What's the bloodiest case you have ever had? (blood dripping off the table, puddles of blood, etc)
Ruptured right iliac artery. 72yo male who presented to us with right lower extremity dry gangrene and several peripheral artery disease. We took him to the cathlab, went into the left and right groins with wires. We then stented his right and left iliacs with the hopes of improving outflow to his legs. Essentially finished the case and shot a completion angio... a huge extravesation was seen at the end of the right iliac stent. We threw another stent, continued to bleed. Then another, then another. After deploying 4 stents with the patient actively bleeding out of their right iliac the attending turned around and yelled, call the OR, tell them we are coming down. Started jamming blood into the patient in the cathlab and got him to the OR. Did an ex-lap and half of the patient's original blood volume spilled onto the table/floor. We kept up with his blood losses early, and the patient survived. Had a rocky ICU course, by the end of the night ~7 hours later, we had replaced his blood volume and then some, probably ended up getting ~25 units of blood total by the end of his hospital stay. The patient left the hospital out the front door on Thursday last week
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Is surgical residency as grueling, rigorous, and stressful as it is reputed to be? This question comes from a premed w/o the experience of say, an M-III.
Yes, but the human body is more resilient than people think. The volume of information is astounding. I can't remember who said it, but it is like trying to drink from a fire hydrant. I work 80 hours a week, but am still expected to be reading for cases on my own time, preparing presentations and studying. You very quickly learn what you can live without and what you can't. If that latter category requires more than 40 hours a week, family, social life, sports, TV, whatever, you are going to be miserable.
How many hours of sleep do you get per day? I'm interested in surgical specialties, but I can't seem to function properly with <6 hrs of sleep. I don't if I will survive residency if I ever get to that point
I sleep 5.5 to 6 hours a night, but I have always slept that much and would be sleeping that much even if I wasn't a resident. I would say that it is hard to guarantee more than 7 hours of sleep, but for the most part, except when on call (most places, every other weekend or once a month), it isn't hard to get that 7 hours if you need it. My typical schedule is as follows:
4:00 Wake-up, brush teeth, eat a yogurt, play with the cats for 2-3 minutes
4:15 Start running to hospital (~2 miles)
4:30 Shower
4:45 Meet with night float team to find out who they admitted overnight or what issues there were
5:00 Chart check all the patients on service (25-40 patients), update the list, identify issues that need to be dealt with and prepare for rounds
6:00 Round with the fellow
7:00 Run through the team list with the nurse practitioner
7:30 - 5:00 Cover the floors, morning is mostly discharges and dealing with overnight things, afternoon is mostly consults and ER patients. If things are slow and the NP has everything under control, I'll slip into the OR. We typically have 5-6 ORs running, so it is always easy to find someone who can use extra hands.
5:00 sign out the service pager to the night team
7:00 leave the hospital (between 5 and 7 finish seeing consults, taking care of post op patients etc)
7-10 - me time, I rock climb twice a week, but for the most part those hours are reading for cases the next day, research, preparing presentations etc.
You have the hours to sleep. I burn ~30 minutes every day running to the hospital and needing to shower at the hospital. I choose to climb a couple times a week. I also make sure that I read at least a little bit every day. The question is what your priorities are outside of the hospital.
