Surgery

In medical school, we “rotate" through all different specialties so we can pick the one we like the best. Right now I'm "rotating" through surgery.

I actually like surgery. It's the first time this year I've gotten to "scrub in." That’s the hospital term for scrubbing-your-hands-and-forearms-with-brown-colored-sopey-stuff-that-leaves-you-skin-with-a-brownish-hue. The point of scrubbing is to prevent the spread of infection; very important in surgery, as I'm sure you can imagine.

Basically, the operating room is divided into Sterile Areas and everything else. The Sterile areas are noted by their blue color and consist of tables, draped in blue cloth upon which surgical tools sit, the scrub nurse, clad head to foot in a blue surgical hat and robe, and the patient, who once prepped and draped, becomes an honorary member of the sterile field.

Before you scrub in, you can't touch anything that's sterile. That means stay far away from anything and everything that's blue. I still cringe before placing my hands on anything blue outside of the OR. That includes furniture, clothing... I've been trained well.

Once you’re scrubbed, you can’t touch anything that ISN'T sterile, or blue. So after "scrubbing" you walk into the OR, butting the door with your hip, with your hands held up, not too low, because then their not sterile, and not too high, because then their not sterile. Generally, the scrub nurse is an expert in all things sterile, so when entering the OR, I generally look to him/her for instructions which usually consist of- don't put your hands there, your hands are too high, your hands are too low, watch the table... Basically the scrub nurse protects the OR from the medical student.

Anyway, once you're scrubbed and in the OR, the scrub nurse holds up your sterile gown, letting you put your hands in the sleeves. You also do a "twirl" maneuver to tie the sash of the gown, where another person holds part of the sash, and you literally spin around. I felt really uncomfortable with the gowning part of the set up because I felt like having nurses essentially "dress" me was demeaning to them- tantamount to having them fan me and feed me grapes.

But, it's not demeaning, and it's all in the name of sterility. And, once you've been gowned and put on two sets of gloves, you can help out with the actual surgery. Today this involved holding retractors. In the same position. For a long long time.

Plant Dignity

So I was reading the Wall Street Journal yesterday. And in amongst the articles bewailing our economy, there was an article on the subject of plant dignity laws in Switzerland.

These plant dignity laws have made genetic engineering experiments quite difficult, as scientists try to breed pest resistant crops and other such things. Now, ethics committees have to get involved to determine whether or not these experiments compromise the dignity of the plants.

My peas just met a very undignified end. I can only hope that they didn't suffer too much.

The World is Coming to an End

At least according to the news.

I can't turn on the television without getting really really depressed about something. I'm worried about houses being in foreclosure (I don't even own a house), I'm worried about the fact that the FDIC insures up to 100,000 dollars, it doesn't seem like enough (I have much, much, much less than that in my bank account), I'm worried that the fed will drop interest rates (?? this might benefit me through my loans), I'm worried about what will happen if there's a bail out (my taxes might increase!!), and what will happen if there isn't a bail out (eek!)...

When I think of my day to day life, it hasn't changed much. My house is near my school so I really don't drive very often, cutting down my transportation expenses as gas prices soar. I live on a medical student diet of Diet Coke, Pasta, and Noon Conference food- my food costs have not increased significantly.

My day to day life has not changed in the slightest. I'm broke, I'm scavenging for free food, I don't drive very often, I'm "paying to work..." yet I have this sense of impending doom. The whole world is falling apart. It's only a matter of time before I go down in flames.

And that's when I turned the channel.

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The Name

So, Emily Forest isn't actually my name- It's not that I'm ashamed of my illness; it's just that it's probably better not to advertise. Especially given my position as a medical student. If I ever become a world famous _________ then I wouldn't try so hard to hide it. But, right now I'm in a position where I, like all others in medical school, have to prove myself, have to come off as professional, able to handle pressure, enthusiastic, trustworthy... all of those adjectives they put on the evaluation sheet next to check boxes indicating "rarely observed" "sometimes observed" all the way to "always observed." And aside from not being professional, able to handle pressure, enthusiastic, trustworthy, you'd better not piss anyone off, particularly on certain rotations, such as ________ (it may be different at different schools- fill in whatever is relevant to you), or you'll end up with a check in the "rarely observed" box.

So, anyway, the name. It's actually my "porn name." One night at summer camp, after "lights out" when we were technically supposed to be sleeping, one of the other girls asked each of us the name of our first pet and the street we grew up on. Basically, if you combine these two entities, you get your "porn name." And, it's supposed to be something like Peppy (your first dog) LaRue (your childhood street). My first pet was named Emily, and I grew up on Forest Street, so I came up with Emily Forest.

And, that is the name I write under. So I can be enthusiastic, together, and trustworthy on the wards.

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Hiding It

So, I'm pretty good at hiding it. But, there are little things. I live in fear of forgetting my medication, so I keep it in my Coach wristlet among my credit card receipts, random change, and crumpled dollar bills. I usually keep about a day or two's supply on hand- the hospital I'm at is a ways away from my apartment so if I forget, I'm a little screwed.

Mostly, everything's fine. I go to the pharmacy, I keep my bottles full, I put pills in my purse, I take them, and I'm normal.

Except for when I'm not. For instance, on Monday, after going to bed quite early Sunday night, I found myself falling asleep during rounds. My face didn't really want to smile, and my feet were perfectly happy to remain still while waiting for the elevator. Life wasn't bad, just a little boring. That, and I felt that if I could find a couch, I'd be able to nap.

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Emergency Room

As a medical student, I spend quite a bit of time in the Emergency Room. Actually, I spent quite a bit of time in the ER before I went to medical school as well. It's just now I'm not waiting around on one of the beds with my latest skiing/ hiking/ biking/ walking accident. Instead, I'm buzzing around with a clipboard, finding patients, asking them if it's ok for a student to interview them (the answer is always yes- some people think that students are the same thing as residents, they forget that I'm a student, they don't understand the white coat distinction...) And then I start. I start by asking every question on our school supplied H&P template. The template is quite thorough, particularly the review of systems. And, because I'm just learning what is important, I have to ask all the questions. And, even though I'm learning that someone's right knee pain may not be relevant to his acute myocardial infarction, I still have to ask all the questions. We have preceptor group, and should I have to utter the sentence "well I didnt ask about his right knee..." during a discussion, then I look bad. And medical school is all about not looking bad in front of people.

Anyway, the ER. So, I'm buzzing around the ER with the History and Physical template and clipboard in hand, when I see my psychiatrist. Now, I have a regular psychiatrist, but she's away right now so I have this replacement doctor who works for the school. I figured that he had a patient in the ED and was visiting him/her to ask why he/she'd taken all the tylenol. I came back to the ED a few hours later, and my psychiatrist was still there, perhaps questioning another patient of his about why he or she took all the aspirin. Anyway, the psychiatrist was there all day, because, I imagined, his whole practice was going down. And all his patients were in the ED in various stages of distress.

Later I found out that he works in the ED and that those were not HIS patients.

I find this heartening.

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Plastic Surgery

As a medical writer, I end up having to research topics I wouldn't ordinarily think to research. Lately, I've been writing a lot for plastic surgeons so I've learned all about hyaluronic acid fillers. These are injected under the skin to "fill things out" and smooth wrinkles. And, they all have names that conjure images of fresh faced youth, like Juvederm. There's even a new product, called Radiesse, that stimulates the body to actually produce its own collagen.

Growing your own collagen isn't always a positive. Elephant Man, who some believe suffered from Proteus Syndrome, was very adept at growing his own collagen. That would not be a good way to explain the way Radiesse works. "Did you ever see the movie, The Elephant Man? Well, a lot of the way he looked had to do with collagen overgrowth, and actually, the stuff that I'm about to inject under your skin with this giant needle, causes your body to start growing more collagen... Hey! Where are you going?! Don't you want to get rid of your wrinkles?"

I'm happy to report, though, that if you are not happy with the way you look, there are many solutions including Accent skin tightening, Juvederm, Radiesse, Botox, face lifts...

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