Venturing into Pediatric Surgery

The sun was shinning today, beckoning me to come outside. Despite the impending surgery shelf exam and a pile of incomplete reports, I made a decision to go running. A run to the ocean and some sunshine was exactly what I needed to recharge before another week of surgery. I have come to realize that it's better to live life when you have a chance rather than put things off for a more convenient time.

It's evident the list of things to do just gets longer.

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"Medicine is like music. You have to listen for notes before you can appreciate the melody."

A truly insightful comment from the pediatric surgeon I worked with last week.

I am still struggling to put the notes together.

My first week on pediatric surgery was interesting. Just when I started adjusting to the world of general surgery, I was transplanted to an entirely different place, where the patients are smaller, have rare congenital anomalies and typically can't communicate directly with me.

You see the entire spectrum, everything from neonatal in the intensive care unit on bypass for respiratory failure to toddlers undergoing hernia repairs that require no hospitalizations to children with appendicitis to teenagers with midgut malrotation.

I spend my mornings in the neonatal intensive care nursery, collecting the numbers that reflect the respiratory, cardiovascular, fluid, electrolyte and hematologic status of the critically ill infants. I feel more like a recorder, writing and reciting the numbers without fully understanding the meaning. I was only beginning to understand adult ICU values. Neonatal intensive care is far more complicated and requires more than one week to grapple the ins and outs of management.

I have come to really appreciate the complexity of pediatric surgery. The operative approach is unique in pediatric surgery. The instruments are so much smaller and special attention must be paid to every little motion. When I watch the surgeons, I am amazed at how they navigate through such small holes to identify vital anatomical structures.

I have three more weeks of surgery left. We'll see what my last week of pediatric surgery brings...