mvenus929 (mvenus929) wrote,
mvenus929
mvenus929

A Chance To Cut Is A Chance To Cure

Yellow Team (Plastics/Derm/Podiatry): Saturday, July 23rd

Saturday was another relatively late start; my team didn't start until after 7. So, I took my team eating breakfast before I headed over to the Yellow tent, where plastic surgery, dermatology, and podiatry were located. After standing outside waiting for direction for a few minutes, I took charge and just entered the tent. There wasn't much to do in the reception room, so I spun off to the left and found myself in the plastic surgery area, where a patient was being prepped for a procedure.

The patient was a developmentally challenged, and very nervous about the procedure. The staff went to find her mother, who was having something done elsewhere in the fairgrounds. The nurse told me to grab a mask and to stand by her head, keeping her calm throughout the procedure. She was having a cyst removed, so she had wear only a paper gown to protect her from the really cold air conditioning.

The surgeon introduced me as another doctor, which bothered me. I'm not a doctor, I'm a student, and don't want to pretend that I am a doctor. I understand that a lot of people don't understand the nuances of medical education (how you can be a doctor but still a student in residency), but I still don't think people should flat out lie like that.

Another second year med student from VCU came in at that point and also grabbed a mask. She stood behind the surgeon as he prepped (with betadine) and numbed up the site (during which I was speaking calming words, as the patient was flinching with the needle). Despite the odd conditions, the field was supposed to be sterile, so the RN assistant was wearing sterile gloves and using autoclaved equipment and everything. It was amusing because one of the other RNs (I think, anyway... she might've been something else) was helping by pouring extra betadine into an autoclaved cup and kept getting close enough to break sterility, which made the assistant back away, causing betadine to spill all over the floor, and the assistant's gloved hand to become unsterile.

As the surgeon was cutting out the cyst, he was talking about what he was doing. He cut into the cyst a little, causing a bit of yellowish liquid to leak out, but from my perspective on the other side of the bed, it was hard to determine where the margins of the cyst actually were. He said it was difficult anyway because it wasn't a well defined cyst; the cyst had been infected multiple times, so there was scar tissue surrounding it (which is why it was being removed in the first place).

When he finished removing the cyst and placing it in the specimen cup, he felt inside the (rather deep) hole that he made and felt the nearby artery pulsing against his finger, and invited me and the other medical student to feel the artery. The other med student was about to reach in with her unsterile gloves when everyone yelled at her and coached her how to put on sterile gloves and maintain sterility. This whole scenario made me realize just how much further ahead we were compared to a lot of our colleagues. We've done sterile technique in CPD already... not well, perhaps, but we've gone through the motions of putting on the gloves and whatnot.

Anyway, I opted not to feel the artery, mostly because the patient was clutching my hand in fear still, and I felt abandoning her to poke at her injury would only serve to make her more nervous. But, it was still nice to see the procedure itself. The other med student then helped to clip the sutures, which were covered with steristrips, and the patient was then sent on her way.

That was about the extent of my derm/plastics/podiatry experience. We sat around and talked for a half hour or so after the procedure, and I eventually made my way to the derm side of the tent, but none of the dermatologists really cared that I was there, so I opted to just head off to my next rotation.
Tags: ram
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