Feeling more like a surgeon

The phone went off at 4:45AM. I had already been laying awake in bed for 10 minutes, wrestling with the idea of getting up and starting another day. It was day 7 of my 2 week stretch without a day off, the black stretch that the R2s have to go through once every month. I already knew what the phone call was before I picked up. Someone had bled into their brain on the neurosurgery service and had to be red-lined to the OR, they needed backup for getting set up for rounds and needed me in early. I was out the door in 10 minutes and driving over to UCLA. After setting up things for morning rounds I relieved my co-resident in the OR and flew through the surgery with the attending. The senior residents were called away for rounds, leaving me as first assist on a pretty awesome case. We cut down to skin, him on his side of the incision, me on mine. Scalp up, periosteum off, drilling down to bone with bone dust flying with the blood and irrigation in minutes. By the time we opened dura the brain was so tight it started to ooze out of our incision. We cut open the rest of the dura to relieve the pressure and started sucking down over the sick looking brain. We found the blood clot quickly, and sucked it out along with the tumor that had bled. Once we had stabilized the bleeding and removed the rest of the tumor, he took off because he had to drop off something for his son. It's a great feeling to be the primary surgeon in any case, being able to go at your own pace and doing things in what you feel is the best way of the various techniques you've been taught. I finished closing the dura, plated and screwed on the bone flap, and was closing skin by the time my senior residents popped their heads to see how things were going. They cracked a few jokes, complimented my work, and left again. It was a great way to start the day.

This is our lot it seems. There's never really ever going to be a day off. Even when you're off duty, you can be called in at any time if they're short staffed. Death respects no vacation days, and for our hospital there's about 10 neurosurgery attendings and 15 residents. The residents are split up amongst 4 different hospitals, and the attendings aren't always in town. We're always on pager in case something comes up, being woken up in the middle of the night or post-call because we may know some critical piece of history or information that wasn't passed on in the rush of morning rounds or sign out. Yea. I'm tired. Vacation is coming up though. Hopefully I'll be able to get some sleep.