Word's finally getting out that I am serious about assisting for the trauma service.
I
volunteer to be on call to assist the trauma surgeons anywhere from 5 to 7 nights a week. There are five surgeons who know they can call me whenever they are on. Most traumas that come to the OR, with perhaps the exception of some ortho trauma, are indigent. Victims of the notorious "SumDood" never seem to have health insurance or for that matter, a job. I can't bill Medicare or Medicaid or the (state? county?) indigent health fund. Put it all together and you'll see that my reward is not monetary. I do it because I love it. I do it because every surgery reveals a new technique, another anatomy lesson, a chance to fix or remove what's broken, torn or punctured. I like to participate in restoring a bloody misshapen mess back to neatness and order. My scheduled cases pay the bills, trauma cases are all about the adventure.
About a week ago, just after midnight, I was called in to assist on a stabbing "victim." I had not intended to be available that night, but I could not refuse. Lucky for me, or maybe more appropriately, as fate would have it, the trauma surgeon who was working that night is Chief of Trauma Services. I had expressed my interest in working in some (or any!) capacity with trauma services to him about a year ago. Perhaps a hospital paid position of some sort. My vision includes staying in-house, being the liaison between the ER and OR, relaying accurate information between departments and expediting surgery starts by helping the OR crew get set up and ready, assisting on the operation, whether it be as a first or second assistant, and doing whatever I can to help post-op. I'm sure he had all but forgotten about my year old inquiry. Since that time, there have been indications (from my Favorite Trauma Surgeon, who said he will recommend me) that some sort of position may indeed be forthcoming, and it may well be a position that I qualify for.
"Do you come in a lot?" Asked the Chief, as he explored the first gaping wound to see if the knife had penetrated the peritoneum.
"It depends on the surgeon on call." I replied.
I was able to rattle off the names of three of the five trauma docs who call me on a regular basis before the conversation was interrupted. I wanted to steer the conversation back to the original topic but, I have learned the hard way that sometimes less is more when I want to illustrate a point.
The peritoneum spared, we irrigated and closed one complex abdominal wound, and one not so complex. He thanked me for coming in and we said goodnight.
The next day my scheduled cases were scattered around at three different locations but I ended the day at the trauma center. I was on call with my Favorite Trauma Surgeon (F.T.S.). Around 1830, just as I was about to wrap it up and wander home, the trauma pager went off so I headed up to the trauma bay.
I don't know if this season has begun in other parts of the country, but here the depression is already overflowing. Almost a parallel to the holiday shopping season which seems to begin before Halloween these days, the Winter/holiday blues now start in the Fall. Our trauma is an attempted suicide by shotgun that managed to miss everything vital on that side of the face, but due to the damage intubation is not a viable option and airway is an immediate issue. We need to set up for an emergency tracheostomy. Off I go to the OR where we have bumped an ortho case. The room is already opened because we will use the ortho set up for drapes and sponges. The scrub has added a trach tray. I call the anaesthesia assistant and I drag the difficult intubation cart and the trach cart into the OR. I explain the truth of the situation to the Anaesthesiologist, dispelling the rumors which have made their way to the OR quicker than I could. The circulating RN has everything in place. I go out to the control desk to meet the ER crew and my F.T.S. as they roll in with the patient.
We are underway with the procedure when in walks none other than Chief of Trauma Services. He is here not to scrub in but rather to document the wound. First I think nothing of it but then I realize that he is seeing me with one of the trauma docs that I mentioned to him just the night before. His attention is on the extent of injuries and not on me, but I know that he knows I am there. He knows that I am serious, and he knows that my F.T.S. really does rely on me. And I feel as if I'm one step closer to that rumored trauma services position. All trauma all the time, with compensation! Talk about a dream job.
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