F’in with Surgeons

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Noyac

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What’s your favorite way of screwing with the surgeons whether they are friends of yours or total f*cktards?

I like to make it so that they can’t get lunch. For example, if they are so focused on turnovers and come to me because so and so from my partners is too slow then I like to put the pressure on them when I’m in there. For example, I did 6 pedi cases today and we finished an hour early, at 1:30 instead of 2:30. The surgeon would be interviewing the next pt and I’d be standing right behind him ready to go, last pt in recovery and ready for the next case. Staff is in on the game.
Today the surgeon said, “damn I didn’t even get lunch today”! We all busted out laughing. Gotcha!
 
When they ask for gallbladder position but I tilt in the opposite direction.

When they glance at me and say How they doing up there? I say, Awful.

When the pt moves a little and surgeon says They're Moving, I excitedly say, That's great! Signs of life.
 
When they ask ‘how many twitches’ and I tell them I’ll give more paralytic, I’m really giving sugammadex.


I think in the next 10 years you will see studies supporting deeper neuromuscular blockade later in surgery to allow lower intraabdominal pressures during laparoscopic surgeries, with less acute kidney injury, and lower incidence of incisional hernia for open surgeries if sugammadex is used after fascia is closed. In patients at low risk for respiratory compromise or particularly if you are planning on using sugammadex, i think it is probably beneficial to reverse later.
 
Usually just heckle them about their favorite sports teams.

If it’s a friend of mine and they have a flip room dead pan that it’s gone, OR couldn’t staff it. The sheer look of terror when a flip room is taken away just makes me giddy.
 
I like to make it so that they can’t get lunch. For example, if they are so focused on turnovers and come to me because so and so from my partners is too slow then I like to put the pressure on them when I’m in there. For example, I did 6 pedi cases today and we finished an hour early, at 1:30 instead of 2:30.
Aren't you back stabbing your fellow anesthesiologist by purposely putting the effort to make them look slower?
 
Aren't you back stabbing your fellow anesthesiologist by purposely putting the effort to make them look slower?
Sure but if they are slow enough to get mentioned to me then they need to take a look at their practice. It is customary to be slow when you come out of training. It is even expected. I’d rather you be slow and deliberate than fast and risky. But over a few months you need to show progression. If you haven’t then we sit down and talk about it. If there are areas of weakness then we focus on them. Maybe your pedi wake ups are slow. So now you do more pedi cases until a better comfort level is attained. In my experience, smart well trained people pick up the pace pretty well.
 
Aren't you back stabbing your fellow anesthesiologist by purposely putting the effort to make them look slower?
And sometimes I just make the turnover real fast at lunch time to really throw them off.
Luckily I don’t work with too many jerks. One of them has figured me out though. He won’t sign the pt until he has eaten.
 
And sometimes I just make the turnover real fast at lunch time to really throw them off.
Luckily I don’t work with too many jerks. One of them has figured me out though. He won’t sign the pt until he has eaten.

That is hilarious

I can just imagine him figuring you out in the dictation room
 
Surgeon: “Table up a bit. Wait too high - back down a little. OK that’s good”

Me: “You sure there Goldilocks?”



Mostly though I like to give them a hard time over their music choices.

If there’s something particularly pop-y or sappy I’ll say something like:
“Wait I think I’m in the wrong room - I’m supposed to be doing Ortho not OB/GYN”

Or

“Hey, what Pandora station is this - Hysterectomy Radio?”

Or

“If we’re listening to this in here, what are they playing in the waiting room?”

Or

“Hey, I kinda like this. I always wondered what it would be like to operate in an elevator”

Or when it’s something particularly slow/mellow

“You know if your gonna keep playing this, you probably don’t even need me here”
 
One GI doc is particularly slow starting his EGDs but insists we do a timeout and goes back to typing on his computer. While im inducing the patient. I wait till he is done typing then ask can i start and then give my bolus of Propofol.
 
I REALLY hate waiting for surgeons to show up after we have induced. Sometimes I will call their cell phone from the OR, and quickly say when they pick up "We've made incision, trochars are in, just waiting for you". It generally takes them a few seconds because they are trying to sort out if they forgot they have a surgical assistant who started the case without them, except at my hospital the primary surgeon has to be there for the time out for the incision, so I generally get "Um, yeah on my way" as a reply.
 
I REALLY hate waiting for surgeons to show up after we have induced. Sometimes I will call their cell phone from the OR, and quickly say when they pick up "We've made incision, trochars are in, just waiting for you". It generally takes them a few seconds because they are trying to sort out if they forgot they have a surgical assistant who started the case without them, except at my hospital the primary surgeon has to be there for the time out for the incision, so I generally get "Um, yeah on my way" as a reply.


This reminds me of one of our clever circulators who texts, “21cm at lips, where do you want the sevo set?”
 
I like to tell my patients that I really have a lot of respect for their surgeon and would trust them to care for my family members. I try to lessen their anxiety by talking up the skills of the surgeon, if it is warranted
Boom...roasted!!
FilthyAngelicJanenschia-max-1mb.gif
 
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Just finishing up residency, but when the surgical residents let the med students close at 3am - "Better hurry, we're running out of anesthesia."
 
Just finishing up residency, but when the surgical residents let the med students close at 3am - "Better hurry, we're running out of anesthesia."

Meh, the anesthesiology residents were very patient when I was learning to close as a medical student so I have no problem sitting there and letting them take their time. As long as nothing else is going on of course.
 
Just finishing up residency, but when the surgical residents let the med students close at 3am - "Better hurry, we're running out of anesthesia."

"No wonder we have drug shortages."


But, honestly we've all been med students once, I'm sure they hate being under the spotlight.
 
When the surgeon walks in scrubbed and ready to gown ask the circulator:

"Hey, did we ever get those special order size 4.5 gloves in for Dr. Surgeon??"

Back in residency, there was one neurosurgery resident I used to like giving a hard time. Whenever he came into the OR I'd ask the circulator:

"Hey, it looks like Dr. So-and-So will be scrubbing in. Is the blood bank aware?"
 
Not really messing, but always liked the look on faces when I pre-placed the defib pads, especially with ortho.


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that reminds me, i once told an orthopod who was being obnoxious during an induction that he should be ready to do a surgical airway as ‘this might be tricky’ ... i was winding him up - you shoulda seen his eyes
 
Surgeon, “15 mins until we’re done.”

Me, “Siri start a timer for 15 minutes...”

(But under the drapes I actually set the timer for 5 minutes.)

Gets them every time.

I’ll frequently do this.
Surgeon: “15 minutes left.”
Me: “So, 30 minutes, got it. Sounds good.”
 
When they ask for gallbladder position but I tilt in the opposite direction.

When they glance at me and say How they doing up there? I say, Awful.

When the pt moves a little and surgeon says They're Moving, I excitedly say, That's great! Signs of life.

I used this one a lot
 
As a resident there was a surgeon who hated any sort of noise in the room. If I remember correctly he even hated the noise of the monitor so who ever was i that room would have to turn it down and stare at the monitor all case. I mean you couldn't open vials or IV bags or he pitch a fit so everything you may use had to be pre-opened.

So being the jerk SR residents we were, we'd come offer people breaks in the room, play the game to while that person was on break, and then one they'd come back give report, start to leave, and then rip open an IV bag on the way out of the door. Outside you could hear him, "What the hell is all that noise?!" Everyone knew it was coming if offered a break in that room.
 
As a resident there was a surgeon who hated any sort of noise in the room. If I remember correctly he even hated the noise of the monitor so who ever was i that room would have to turn it down and stare at the monitor all case. I mean you couldn't open vials or IV bags or he pitch a fit so everything you may use had to be pre-opened.

So being the jerk SR residents we were, we'd come offer people breaks in the room, play the game to while that person was on break, and then one they'd come back give report, start to leave, and then rip open an IV bag on the way out of the door. Outside you could hear him, "What the hell is all that noise?!" Everyone knew it was coming if offered a break in that room.
Y'all shoulda wrote 'little bitch' on his hat.
 
As a resident there was a surgeon who hated any sort of noise in the room. If I remember correctly he even hated the noise of the monitor so who ever was i that room would have to turn it down and stare at the monitor all case. I mean you couldn't open vials or IV bags or he pitch a fit so everything you may use had to be pre-opened.

So being the jerk SR residents we were, we'd come offer people breaks in the room, play the game to while that person was on break, and then one they'd come back give report, start to leave, and then rip open an IV bag on the way out of the door. Outside you could hear him, "What the hell is all that noise?!" Everyone knew it was coming if offered a break in that room.

And your department/attendings felt it was safe to accommodate these requests to turn off all volume alarms and monitors? Nothing says respect like being told you are not to be seen or heard...
 
I think in the next 10 years you will see studies supporting deeper neuromuscular blockade later in surgery to allow lower intraabdominal pressures during laparoscopic surgeries, with less acute kidney injury, and lower incidence of incisional hernia for open surgeries if sugammadex is used after fascia is closed. In patients at low risk for respiratory compromise or particularly if you are planning on using sugammadex, i think it is probably beneficial to reverse later.

I think you just went to a Sugammadex talk.

What's the risk of AKI after a lap chole? #pawn
 
Just a thought...When fully draped, place hand over pts shoulder and give a little side to side wiggle for about 5 seconds. Draw surgeon's attention to ECG monitor and say, "hmmm, that's a weird rhythm." It will look like VF or torsades.

However, do not attempt this if there is an AICD; that would be less than ideal.
 
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