Saturday, July 2, 2011


So last night, I was waiting to start a section and the anesthesiologist and I were in the OR waiting for the patient to arrive. We both noted it was July 1st...and were glad that we were in rural fly-over country hospital instead of Mecca. I was the least experienced person in the room, having graduated from residency 5 years ago.

We were both musing about intern year. He's significantly older than me, but the themes were similar. Sheer and utter fear that first day. The thrill of being able to write orders. Feeling overwhelmed. The weirdness of signed the MD after our names (I don't do that signature has degenerated into my initials).

He told stories of his attending snoring during a case his first month.

I talked about the first time I held a scalpel...July 2nd, 2002. I was the intern on the gyn team and was scrubbed in for an abdominal hysterectomy. The scrub nurse was told to give me the scalpel and I was told to make the skin incision and then put the scalpel down on the Mayo.

My first reaction was "ARE YOU FUCKING NUTS?!?!?!?!?! I could HURT someone with that thing!!!!!!" But I didn't say anything and suavely took the scalpel (all the while trying not to shake) and placed it on the line the attending had drawn. Took a deep breath and cut.

Evidently not even remotely hard enough. I didn't even get into the dermis! The attending looked at me and said "You CAN cut more than one cell layer at a time." And he put his hand over mine on the scalpel and we did it again, this time exposing the yellow balls of fat lying just under the skin.

And now...I still respect the scalpel, but it feels natural. It's a part of my life. As are the Mayo scissors, the hemostats, the pick-ups. I can use any of them with either hand. I like the ritual of slapping them into my hands, ready to use. The dance of gowning and gloving is almost as formal as a waltz with people moving and presenting parts at precise times.


Dr. G said...

SO excited to be in your shoes next year...and petrified at the same time :)

rlbates said...

I was a 3rd year medical student when I got to use the scalpel. Was taught how to do amputations, debridements, and circumcisions. And, yes, I still respect the scalpel 30 yrs later.

Grumpy, M.D. said...

The first time you work without a net is always scary, too. No matter what you do.

Shrink2B said...

I just started my Psychiatry residency yesterday - and I feel the same - ABSOLUTE FEAR.
I'm not wielding a scalpel, but the feeling is the same.

Anonymous said...

once you get through that first cell layer it becomes a vital necessity and you cannot stop.

AtYourCervix said...

My favorite phrase when gowning and gloving in the OR is "shall we dance?"

I totally respect the amazing power of the scalpel.

Mathi said...

Is it odd that about half way through reading this post I started to hear Wierd Al's "Like a Surgeon" in my head?

ER's Mom said...

One of my favorite songs!

Too true, I was up all night before I started my first attending job because of nerves.

Sally Brogan said...

apart from medical professional you are good writer too!!!

generic pill

Grumpy, M.D. said...

My signature has also died. It used to be a very clear, "Ibee Grumpy, M.D."

Now it's just a scribbled "I", followed by a wavy line.