The past week was less stressful than I expected it to be. Not because I'm some sort of natural at being a doctor but rather because the work load I had anticipated didn't exist.
The chief, the attending and I did almost everything together. Sure, I got to change the bandages and remove chest tubes and suture at the end of surgery, but this wasn't anything I hadn't really done before. The only difference really was that I wrote a few release notes and my computer access was upgraded to full access of a doctor instead of my limited intern access. A lot of time was spent in the chief's office drinking coffee and eating snacks.
It was fun being back in the surgery department for a week. I all of a sudden saw a lot more of my surgical colleagues than before (the internal medicine department is on a different level of the building so at most I would see the surgeons in the hallway or at lunch but due to politics, you ate with your department). My time in internal medicine did shine a bit through while writing the first release letter.
Surgical release letters are quite straight forward and to the point with little story telling involved. Patient had this. We did that. He left in a good condition.
Internal medicine release letters are some what of a novel about the patients life. It includes a long history of the patient, all the ailments he has, all the medications they are on, all the diagnostic tests that were run and the interpretation of them, how the treatment will go on from here.....they are easily 5-7 pages long compared to the usual 2 in surgery.
So when I was working on the first release letter for my thoracic surgery patient, I started with a good thorough history of all the doctors the patient had already been to and had lead them to us. Continued with all the x-rays we had done and the interpretation of each. And filled the rest of the slots with ample information. When the attending came to look over the letter with me, he deleted about 2/3 of the text. From that letter on, my letters were short and to the point.
We operated Tuesday through Thursday and had 4 operations. Removed a segment of a lung, a small part of a lung, took samples of a lung with a lot of adhesions and removed a lipoma on a mans chest. Most of them went as planned and only took 2-3 hours. The one that really got me was the patient with the adhesions.
It was on Wednesday that we had two operations. The first one wasn't a problem and even finished a smidge earlier than expected. The second one was only supposed to be taking a sample from the pleura (the tissue covering the inside of the chest and the lung) since it looked thick in the CT scan and the patient had a history of working with asbestos (needed to see if that was a mesothelioma (I'm sure you've heard the commercials on TV about asbestos and mesothelioma and how you should hire their lawyer to get money)). The operation was expected to take 1.5 hours. It was already hard enough gaining access to the inside of the chest due to the adhesions but once we had an opening, we saw just how stuck together everything was. The surgeon just sighed and said this would take a bit longer. I sighed in my head because that day was technically a day I could go home an hour early and I had a massive to-do list I needed to get stuff worked off of). About an hour after that realization the anesthesiologist asked how long we anticipated the surgery to last and the surgeon replied, "easily 2-3 more hours". Great. We luckily all requested chairs to sit on because my back was already making itself noticed an hour into the surgery. I waited until 2.5 hours into it to ask for a chair though. Luckily the staff was friendly and we chatted a bit during the operation because all I did was hold hooks and was hardly to actually see anything in the chest. Not the most exciting thing to do. Chief came in the OR and told me he was going to go do the seminar with the interns and then come back in time so that I could catch the 5:25PM train with the other interns. He said he wanted to be in the OR by 4:40 since I had to leave the hospital by 5 if I wanted to catch the train. He didn't show up until 4:55 and we were basically done just doing the last suture. I hurried off to get changed and grab my stuff and left to catch my train.
The week was fun and relaxed and the chief is still trying to convince me to start in the department. If I really did, I know it would be a rather relaxed job. The surgeries might kill my back but all in all, it would be a chill work environment. To bad my dream isn't becoming a thoracic surgeon.
Remember Ali? The little boy from Azerbaijan I told you about? He had his check up ultrasound this week and everything looks good! I started a little donation collection to help the family out. Below is the letter I sent out to family and friends asking for even just a little support to help this little family out. If you have $5 or however much to spare, I'd greatly appreciate it if you participated and I know the family will be so thankful as well!
Dear Friends & Family,
I’ll try to keep this short since I know you are all busy people. A few months ago, I was introduced to little 2.5 year old Ali from Azerbaijan. His father worked really hard to get a scholarship to study in Germany. One of his biggest motivations was to get better medical care for his son. Ali was diagnosed with hydronephrosis in his home country. This refers to distension and dilation of the kidney pelvis and if left untreated could lead to kidney failure. For Ali, this meant many painful days of kidney pain and for his parents a lot of frustration not being able to help him.
Through many fortunate coincidences, I was introduced to him and his family while working in the urology department for my internship year. The doctors took a look at him and his files and referred me to the pediatric surgeon. This surgeon was nice enough to meet with me and explain possible treatment options for Ali. We were perhaps looking at a $13,000 operation bill that I would have started fundraising for. I organized for Ali to have an examination done that would determine if he needed surgery or not and covered the costs for the family with some help from my grandma. Although his hydronephrosis was rather advanced, as if by a miracle, he had grown out of it! That isn’t unheard of but we weren’t expecting it due to how advanced it was a few months ago. So yay! No surgery needed! The surgeon offered to give Ali a check up before returning home to Azerbaijan in September 2015.
In the end, it couldn’t have turned out better and Ali looks much healthier than he did when I first met him. However, the family went through great trouble to get him better medical help. They took up credits in Azerbaijan to pay for the flight to Germany and had many other expenses to make the trip happen. They came to Germany not speaking a word of German and into a culture completely different than their own in order to get the best help they could for Ali. They’ve been nothing but kind, welcoming and modest. I would like to help the family pay off some of their debt. This is where I need your help. I’m asking you to donate what you’d like (I’d be thrilled even if its $5) to help this great little family.
We often take our good life circumstances for granted and its
situations like these that make me grateful for what I have and motivate me to help others less fortunate. I thank you in advance for your humanity and donations!
Bank Account: ApoBank Viktoria Hasselhof
IBAN: DE87 3006 0601 0008 8322 85
Thank you to everyone who helps out!
Next week I'm back in Gastroenterology for a week. So it's back to long rounds and even longer release letters!