Saturday, August 07, 2010

One down, eleven to go

Well that wasn't so bad. The first month of intern year only took about 31 days and I managed to survive all of them.

It turns out, though, that the ENT service at this particular hospital is wholly unlike any ENT service I've seen before. This service is dominated by one particularly prolific, fantastically mustachioed, head and neck surgeon. This man has assembled a unique team comprising other attending head and neck surgeons, an oral maxillofacial surgeon, a head and neck surgery fellow, a PA, an NP, and a gaggle of residents. Together, the team facilitates a near continuous flow of complex facial reconstruction patients through the operating room, to the surgical intensive care unit, to a dedicated head and neck step-down unit, to a standard hospital room, and, finally, back home good as new. Well, sort of like new, except with various distant body parts now SURGICALLY ATTACHED TO THEIR FACE.

Sure, there were plenty of standard cases - thyroids that had to go and necks plundered of lymph nodes that might be hiding cancer cells - but this finely-tuned machine churned out some cases that I might not have seen anywhere else. At one time, I was taking care of three people whose jaw bones had been consumed by cancer. Large segments of the jaw bone had been removed then rebuilt using A BONE FROM THEIR LEG. Crazy, no? How about the guy who's esophagus was taken out and rebuilt using a rolled up tube of abdominal muscle and it's overlying skin? The radiologists puzzled over an image from one of his studies for hours before finally diagnosing "hairy esophagus."

While last month was unquestionably rewarding, it was not without it's sacrifices. I'd leave the house at 5:30 AM and return between 9 and 10 PM, so I would go many days without seeing my daughter awake. I'd be home just long enough to try to eat something, tell my wife how much I love and miss her, then go right to sleep. And I've come to learn that sleeping 5-6 hours a night (to say nothing of the on-call nights) just doesn't cut it for me. One afternoon during my second week on service, I realized that I'd been so exhausted that I'd written the wrong date on all of my notes that morning. It was July 9th, and I'd been writing July 8th. A mistake made more painful by the realization minutes later that July 9th was my birthday.

How lame is THAT?

So, I think the take-away message is that this year will be a HUGE hassle. But I'll learn plenty. In just 31 days I've already learned to radiologically differentiate candidiasis from hairy esophagus; I've learned that you have to turn the knob left then right in order to open the staff bathroom on the tenth floor of the hospital; I've learned to eat and drink whenever the opportunity presents itself whether or not I'm hungry or thirsty; and I've learned to double check the calendar in the morning to be sure that my notes are correct and to ensure that I collect on any presents that might be coming my way that day.