This is a bit of a rant.
I work weekends. I have to be able to do just about any case that comes along. I understand that the
There, I feel better.
First and foremost, harvests suck. Nothing sucks worse.
Second, eyes suck, but not as much as harvests. Retina and vitreous surgery sucks more than other eyes.
Third, any case with certain doctors suck, because the doctor is an asshat. Luckily, this is actually a small set of surgeons.
Any case involving more that one surgical specialty sucks. The suck factor goes up exponentially. A case with two specialties sucks 4 times as much as a similar case with 1. Three specialties sucks 27 times as much. Four specialties sucks 256 times as much. If we get to five specialties, just put a central line in me and hook it to wall suction.
Any case which departs from its script sucks. Some departures suck more than others. This includes, for example, the unscheduled opening of an endoscopic case. Note that just because we don’t know what we are doing going in doesn’t mean that there isn’t a script. For example, an exploratory laparotomy for bowel obstruction has departed from the script if we find a huge diaphragmatic hernia. It hasn’t if we find a tumor or adhesions.
Dead bowel sucks. Smells too. That’s why it sucks.
Any case scheduled to last more that 150% of what a normal version of that case would last sucks. First it's going to last twice as long as it's scheduled for, and second the surgeon knows something, and it's not good.
Any case scheduled for longer than two hours sucks. (Corollary, heart scrubs are crazy.)
Any case that requires re-draping sucks.
Any case with broken bones in more than one limb sucks.
Any case in which the circulator has to leave the room for anesthesia more than twice sucks. The circulator is there to get me things, not them.
Aneurisms suck. All of them.
Holding retractors on vaginal cases sucks.
Interesting cases suck. After 19 years, if I haven’t seen it, I probably don’t won’t to. OK there’s one exception. Years ago, when I was a baby scrub, a case down the hall was a removal of a cyst. When the surgeon cut into the area an insect stuck its head out of the wound. The patient had been in the tropics recently. I didn’t see that case, but I’ve always wanted to see another one. Otherwise interesting is out.
So there it is, an incomplete list of ways that cases can suck. I leave out that there are certain case and doctor combinations that suck and that certain staff have people that they can't get along with, which sucks. I, of course, can get along with anyone.
I've never had a day like yesterday before. It certainly wasn't the worst day of my life, but it was far from the best. It was mainly a long series of weird, mostly minor frustrations.
The day started when I rolled over, looked at my alarm clock and noticed it was 7:15. My shift starts at 6:45. I live an hour from work. This math doesn't work well. I jump up, run through the house, grab the phone to call work. No dial tone. I get my phone service, along with my internet, from the cable company, so I pull up my browser and connect to Google. I have internet, but not phone. I find the antique, princess phone that we keep for power outages, and hook it up. No dial tone. So I quickly get dressed, and start to work. planning on stopping at a convenience store to phone work. I don't see a phone at the first store on my way. The competition doesn't have one either, and it's the last store before I leave town. I turn around to got to QuikTrip, which I know has a phone. As I pass the first store, I notice a pay phone I overlooked before and pull in. No dial tone on the pay phone. I go into the store, and ask if there is a general failure of the phone system. They have dial tone in the store, and I make my call.
An hour later I pull into the hospital. As soon as I hit the front desk, my boss tells me "Call your mother." Never a good sign. I call her. There is a minor family crisis embedded within a major crisis. I can't do anything about the major crisis, but I can fix the minor crisis. What's more I'm the only one who can do anything, and it needs to be solved immediately. I check my OR, and see that another scrub is opening and is going to be running the mayo. I'm only there to hold retractors, so I ditch my room, find a phone and solve the minor crisis with a few phone calls. I also call the cable company and get them to send a tech to my house to fix the phone. My wife will be surprised.
My first case is a big complicated case with two surgeons, each in a different specialty. One of my rules is that the suckiness of a case increases exponentially with the number of specialties in the case. Two types of surgeons means the case sucks four times as much as a comparable case with one type of surgeon. This is a long case, so the suck factor is way high. Add on that the scrub running the mayo is in over his head, and I had an unpleasant couple of hours. (On a side note, if a surgeon asks for an instrument by name, get that instrument and no other. It really will make your life easier.) The rest of the day wasn't too bad, and the evening charge nurse took pity on me and let me leave early.
As I pull into my driveway, I notice what appears to be a small dog lying in the yard, next to the drive way. It doesn't move as I pull in. I walk over to it, and it is a small dog, with a lot of Jack Russell terrier in it. I nudge it with my foot. The whole body moves in one piece. Dead. I thought dogs crawled under bushes to die. When I go in, I find out that we have to go to Wally world, and the dog must be disposed of before we leave, so as to not disturb the sensibilities of the children. My wife doesn't volunteer. While I try to wrestle the dog into a trash bag without actually touching it, a long expected cold front arrived and dropped the temperature by about fifteen degrees in five minutes. Nice touch that.
After the trip to Wally world, I notice Lord Ratbane's litter box. There is cat stool with blood in it in the box. Although the cat seems to be acting fine, there is a vet trip in his near future.
I gave up and went to bed.
Today was a nice day.