So my general surgery block is coming to a close, and surprise, surprise, I'm actually a little sad to leave. Just a little. Surgery has been ups and downs and one hell of a learning experience. It's pretty much the 'real world' of medicine and I've been pushed far more than I'd ever been. I'd feel indignant at the vascular SHOs goyang kaki-ing while I stammered referrals down the phone, but at least I can hold my own now when bleeping the cardio reg. I'd gone from never doing a night shift to ringing a consultant at 4am with a severely unwell patient. I've come from flicking through the BNF for dihydrocodeine doses to signing off all the needed PRN prescriptions to stop nurses from bleeping me every 15 minutes. And now that I've actually felt a properly peritonitic abdomen, I'm a little better at sorting teenager RIF pains from functional bullshit to the real deal. (But only a little. The regs can pretty much look at a RIF pain and tell if it's going to be a watch and wait or a dx lap.)
I'd say I've come off as a little more confident in general, except when it comes to the consultants. Quite frankly, 3 out of 4 of the consultants terrify me and let's just say it doesn't do wonders for my self esteem. I just feel constantly belittled and unworthy everytime I attempt to speak to them, so I don't, unless it's absolutely necessary. The regs nearly make up for it though. Though some came off as bursque and stoic, sometimes it's just the way surgeons are (and sometimes it's just a case of resting bitchy face. It's real.) Some are more approachable than others, but they're generally ok.
There's one reg I like in particular. He smokes like a chimney, swears like a sailor and has the most scathing, crude sense of humour which cracks me up everytime - but he's also the most appreciative, straight talking guy ever. Communication has to be clear cut, black or white, no waffle please. It's made me realize how much ambiguity goes on in our daily communication that only serves to confuse people or lead to non-decisions or non-resolvement of questions. He speaks his mind and doesn't give a shit what other people think. And he'd always say 'thank you' sincerely to the FY1s - the nobodys, the bottom of the food chain - for simple things like chasing bloods. It's the little things.
There was an incident once where I did something and the consultant got really mad, not directly at me but at the fact it had been done and he wasn't told. The reg immediately apologized on my behalf and claimed responsibility even as I was on the verge of tears. In the end there was no harm done and there wasn't even the need for anyone to be held responsible for anything, but I'll never forget the way he stood up for me.
No matter how bad things seem, there'll always be someone who can make it a little better. It's in the people.
Also one protip: if your SHO is a CST, you're gonna have a bad time. Quite simply because they'd be scuttling off to theatre at any instance and feel nothing about letting you deal with all the ward work and crap. In fact the best SHOs on general surgery are the medic/GP wannabes, because yknow, they're actually around. And care. And help you when you're out of your depth. And have pretty damn good medical knowledge. It is scary being an SHO sometimes though, especially when it comes to presenting patients on the round. I have no idea how they can remember everyone. All the hemicolectomies and lap appendixes blend into one after a few. And consultants do not take kindly to a blank 'ummm..' on a round, or a mix-up. Personal experience. Which is fair enough.
God help me I'm 4 months away from being an SHO. (Which probably won't apply as I'll be my own FY1, SHO and reg in godforsaken Wick. As my favourite demure SHO would say, fuck me in the arse.)
Things to suck less at/to do in the next 4 months:
-talking to family (the dreaded 'patient's family want to speak to a doc')
-talking to angry family members (kill me please)
-doing the palliative conversation
-dealing with sickies (never forget the ABG!)
-remembering and presenting patients
-get a proper audit going
Two more work days and it's hellooo neurosurgery!