wOrKiNg iN BoStOn

BOSTON-work (play will come later when i find time to blog again!=P)

It's been 2 weeks in Boston..but it's felt like 2 months or even years. These 2 weeks have certainly been one of the most unforgettable experiences in my life so far.

Not that it was FUN. No way. It was just so intense and demanding, yet so fulfilling and enjoyable. I've always liked working hard believed myself to have quite alot of drive and stamina. But compared to the general surgeons at mass general hospital I realize I a looonnng way to go..

I have always held some fascination and respect for surgery. There was just something about cutting through the skin and layers of fascia that seemed so violable, yet intimate at the same time. Then there were the people who practised this art—the surgeons themselves. These were people who with guts and grit—no pun intended—and seemed to thrive on stress and sleeplessness. Every hour of every day in every place—the operating room, the outpatient clinics, the wards—they made moment-to-moment decisions, about matters of life and death.

They were in the hospital by 6am latest to start rounds, then rush to the Operating room (OR) by 8am and operate till late in the day. After which they will do evening rounds and then head home--if there are no emergency night cases.

These 2 weeks I've been thrown unsuspectingly into this crazy world of theirs. In an unfamiliar place with unfamiliar faces, it really wasn't easy. My first few days were spend feeling cold, tired and sorry for myself. I felt so homesick. It didn't help I was attached to Baker team 5--one of the busiest teams in mass general. And my supervisor was Dr M L, a brilliant and skillful surgeon, but someone quite strict with very high expectations.

I had to wake up latest by 4am so I could reach the hospital for morning rounds. Then I would rush around to get the patient's files and charts. Then I would spend the rest of the day in the OR. These were probably my favourite times. I scrubbed up for all the cases, got to retract, cut, staple, use the GIA stapler, suture and even got to suture a whole incision using subcuticular stitching by myself!Of course my supervisor was watching over me the whole time so I had to keep telling myself 'keep cool steph'..

There really wasn't much time in between operations except to read up on the anatomy of the operation so you could answer the questions the attendings asked. It didn't help that the attendings in my team were all foremost surgeons in their field, having written books and lots of articles on their subjects.

Apart from anatomy questions they also asked things like who Kocher and Cushing were, what they were famous for, history of cancer etc etc. But it was fun. I realised that if I racked my brains hard enough and actually bothered to think, i could actually come up with the answers (though not always correct/complete)

I realised I never bothered to use my head much in Singapore. If a consultant or someone asked a question, I would: straightaway give an answer if i knew, or say whatever first came to my mind without thinking it over, or just shrug and say 'don't know'.. Or they would just give the answers straightaway without giving you the chance to figure it out yourself.

Here they gave you time to think as the surgery went on. And they wouldn't allow the interns or residents to help you. So there I was, finding myself very alone, watching the operation go on, yet racking my brains for answers and trying to remember anything I may have read before. It was stressful but exhilirating and addictive nonetheless.

My supervisor, a senior resident is a very smart, skillful surgeon. He was quite aloof at first but I've gotten to know him a little better. I guess he saw I was eager to learn. He is an intense guy but I like how he dispenses his advice..it's almost poetic! I'm someone who love quotes so I love it when people tell me important pearls of life, and I'll definitely remember them better..

'When I say pick up the skin, you pick up the skin and nothing else. One thing you must learn from this rotation is accuracy. It's very important in surgery, as in many things in life'

'When I move, you move. It's almost like dancing' (I was helping to grasp the skin as he cut the fascia')

'Even something as simple as closing the skin, you must focus. Cos if you do a perfect whipple but the skin gets infected, the patient can go downhill from there' (Can't remember exactly what he said but something to that extent)

Anyway I better go..it's like my only free saturday but I decided to use it to blog before I never get the chance to..(I gotta go for call on a sunday. argh) There's so much more I got to tell but i think it would never end if i carried on...

an eerily pretty night in boston as i walked back to hall one day