I'm sitting in the resident's lounge at Baylor University Medical Center in Dallas, experiencing my first night of call on general surgery in the month of August. I started yesterday. It was a typical first day. We did all of our orientation stuff, got parking, got ID badges (mine still isn't working on all the doors), and filled out lots of paperwork. Then the students met with Dr. Jones who is the chairman of the department. He lectured us over fluids and electrolyte replacement of the surgical patient. Then I went to clinic and saw a patient with a unilateral breast discharge and possible masses. That's always suspicious (even though this patient has a history of cysts in that particular breast), so we ordered a mammogram and an ultrasound to rule out cancer. Then we had trauma conference and went home. Dinner was pork tenderloin, Caesar salad, and hashed browns. It's good to be home with parents that can cook.

Today was nice. I got here at 6:30 for basic science lecture (which was over acute respiratory distress syndrome or ARDS). Then it was straight to the OR to observe a mass removed from a guy's parotid gland (in the cheek), and then I scrubbed in on a 5 hour case involving cancer of the esophagus. It was way interesting. Apparently this 80 year old patient went to the doctor for a routine colonoscopy but also complained of minor swallowing problems when asked about other symptoms. So the GI doc also did an endoscopy (where a camera looks down the throat into the stomach) and found an adenocarcinoma of the esophagus right at the junction of the stomach. This sort of tumor is usually from long standing reflux disease (same as the commercial that urges you to take the little purple pill). So the surgeon needs to cut the cancer out (along with parts of the stomach and esophagus to make sure all the cancer is gone) and then sew the esophagus back to the stomach. This procedure is called an esophagogastrectomy. Then I had dinner with the team. We have a chief resident in the fifth year, a 3rd year, a 2nd year, an Intern (1st year), a 4th year medical student (me), and a 3rd year medical student. Tonight I've been reading and watching television on the fabulous big screen TV in the lounge. I'll most likely be hanging out in the ER the entire evening taking trauma call. Baylor is cool that way, because whichever surgery team is on call also takes trauma that night. Plus Baylor is a level 1 trauma center, which means we get all the major cases (along with Parkland a few miles away). So I'm looking forward to call and not too worried that I probably won't be getting much sleep tonight. This month is really going to kick ass.