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Tuesday, June 9, 2015

Standing up to be Happy

Woke up to a dream today, like the last few days. Ran to surgery ward where we discussed deep vein thrombosis - Virchow's triad and more. Try this question:
A very young girl (13 or 15 year old), comes to emergency room with acute abdomenal pain in the right iliac fossa. What do you do/ask/investigate?
After rounds, where we saw dramatic improvement in a thromboangiitis obliterans case after lumbar sympathetectomy - his left leg which was colder than the normal right limb has suddenly became warmer, Anie, who just landed in India last day, gave us chocolates and the best cake on Earth which her mother made.

Later had fruit salad with ice cream with Trees (who's leaving for home today), Sweety, and Maggie, followed by butter fruit juice and heard about the amazing fight over closed toilet doors in LH. Speaking of going home, Hari is also going home after having handed over Terrorist to a mess worker two days back.

My order for rechargable batteries and there charger was delivered by Amazon/BlueDart in the evening. So, while that's charging, I set up my standing desk again.

My standing desk. The zig-zag aluminium laptop stand was originally meant for using on the bed, but it is very versatile. The wireless keyboard and mouse you see on the table is not used while standing, but rather when it becomes sitting/sleeping desk.
Just as I finished setting it up, I discovered this #100HappyDays challenge and decided I'd enroll. The standing desk and the fruit salad would be happy day #1.

BTW, for that young girl, if you take her to operating theatre, you might not find acute appendix like you wished for. You ask for last menstrual period and rule out Mittelschmerz - which occurs at the middle of the cycle and presents with pain. It'd be a good idea to rule out pregnancy too.

Sunday, June 7, 2015

Turns out there's a reason why people love Surgery

Reading someone else's blog is a great motivator to write one's own blog. I just went through some of the very first posts in Lamya's blog. And the idea of documenting one's day/week in excruciating details still fills me with enthusiasm.

The reader deserves to know. They can't be left hanging off the cliff. Every story needs to be completed, or continued. If you do not plan on finishing a story, do not begin writing one (at least, do not invite readers).

Surgery is what I wasn't sure of. And it is the only thing I am sure of, now. More than my love of learning, it is Balu sir's love for teaching that keeps me hooked. Nothing is complicated. Surgery is like plumbing. Conceptually very simple, but when you get down on your knees and reach out to the corner to fix a leak on the pipe, it is a tug-war between your perseverance and the graveness of the leak. If you become lazy and do a quick hack, you'll pay for it in terms of complications soon.

Sometimes in the operation theatre I come up with ideas of building robotic hands that can go inside the peritoneum and hold that structure just the way the surgeon wants. If you watch the struggle to get the gall bladder into a plastic bag in laproscopic cholecystectomy, you'll definitely come up with such ideas. It is all about reaching into that space, why should it be so difficult? If only you could put your hands inside the body like Neo does in Matrix 2.

Fact is, that is what surgeons do. When a giant cyst is trapped inside your body, pressing on your nerves and causing you unbearable pain, all you want is someone to reach inside and take it out - something that no amount of medicine can do. That desperation is the license for surgeons to be daring. It is what lets them cut tissue knowing for sure that it is irreplacable. Surgeons live the Nike slogan - they just do it.

The results are usually immediate and dramatic. Here is a patient who's crying and dying, and minutes later he's smiling and dreaming again.

I am that patient. Hopeless and desperate before going in, and within days of surgery posting I've regained my confidence in what I can do.