Road trip

Up at 4, in at 5, and freezing all morning...that was how the day started.  Fortunately, it got better from there thanks to having a good team and a very good senior resident.  After morning teaching (which was actually really good...one of the residents did some nice tumor board presentations and one of the surg onc attendings gave a really good look at a relatively new procedure that may allow partial rather than complete removal of the uterus for certain cancers, which in turn often permits retention of fertility -- neat stuff!), the senior told us that there were really no cases for us in the OR today, and that she was going to head to UPMC Passavant (about 30-40 minutes north of Pittsburgh) to help one of the attendings there with a couple of cases.  She told us that one of us was welcome to come along, but we were also welcome to stay and help out with floor work.  After a brief discussion with my classmate, I decided what the heck, why not?  A change of scenery would do me some good, right?

I have to say, it turned out to be a good decision.  I got to scrub in and assist with a pair of cases (including some suturing), got some studying done (our first case started almost 2 hours late), and got some really good one-on-one teaching with the attending and senior resident.  Our first procedure was a laparoscopic bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes, abbreviated BSO) and laparoscopic assisted vaginal hysterectomy (removal of the uterus through the vagina; it's actually a pretty cool procedure) in a patient with complex endometrial hyperplasia with atypia (very high risk of becoming or coexisting with cancer).  It was a semi-involved procedure, particularly the hysterectomy -- all three of us crowded into a small space, with the attending and I holding retractors so the resident could see what she was doing.  It went pretty smoothly, though.  Afterwards, I got to stitch up the umbilicus and got some very useful suturing tips from my very, VERY patient resident (subcuticular suturing is something I need a little practice at...).  The other case was just a brief dilation and curettage (D&C) in a 63 year old patient with cancerous lymph nodes but no known disease focus.  It took about 10 minutes to rule out endometrium as the primary source.

That was pretty much my day at Passavant (well, other than the nurses trying to set me up with their daughters...much laughter was had at my expense).  It was definitely a worthwhile experience, so if you're a medical student and doing gyn onc, definitely take any opportunities that arise to help out offsite.  It's good times -- and highly educational.

Anyway, that's it for me for tonight...I'm bone tired, so I'm gonna head to bed.  I'll be back on Monday with further updates and tales (and possibly briefly over the weekend to comment on football, but we'll see...I'd give that one a Bill Belichick "questionable.")  Till then, peace and God bless!