View Full Version : Hey doc ollie, I cracked another chest today...


womansurg
12-12-2002, 04:34 PM
So, my record's now 2 for 5 . Another s/p CABG, PEA, bright red blood out CTs, found to have right ventricle rupture. She died.

I was thinking about ya, bro :laugh: !

droliver
12-12-2002, 06:35 PM
I've decided I'm just too old for that kind of excitement anymore. Come July its goodbye thoracotomy.....hello facelift :)

southerndoc
12-12-2002, 07:17 PM
Sweeeeeeet!

Ain't nuttin' kooler than crackin' chests. Oh yea! Let the crackin' begin!

ortho2003
12-13-2002, 04:27 AM
anyone else find it disturbing that someone is this excited about a patient that died? I don't think a smiley face belongs in that post.

womansurg
12-13-2002, 04:28 AM
Originally posted by droliver
I've decided I'm just too old for that kind of excitement anymore. Come July its goodbye thoracotomy.....hello facelift :) Hey super! I figured you were interested in plastics since you wrote so much on it (and seemed to know so much). Where are you doing your fellowship?

mikecwru
12-13-2002, 05:54 AM
Originally posted by ortho2003
anyone else find it disturbing that someone is this excited about a patient that died? I don't think a smiley face belongs in that post.

How many posts should she wait before she smiles either in a message or in person?

Here's a tip: if you evaporated this instant, patients would die, get in accidents, and have horrible things happen to them. There is nothing wrong about getting excited about wanting to take care of these patients and thinking the procedures are cool.

<hands over a kleenex>

mike

droliver
12-13-2002, 11:38 AM
Originally posted by ortho2003
anyone else find it disturbing that someone is this excited about a patient that died? I don't think a smiley face belongs in that post.

I think you aren't "in" on the gallows-humor aspects of our job. You do your best, but sometimes you will not be able to help someone. If you take yourself too seriously all the time doing the unusual demands you get during your training you'll 1) go nuts & 2) be cranky

womansurg
12-13-2002, 02:29 PM
Originally posted by droliver
I think you aren't "in" on the gallows-humor aspects of our job. You do your best, but sometimes you will not be able to help someone. If you take yourself too seriously all the time doing the unusual demands you get during your training you'll 1) go nuts & 2) be cranky Yeah, truth be told, yesterday was an awful day and the excitement and interest of doing that procedure was probably the only bright spot in my day - despite the futility of it.

I lost a critically ill patient that I'd been nursing along in the ICU for a couple of weeks. Right hepatectomy for multiple colon metastases in a 64 year old farmer. Our margin was extremely close and we ended up getting into the vena cava trying to get around it, with heavy losses. Then, he got fulminant pancreatitis postop after ERCP for persistent biliary leak. Progressive multi-organ system failure - until it just became time to let go. I had grown very close to the family throughout our battle to save him, and it was very difficult working through the decision to withdraw support with them.

So, I responded to this code in telemetry almost just to get a break from the emotion of the ICU, ended up doing a bedside thoracotomy, returned to the ICU adrenalized and with blood all over my shirt to find the entire family looking for me to say their goodbye's and thank-you's. Lots of hugs and tears.

I really needed to focus on the positives when I got home.

njbmd
12-15-2002, 05:27 PM
Hey there,
Got a chance to open my first one. My hands were shaking but once I started opening the wires, I forgot how nervous I was. Same thing as womansurg, bright red blood pouring out of the chest tube. I wasn't alone, the CV fellow arrived in time to help me out. You step up to the plate and you hit a home run. The important thing was that I just didn't stand there. Yes, it is pretty cool to know how to do this stuff and get a chance to do it only seven months out of medical school. I feel like I can say now that "I AM a surgeon" and nothing is this cool.
njbmd

womansurg
12-15-2002, 08:39 PM
Originally posted by njbmd
I feel like I can say now that "I AM a surgeon" and nothing is this cool.
njbmd Way to go, Nat! Don't just leave us hanging. What'd you find? How'd it turn out? I'll be looking for the whole story on your journal page :) .

hotbovie
12-16-2002, 05:25 PM
Boy, can't wait...it's pretty cool to think I could be doing that in less than a year.

I have had similar experience on a much smaller student scale. Last year, as I was finishing my surgery rotation, we had a trauma come in GSW to chest, coded. They cracked the chest in the trauma bay, pt was unsalvagble with a big hole in the inominate. Once the code was called, I was able to get closer to see the damage. The trauma fellow showed me how you cross clamp on both the aorta and the pulmonary artery. Then she slapped the clamp in my hand and said, "here, practice!". Granted, the patient was dead, but technically he was dead when they cracked the chest, too. Anyway, I thought it was fun.

This year, in my sub-I on a particularly busy trauma day, we started out with a trauma arrest. This was blunt trauma, so no chest cracking... but as we were waiting for the pt to arrive the everyone was deciding who would do the chest tubes and who would do the cutdowns. I asked for and got permission to do a chest tube. I got it in without any help. Later that day, the exact same scenario happened again. This time, I got my chest tube in just seconds after the intern on the other side got his in...and encountered a huge amount of blood. Both patients died (in fact we would have been surprised if they had survived, as we were doing last ditch stuff), but still I had a blast that day.

My parents think I'm weird.

womansurg
12-16-2002, 08:39 PM
Originally posted by hotbovie
I have had similar experience on a much smaller student scale....My parents think I'm weird. Not so much a smaller scale, bovie. It's pretty similar in a live patient. That's great experience that you're getting.

Your parents are right: you're weird. And so am I, and so is every good surgeon. Who knows why we get a rush out of intervening when the human body goes awry? But the fact remains: people are good at what they're interested in, and we are interested in this crazy stuff...

KG
12-18-2002, 06:00 AM
Oh boy, will I be that weird too, someday? :) (And by the way, womansurg, Peesoo is really, really cute!)