Simultaneously best and worse shadowing experience: I'm following the senior surgery resident on Vascular. They're in the OR doing a nonemergent splenectomy for a large splenic artery aneurysm. The attending is a talker...seriously stream of consciousness level, describing what he's doing, what the resident should be doing, down to minor details like how to orient the tips of the instruments. Nonstop information deluge, and I had found a friendly anesthesiologist that day, so I was on a stool behind the curtain looking almost straight down on the whole thing. It was a phenomenal experience, perfect for someone like me who had no idea what would be on a surgeon's mind during a procedure. Sure, it can be more fun when they chat, but this was educational.
Then the doc's constant words start being peppered with "what are you doing?" and "you're a 4th year, you should know this" and the like, constant corrections, repeating himself...you could see the resident get flustered and start making more and more mistakes, the anesthesiologist starts loading the patient up with blood. Finally, the attending tells the resident to page the Vascular fellow and get out. He proceeds in a hurried silence.
At this point, I felt more than a little awkward. See, though I was 'on the service' in general that day, I was technically assigned specifically to the resident. She could tell me to go see something else if she wanted, but without a specific instruction from her, I was to follow.
I did NOT want to follow her. No resident who just got reamed out by their attending wants some snot-nosed premed who just saw the whole thing tagging along. And besides, I wanted to see the rest of the operation. So I stayed.
The rest of the procedure went smoothly...the doc controlled the bleeding, the anesthesiologist kept the patient's pressure up, the patient was young and otherwise healthy, able to handle a large volume loss, etc. But it was eye-opening for me, to be sure. Not only on the technical front - though it was interesting to see how people responded when things started to go south, something I did not see in my other shadowing sessions - and not simply because of the thought process on display. The thing is, I want to be that attending someday, or close enough, but to get there, I'm going to have to be that resident. I will frak up, and get in trouble, and maybe even, as she did, get into a situation where even the scrub nurse comments on my technique after I leave. I will have to not only put up with that, but learn from it. Honestly, as humiliating as it was to have all of the mistakes described in detail like that, the doc's constant description/advisement is exactly what I hope I encounter at that stage, because I'll learn from it. But it really drove home how intense the path I'm signing up for will probably be.
