I’m back at school again, and while I don’t start classes for another two weeks, I am doing a neurosurgery clerkship for the next two weeks. Today was my first day. Despite my jet leg and weird sleeping schedule, I managed to make it on time for 8am.
Today I stood in the OR for 5 hours. My back is in pain. My muscles are stiff. But it was a nice experience watching surgery. First up was an emergency aneurysm at the internal carotid artery near its bifurcation at the Circle of Willis. The attending I’m following opened up the skull no problem. Up next, because the aneurysm was so deep in, the resident used a microscope-like device for a clearer image. The was also hooked up to a TV, so myself and two other students got to watch. At one point, while the resident was trying to clip an artery, he accidentally nicked it – blood! Panic! Blood was pooling and tension rose. Suction. More suction. Now under pressure, the resident had to make sure to properly clip the artery before it was too late. Two clips went in to stop the bleeding. The anesthesiologist started the timer. With the bleeding ceased, the resident clipped the proper artery. 2:30 and 3:00 on the other clips. It was time to take them off. Success! The proper artery was clipped and normal circulation was restored. The resident, however, stressed and anxious, took his frustrations out on the student OR nurse that was assisting. He yelled at the head nurse. It was an awkward moment. She wasn’t even at fault. But the bleed was fixed and the surgery continued. The aneurysm itself was big – so big that the resident cauterized as much of it as he could, but left the rest. And that was it, the meninges were sewn back together, as was the skull and muscle, and finally the head was sewn shut. Just over 3 hours.
And there was no time for a break either. My attending hopped right over into the next OR for the next patient who suffered an epidural hemorrhage with an intracranial contusion. The patient was placed on his side, his head held in place by a heavy-duty, metal gadget. I helped. I also got to shave his head. This surgery went quickly without any complications. Because the hemorrhage was epidural in nature, the meninges weren’t cut and the brain wasn’t exposed. The attending removed the hemorrhage with ease and quickly sutured up the patient. It was 1pm and we were done.
Luckily, the attending introduced me to some nurses (where I’ll be every morning) and my day was done! Yippee! Only now do I realize the value of Tim Hortons coffee. No matter how gross, the caffeine does keep me up. And because I left home with no breakfast and no caffeine fix, I was tired, pooped, and had a massive headache. And for the rest of my clerkship, I get to start at 7am instead of 8am (groan). Tomorrows goal is to eat breakfast and drink something caffeinated before I head out.