June 12, 2003
ATLS

Today was the first day of ATLS, the course that certifies each of us to be member of a trauma resuscitation team--obviously a necessity for all surgical specialties (especially when you consider scheduled elective cases are in reality controlled trauma). As I topped the steps to the 3rd floor of the hospital, I found myself walking behind a quartet of big, strapping guys, all in polo shirts, khakis, and dress shoes, all around 6'2".

Ortho.

They really couldn't be anything else.

And when it comes down to it, of the interns, the largest fraction at Duke are Ortho. I think there are half as many General Surgery categorical interns as Ortho. I wish I was interested in fixing bones because I think Ortho is a fantastic specialty, but alas, I'm stuck with the "general misery" of peritonitis, running the bowel, stabilizing trauma, &c.

Honestly though, today I realized that my choice, though not the most rational (because I could have gone the accelerated-track Internal Medicine clinical research route that would have me subspecialty boarded within 5 years), is probably right for my disposition. We had a practical pig lab where we performed procedures on a hapless (but anesthetized and intubated) swine. I felt at home with instruments in hand, cutting tissues, tying sutures. I have tremendous amounts to learn, but the action, the ratchet of clamps or the feel of a needle driver in tissue, and the focus on the patient's entire well being--not just their ears, nose, throat, or brain, or bones, or pee-pee apparati--is the "fun" of General Surgery.

I'm going to goof many times down the road, and will surely bemoan my lot, but I think this is right.

I hope this is right.
_______________________________

Incidentally, I'm writing this from a new computer. It's time I retired my 1st Generation Titanium Powerbook, the poor fellow has been routinely thrashed to the limits of his capabilities. And titanium and all, he's a little worse for wear. His screen isn't quite so bright and cheery in the mornings, and he tends to be cantankerous when he boots up. He did serve me well in Hawaii.

I've taken to calling his replacement, a 17-inch Powerbook, "Essex" because this is one big machine, more like a flight deck than a laptop. Now aluminum, it's surprisingly light and thin, and it's much more responsive (having twice the microprocessor its predecessor had). I also take migrating to a new computer as a chance to clean the slate, and reorganize my directories, my email rules, blow out the cobwebs.

For a mildly anal person, this is quite pleasing.

Posted by erich at June 12, 2003 05:36 PM
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