June 14, 2003
Scrubs

The 2nd day of ATLS was generally more of the same. The lecturers tamping what we needed to know into our braincases, practical sessions and then the written exam and practical exam. We had an interlude that is famous in Duke lore: Dr. Georgiade's "Shark Talk", where he narrates us through a famous old text I think originally compiled for Mediterranean sponge divers about how to swim with sharks.

Basically, we have to think of the hospital as being like a shark tank in which residents are little fish. Most of the time, assuming we swim quietly, we won't get bitten, but in our years of training it's inevitable that we will be bitten, or fishes near us will be bitten. Dr. Georgiade's talk gives us pearls of wisdom on how to respond to these circumstances, e.g. when other fish are being bitten, get out of the water; don't try to help and get bitten in the process, perhaps inciting a feeding frenzy. Of course, Dr. Sabiston was known as the "Great White".

Back to ATLS, As I sat next to one of the course administrators checking my exam, things were looking good. First 20 questions, none wrong, next 10, one wrong, on to the last 10, four wrong in a row...I start getting worried...8 wrong max to pass...it's a sprint to the finish...but I pass. The practical? I kill two patients before I pass.

Then in the evening, Dr. Jacobs's dinner reception for all the new interns. He and his gracious wife have moved into a pleasant new house in Hope Valley. I actually had almost gone to the wrong reception, his road forks, and I took the wrong one and ended up at the Pediatric chairman's party. I knew something was wrong when I got out, saw a resident I didn't recognize (from ATLS) introduced myself, asking him if he was Ortho, and having him respond that he was Peds.

Anyhow, the reception was a pleasant affair. I got to meet our new Program Director. He seems personable, and I know he was one of the resident choices, so I'm sure we'll get along for the next 5+ years. The catering was quite good; grilled summer squashes, stuffed pork loins and some quite passable dessert squares. I had a jolly time at a table with a couple of the other General Surgery interns and an OHNS intern. Apparently none of us is married (where every single Ortho guy is married or engaged); and some joking ensued when the chairman told one of my compatriots that they'd increased the number of incoming PA residents to 17, and that most of them were women. His face visibly brightened at the prospect and I couldn't help calling him on it.

Dr. Jacobs said he refuses to function as a matchmaker.

Interesting aside, Dr. Jacobs told us that he has commissioned a Time-Motion study of surgical residents at work because he wants hard data to take to the hospital administrators to deal with the hospital inefficiencies that are surely to come to fore with the new work-hour rules. I think this is a really smart thing to do. I'm glad he thought of it. He said, having gone through surgical training, he obviously knows the data first hand, but he needs to have the numbers to show to the people upstairs (who clearly haven't been surgical house staff).

He's looking out for us.

Posted by erich at June 14, 2003 03:52 PM
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