries from head to toe and everything in between. Some abbreviated and others extensive. All bring their own sense of fascination as they are usually a definitive treatment for the patient's particular condition. On numerous occasions I was able to witness cases that I thought were simply for the textbooks; in other words, those that rarely make their way into the operating room. Skin grafting, thyroglossal duct cyst removal, gangrenous cholecystectomy, thoracotomy, colectomy, craniotomy to name some that have stood out. After meeting up with the anesthesiologist and putting the patient to sleep, I stick around if the case has some educational appeal. Since I never had the traditional general surgery rotation, I am doubling up this month to get the most possible from this experience.

Life in the O.R. is an array of medical art. Everyone has a role and moves to fill it with precision. The colors of contrasting sterile blue against blood red seem to glow under the lights while everyone mysteriously peers over their masks. Instruments shimmer in cleanliness as they move to and from the operating field. The sounds of monitors keeping pace, instruments doing their job and personnel collaborating fills the silence creating an ambient effect. In concert everyone works together to see that the patient has a positive outcome. It's a beautiful place to observe and learn, it's a place where things get done. 

Question of the Week
A febrile 12-year-old child presents with severe right lower quadrant
pain that is interpreted by the attending physician as acute appendicitis.
The patient has also been complaining of joint pain. At laparotomy, the
surgeon notes that the appendix is normal; however, the mesenteric lymph
nodes are markedly enlarged and contain focal areas of microabscess
formation on cut section. This patient is most likely

A. An asthmatic
B. Deficient in C1 esterase inhibitor activity
C. HLA-B27 positive
D. Leukopenic
E. Serologically positive for toxoplasmosis

Answer & Explanation

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