Carnations and rectums

Today as I drove home from the hospital I thought, why didn’t I choose a career that made me feel smart? I could’ve become a preschool teacher. Or run a florist shop (hello, there’s only so much to know about carnations!) Instead I chose a career that consistently makes me feel stupid.
For example, my first major task of the day. Dr. T and I were examining a patient who had had surgery a week ago and had healed quite nicely. The incisions in his stomach were closed with staples. Dr. T handed me a staple remover and said, “Go ahead.”
Taking staples out isn’t rocket science; I learned it in nursing school 6 years ago. But actually, I thought as I opened the package, that was the last time I had a surgical patient and actually took staples out. They sure looked like funny staple removers, I thought, but I decided to be brave and go ahead.
“Ow!” The patient winced as I accidentally poked him right in his tender incision.
“Hold it the other way around.” Dr. T explained graciously.
I turned it around and took out the staples, one by one.
My second major task of the day came when I was watching a colonoscopy and Dr. T motioned for me to put a glove on and stick my finger in the patient’s rectum. Oh sure, I thought, why not? Doing a rectal exam is actually on my list of things to do before I die.
I stuck my finger in.
“All the way in.” Dr. T counseled me in a quiet voice.
So I went all the way in.
“Do you feel the tumor around the circumference?”
I’d never actually stuck my finger in anyone’s rectum before just to see what it felt like, but it did seem like what I would imagine a circumferential tumor to feel like.
“Yes.”
After I had extricated myself Dr. T advanced the scope and showed me the live pictures of what was indeed a well-developed case of rectal cancer.
Later in the day I scrubbed in for one of the surgeries and there is a complicated way to get into your sterile gown and I messed it up and lost the ties for my gown and the OR nurse had to use a metal clamp to hold it together at the back. During the next case I was standing near the anesthetist and he asked if I wanted to intubate the patient and I had to say yes, I had no choice. I started out holding the tongue blade in the wrong hand and he had to remind me how to tilt the patient’s head back and I got the tube in but then I wasn’t completely sure that I had it in the right place, so I had to ask him to check. It was indeed in the right place, and when we were done he said it was a difficult intubation, but I thought, if this was an emergency and I was the only one around, I probably couldn’t have done it. The anesthetist just sat there and ate bran flakes out of a Styrofoam cup and turned knobs on the monitors.
During the next case, a hemorrhoidectomy (hemorrhoid removal), I stood near Dr. T and held the patient’s anus apart with retractors while he cut out the hemorrhoid. Holding an anoprocto retractor in one position for the duration of an operation is hard enough, but being able to release it after your hand has frozen to the handle is even harder. At least the patient was asleep for most of the operation.
The surgical assistant was very nice and during one of the cases while I helped him suture, he quizzed me.
“What is the name of this fascia overlying the inguinal ligament right here?” he pointed down into the incision.
From somewhere deep in the recesses of my mind I remembered.
“Scarpa’s fascia.”
“And how do you spell it?” He asked.
“S-C-A-R-P-I-A” I said.
“Sort of.” He answered.
In the car on the way home I sounded it out in my head and tried to figure out why an Italian word was spelled the English way.
We can’t all have everything. I always said that if I had to choose between being dumb, ugly or mean, I would choose to be mean, because that was the most changeable trait. But after standing around stupidly all day I’m beginning to feel that the choice was already made for me. I was introduced as “Heather Davies, the medical student.” I should’ve just saved Dr. T the trouble and introduced myself.
“Hi, I’m Heather, and if you feel a very hesitant finger up your bum, it’s just because I’m nervous. And if you end up with a lot of air in your stomach it’s because I stuck the tracheal tube down your esophagus. And if you wake up and find my hand by your backside, its because the anal retractor is still stuck there too. And if your incision reopens because I jabbed you with a staple remover, don’t worry, I can staple you back together again.”
But all that aside, my dear readers, don’t worry. I still have many years of school ahead of me. Time enough to learn enough. After all, there’s only so much to know about rectums.