I'll miss renting....

Sorry everyone, I will be back real soon, I promise. In my defense, I have been house hunting. Found one. That was the easy part. I have had issue with both the mortgage broker and the realtor since the offer was accepted. Seems they don't always think of what is in your best interest. I have had a crash course in fending for myself, because now I trust neither of them.
On the up side, it is a very nice house that has been well maintained and is fenced and cross fenced which works well for the horses.
So today I went into town to do a lap chole, and on the way in, I was totally pissed at both realtor and mortgage broker. I was rehearsing which piece of my mind I was going to give them each next time I talked with them. I had pumped myself up with adrenaline over all of the inner dialogue.
Then something interesting happened. After helping remove a sick, friable, fat encased gall bladder from a cirrhotic liver (yes people, you may able be hide alcohol consumption from the outside, but you can't fake it on the inside), I was changing in the locker room to go home and suddenly wondered why I had been sooo pissed at either the realtor or the broker. Everything had neutralized in my head and seemed to make sense now. And then I realized what a relaxing, meditative, restorative therapy surgery is for me. It's more Zen that any hobby I've ever had.

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So, what happens to your blog when you die? Does it have an expiration date too?

Slacker

Sorry, I will resume posting soon. Lately I've been having an easier time lurking. I've come across some blogs to add, Ah yes, residency, Neumed and retrieved T's blog which somehow missed the transition when I changed Internet browsers. I also discovered that Panda Bear is leaving us for good but will return with a book someday.
I always think of ideas for posts when I'm lurking but finding the time to type them up seems to be the holdup. Comments on other blogs however, seem to take no time at all.

Oh say can you see?

I have seen the inside of many people, from the bones of their extremities to the deepest parts of their abdomens and pelvises, or is that pelvi? I've even been privy to the inside of their skulls, where the pulsating gray and white matter rose up slightly after the skull flap was removed, as if in a subtle greeting. Many have been exposed before me and I thank the powers that may be that I have never been exposed in such a manner. Due to a knee arthroscopy years ago, the joint of my right knee is no longer virginal, but none have seen beyond that. For my knee scope I had spinal anaesthesia (as was the standard where I had it done) and I requested no other drugs for the procedure so that I would remain alert and I could watch. It was great, and of course I still have the pictures
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But I am so curious! I want to see what the arthritic joint of my right index finger looks like on xray. I have a constant urge to "accidentally" leave my hand under the c-arm when the surgeon calls "Shot" in hopes of gathering a glimpse. Once, while seated during an ankle case, the c-arm image revealed a patella! The surgeon moved the ankle slightly and requested another shot. There it was again, a ghostly, blurred, yet undeniable image of a patella. I then realized that it was my knee, under the table in the path of the image intensifier. But alas, the realization came too late for me to study the image.
My brother had his gallbladder removed. There was no video and no pictures. Not that it is routine to do so, but, if I ever have a lap chole, I want to see what lies within my peritoneal cavity. Take the tour to my pelvis and show me my uterus (I am always amazed at how small they can be!) and tease out my ovaries so I can check on them also. If it's not retroperitoneal, may as well peek at my well behaved appendix too. But don't do a prophylactic appendectomy just yet, I still have not made a decision about that! Back up towards the diaphragm and check out my pulsating heart against the left wall. Perhaps a peek along the left and right paracolic gutters seeing what can be seen without manipulation. I suppose I would want leave the rest alone so as not to disturb the natural resting places of my remaining organs.
What kind of images come back from the wireless capsule endoscope? I imagine something like Fantastic Voyage, though I'm betting it's not as fantastic. Yet, when the time comes for my colon check-up, I wanna see! If I need an EGD, video please!
The one organ of mine that I hope no one ever gets to see is my brain. First I don't want anyone laughing at how small it is, or how much larger the right side is than the left! Secondly, if someone is looking at my brain, whether it be from a hole in my skull or a diagnostic image, I've probably got bigger problems than I care to see
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I have some bizarre thought patterns from time to time. Just the other night I was riddling, "Where do frogs and toads go in the winter?" I opened the front door to let the dog out and there, for the first time this year, was a toad (frog?). As I pondered I realized that I could hear toads croaking all throughout the arid neighborhood. So, where did they go for winter? South? There are no ponds, creeks, lakes or fountains nearby so why are they here now? Do toads even care about bodies of water?

Six word memoir

I've been tagged by Sterile Eye to come up with the six word memoir. It was actually much harder than I thought it would be. I had many variations, most seemed to beg for seven words. Of course I wanted to reflect upon my first love, assisting in surgery, since it consummates my life's passion. After several days this is what I finally came up with.

Sometimes, even four hands aren't enough.

Seems a little benign, (it's hard to relay a lot of passion in six words, unless it 's the other kind of passion, if you know what I mean) but for those of you who have been there, you know that indeed, sometimes a third set of hands is a blessing.

Now, to tag six others! Since this meme has been going around a while, I am running out of people too. Let's try MBA at Addicted to Medblogs, Rad Girl, anybody over at MDOD, there are so many entries there now I can't keep up, vitum medicinus, and I'm out of taggies.

Ambulance Chaser

One day while visiting my father I noticed a device sitting on the floor next to where he sat on the couch. I had seen it there before on numerous occasions. My father had a ham radio operator's license and I had always assumed it to be a walkie talkie or some sort of hand-held ham radio gadget. Then one day, I held it. The clouds parted, a brilliant light shone down from the sky, and I think I heard harp music somewhere in the background. As I turned the volume switch on, my father who had decided that my career in the medical field was at last, something he could be proud of me for, brightened when he informed me, "I have the ambulance programmed in there." And so began my relationship with his scanner.
When my fathers health worsened and he could no longer remain at home, the scanner went everywhere with me. I think he got a kick out of it, inquiring if I had heard anything interesting on the ambulance channel that day when I would go to visit him. When he passed on, the scanner became part of my inheritance.
Since that time I have modified the channels, deleting the ham radio frequencies, adding fire and of course, all of the med channels, flight channels and ambulance dispatch channels. I now know of incoming traumas before the OR does.
Very few people know that I own a scanner. There seems to be a sort of cheesy, busybody, Jerry Springerish stereotype associated with scanner owners. I'm careful not to call the OR and ask, "Is that GSW coming down?" or, "Is there anything surgical coming down from that ped vs. auto?" because that would be cheesy. I still have to wait to be invited to the trauma-rama, but when I am on trauma call it gives me a heads up and I can get the animals and myself all set to go so when the call does come to me, I am ready to roll. There have been a few occasions when I "just happened" to be in the vicinity of the trauma center when the OR called.
Now if I can just get them to give me a trauma pager........

Day dreaming

Today I am blowing off a baby shower for a friend of mine. Don't fear, we are having another surprise shower for her next month. Of course since it is a surprise, she doesn't realize we are having another one for her and she will probably resent me until then.
Instead, I am listening to Bongi's interview on the DR. A show. I was unable to catch the live broadcast. In listening to Bongi speak of the medical training in his country, I think it would be a method that I would enjoy. Gathered from his blog posts and this show, I envision it as shotgun training so to speak, sink or swim, flying by the seat of your pants, relying on yourself and your own skills, hand sewing instead of stapling, knowing how to do open procedures before you learn them laparoscopically.
In my desire to assist on general surgeries, I never count laparoscopic surgery. It is it's own category, a non-surgery so to speak. When we are doing a particularly nasty lap chole and the anatomy is skewed, things are bleeding, there are adhesions everywhere and the common duct is not easily identified, I have been known to chant in my head, "Open, open, open..." Some surgeons will stubbornly plod on for a great length of time and then finally decide that it is time to open in order to finish the procedure safely. Others stubbornly continue on until they have conquered the diseased gallbladder through the camera, as if opening is admitting defeat.
In bowel resections I'm always happy when the surgeon does a hand anastamosis, it means more for me to do. A double layered closure of the anastamosed lumen of the bowel is definitely an art form and in my opinion, definitely worth learning.
I am not sure on the money conversion but it sounds as if medical school and surgical training is much less there. Something I may actually be able to afford. Of course, it is probably all relative if you remain in South Africa to practice. I don't know the laws but often surgeons trained in other countries (continents!) are not allowed to practice in the US. Even an RN's training may not be recognised. The years spent in school are fewer it seems, beginning just out of high school (high school is a very distant memory for me) with what sounds like a more streamlined curriculum. Science, science, science, and perhaps fewer of the filler pre-reqs that you'll never remember nor use again.?
I think I had better start practicing my accent......
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Noncommittal

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Things are brewing in the/my world of orthopaedics. An offer is on the table for me to be exclusive with two orthopods and possibly a third if he wishes to join in. I will only be dedicating Mondays and Tuesdays to them. The rest of the time I am free to freelance as I have been. That includes keeping up with my trauma surgeons. I can't give up trauma and thank goodness the ortho docs aren't asking me to.
The paperwork is being drawn up and we will sit at the table soon to fine tune the contract and seal the deal with blood ink. I've come to realize from this deal and the attempt to find a house (my first!) to purchase, that I have some moderately serious commitment issues!

Response to J.B.

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I recently (okay, not so recently. I apologize for the delayed response J.B.), received an email asking my advice on becoming a Surgical Technologist and if I thought that it was a good career choice on the path to becoming a doctor. As I was typing away my reply in gmail, I thought that this might make a good post for anybody else who may be wondering the same thing. I also encourage any tech students or prospective students to feel free to ask me any questions they may have relating to the field. While names will not be revealed, I may post the question and response so if you don't want it to be posted, let me know when you email me.
I have precepted my share of students and always enjoy teaching. I see so many "experienced" RN's and Techs do things that are not acceptable. Sterile technique is one of my biggest pet peeves and I am not above chastising a circulating nurse for breaking rules. Oh, but that is a rant for another day. On to the answer.......
"Is Surgical Technology a good career to get into on the path to becoming a doctor? "

I think becoming an ST is an excellent path to MD. I know of several surgeons today that held various positions in the OR while going to school on their path to becoming a doctor. Some were orderlies, some were techs, transporters, etc. I understand that having a job in a hospital and more specifically, in a patient care area, such as transport, ER tech, OR tech, to name a few, is beneficial for students on any path to medicine whether it be nursing school or beyond. I am told It looks good on your application and it helps you get accepted.
The nice things about being a surgical tech, at least the things I found great about it, are hands on experience with patients, the camaraderie of the OR, feeling the pride of being on a professional OR team, the chance to be immersed in the entire surgical process, and a not so bad paycheck. You will read about anatomy and study the pretty colored pictures in the anatomy book, but you won't fully understand anatomy until you look inside the real human body. If you simply listen to those around you, especially conversations between the surgeon and the anesthetist, you will learn a lot. What you don't understand, ask or look it up. I have yet to find a surgeon who isn't willing to teach someone who is eager to learn. I find it rewarding when I am research something, and then within a few days actually see it come to life in the OR. If you truly want to learn and you are motivated, as a surgical tech you will be in the best classroom in the world and, you are getting paid to be there!
The drawbacks as an ST might be taking call, working holidays, too rigid of a schedule for working around your school hours (be sure to discuss this with the local hospitals you may work for after graduation), and having to live within call distance of the hospital you will work in. Call response time is sometimes fifteen minutes but more typically half an hour.
If you choose to become a surg tech, you will know almost immediately whether or not it is for you when you begin your clinical rotations. This is the point where many students realize the full extent of their future job requirements. I will say that you should have a tough skin and not let things that people say get to you. You will probably get yelled at more than once and it may very well be by the surgeon. The mistake is to take it personally. Don't argue, listen. If you are being yelled at, there is probably a lesson to be learned. If you still have an issue or feel you were attacked unjustly, take it up with the offender after the case.
You may find the sights, smells, sounds, and sometimes the conversation of the OR to be offensive. If your clinical site is at a very busy hospital, you may find that standing for eight to ten hours a day is very tiring. Your feet may burn, and your legs may ache, but the good news is, you get used to it!
Surgical Technology can be a very demanding career, but it can also be very rewarding.
Thank you for the question, J.B. I hope that my response was of some help. Feel free to contact me anytime should you have more questions, and good luck to you in whatever path you choose.
MMT
makeminetrauma@gmail.com