The End of Surgery

Friday was the last day of surgery. We ended on a somewhat anti-climactic note with the surgery shelf exam, a somewhat arbitrary measure of knowledge and clinical reasoning. I was experiencing flashbacks (nightmares) to preparing for the Step 1 exam, as I hopelessly reviewed esoteric details of diseases I had never encountered. It was certainly one of the least pleasant testing experiences I've had with 100 long questions in 2 hours- marathon test taking at it's worst. Sigh.

"If you finish you are ahead." I was told by another medical student.

As I studied for my shelf, the fellow on my service was preparing for his oral boards. Sadly, the tests just never end.

I left the exam feeling numb and bit flustered. Before I could start thinking about the test, I plugged myself into my headphones, tied my running shoes and set out for a long run. Actually, a really really long run- the longest run I've had thus far (14miles).

With the sun beating down on me, I just had the urge to keep going as I took in the sights of a city I had become estranged from while being on my surgery rotation. Moving one step forward, not looking back at all. This is definitely the year to run a half marathon.

Despite the challenges of surgery, I will definitely miss the rotation.

***

My last two weeks of surgery were spent on the kidney transplant unit. The best night of my rotation was on Monday, when I joined our team during an organ procurement. At 10:30 PM, we set out from San Francisco in a black van and made our way to a local bay area hospital, where we procured the liver and kidneys from a donor. The experience was surreal.

I felt disconnected at times-- not quite fully thinking about exactly what we were doing. But I also kept reminding myself how the organs we harvested could potentially save lives. No matter how I justified it, I could not forget the reality of what we were doing. We were removing organs out of a patient, who had been proclaimed brain dead. I got my best anatomy lesson that night. The heart continued to beat and the organs remained perfused, as we dissected away one organ at a time.

***

After my shelf and long run, I spent my golden weekend in the company of family and friends. My weekend was filled with quality time and food. I was able to recharge and refocus my energy.

I move now to Pediatrics, which starts next week.

Before moving ahead, all third year medical students will congregate in the classroom for a week of intersession, a series of lectures and small groups dedicated to ethics and clinical reasoning. Even after being lectured about how to resolve ethical dilemmas today, I feel more confused and uncertain about how to grapple key ethical topics, including allocation of scarce resources, end-of-life care decisions, euthanasia and patient autonomy. I hope this week will shed some light on these topics.

It's hard to believe that we are over 50% of the way through our third year of medical school. We reminded of this during one of our lectures, which focused on planning our fourth year of medical school. Already? I'm still just getting the gist of third year.