This morning was sort of frantic. I woke up at and noticed the sun shining. That's not a good sign, because I was supposed to be on my way to work before the sun came up. Then I looked at my alarm clock, which was blinking the dreaded 12:00. So there was a power flicker and my alarm didn't go off. So I called my residents to apologize and offered to come in Sunday morning, which I will do. Ugh, what terrible luck. I'm sure they'll understand, but it's never good to miss work for silly stuff like that. What a bummer. The rest of the day has been spent working on my residency application. I'll be pleased when this is all over, and I am moving very close to finishing this thing. Thank God the main stuff is out of the way--now I'm left with adding extra-curricular activities, hobbies, interests, blah blah blah. Plus, Nick called me to let me know that my USMLE Step II scores have arrived in Houston. I'll be opening that letter when I arrive in Houston on Tuesday. I have scheduled meetings with Dr. Andrassy (the Chairman of surgery), Dr. Fischer, and hopefully Dr. Safi (the Chairman of Cardiothoracic Surgery).
Yesterday I was post-call but still had a nice surgery. First off was a trauma that came in. Apparently a woman fell from 3-stories, and had a few internal injuries. We sent her to interventional radiology where she had a branch of her hepatic artery embolized to stop bleeding. Her right renal artery was avulsed, so she lost her right kidney. It's amazing to think that a guy came in a week earlier after jumping off a 10-story overpass with no injuries whatsoever, and this woman falls 3-stories and loses her right kidney. Then I did a procedure with Dr. Stratman, a younger general surgeon who is very nice and a good teacher. We did a laparoscopic cholecystectomy. Translation=we took out a gallbladder using a camera and robotic devices without opening her belly. People usually get their gallbladders taken out, because they have pain in the right upper quadrant of the belly, often while eating. The gallbladder stores a substance called bile, which is this goopy green stuff that helps you to digest fat. The pain could be because there are gall stones in the gallbladder, stones in the exit duct (cystic duct) of the gall bladder, or even in the common bile duct which empties into the first segment of the small intestine called the duodenum. To make sure there aren't any stones in the hepatic duct (which would not be helped by taking out the gallbladder), we do a procedure called a cholangiogram where radioactive contrast is injected into the cystic duct and an x-ray is taken to see if the contrast is emptying properly into the small intestine. Well, in this patient's case, the contrast mysteriously stops right before it reaches the small intestine. This is most likely due to a gallstone obstruction or a narrowing of the lumen of the duct. So she'll visit the GI doctors who will put a tiny camera into the bile duct and see what's causing this blockage. If it's a stone, they'll take it out. And if it's something else, they can usually fix that problem too. I've included the x-ray image of the blockage. The top two branches (called the left and right hepatic ducts) come from the liver (where bile is made) and combine to become the common hepatic duct. Then the cystic duct from the gallbladder hits the common hepatic to form the common bile duct. You'll notice that the gallbladder is missing from the x-ray, because the cystic duct was clamped off and the gallbladder already removed when we shot the film.
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Last night was spent with several people. We started at a place called Primos (means cousins), which is a Mexican/cafe place on McKinney in the Uptown area. I got there early and sat at the bar with my $1 off margarita. A gentleman named Galen Johnson sat down next to me which lead to the normal pleasantries. He found out that I go to school in Houston and work at Memorial Hermann Hospital. Well, he works for Trammell Crow, which is a huge real-estate/contractor company. It turns out that he's involved with Memorial Hermann to build a bunch of new hospitals. Before that, he was an executive with Baylor University Medical Center, which is where I'm currently doing my rotation in general surgery. Also, his father used to be the CEO of BUMC, which is pretty cool. He knows every surgeon I've worked with this month, and his kids when to high school in Lake Highlands with one of my favorite attendings, Dr. Derrick. So it was totally cool to chat with him for an hour or so. Then he paid for my drinks, wished me good luck, and left. It never ceases to amaze me how I tend to bump into these people. It's further evidence that my life is actually a version of the Truman Show, with these "random" beneficial events occurring every so often. I hope and everyone at home watching their television sets and enjoying my life thus far. Then Charmaine (of The University of Texas Medical School-Houston), Mary Mathieu (of the University of North Texas Graduate School), and Mary's two friends (Kaley mentioned previously and Nicky) arrived. We had a few drinks, then Charmaine and I left for an Irish Pub. The place is called The Tipperary Inn, and it's outstanding. I was totally amazed with the whole presentation. We were joined by Ryan Ricks (of Club 1948), Kristin Ohlenforst (of ohlenforst.net), Baseball Jim (working in Dallas), Katie Sternweis (of The University of Texas-Southwestern Medical Center Graduate School for Psychology), and two other friends of Kristen. I really enjoyed this place and plan to return at some point in my life. Then I went home and fell asleep.
Yesterday I was post-call but still had a nice surgery. First off was a trauma that came in. Apparently a woman fell from 3-stories, and had a few internal injuries. We sent her to interventional radiology where she had a branch of her hepatic artery embolized to stop bleeding. Her right renal artery was avulsed, so she lost her right kidney. It's amazing to think that a guy came in a week earlier after jumping off a 10-story overpass with no injuries whatsoever, and this woman falls 3-stories and loses her right kidney. Then I did a procedure with Dr. Stratman, a younger general surgeon who is very nice and a good teacher. We did a laparoscopic cholecystectomy. Translation=we took out a gallbladder using a camera and robotic devices without opening her belly. People usually get their gallbladders taken out, because they have pain in the right upper quadrant of the belly, often while eating. The gallbladder stores a substance called bile, which is this goopy green stuff that helps you to digest fat. The pain could be because there are gall stones in the gallbladder, stones in the exit duct (cystic duct) of the gall bladder, or even in the common bile duct which empties into the first segment of the small intestine called the duodenum. To make sure there aren't any stones in the hepatic duct (which would not be helped by taking out the gallbladder), we do a procedure called a cholangiogram where radioactive contrast is injected into the cystic duct and an x-ray is taken to see if the contrast is emptying properly into the small intestine. Well, in this patient's case, the contrast mysteriously stops right before it reaches the small intestine. This is most likely due to a gallstone obstruction or a narrowing of the lumen of the duct. So she'll visit the GI doctors who will put a tiny camera into the bile duct and see what's causing this blockage. If it's a stone, they'll take it out. And if it's something else, they can usually fix that problem too. I've included the x-ray image of the blockage. The top two branches (called the left and right hepatic ducts) come from the liver (where bile is made) and combine to become the common hepatic duct. Then the cystic duct from the gallbladder hits the common hepatic to form the common bile duct. You'll notice that the gallbladder is missing from the x-ray, because the cystic duct was clamped off and the gallbladder already removed when we shot the film.
Last night was spent with several people. We started at a place called Primos (means cousins), which is a Mexican/cafe place on McKinney in the Uptown area. I got there early and sat at the bar with my $1 off margarita. A gentleman named Galen Johnson sat down next to me which lead to the normal pleasantries. He found out that I go to school in Houston and work at Memorial Hermann Hospital. Well, he works for Trammell Crow, which is a huge real-estate/contractor company. It turns out that he's involved with Memorial Hermann to build a bunch of new hospitals. Before that, he was an executive with Baylor University Medical Center, which is where I'm currently doing my rotation in general surgery. Also, his father used to be the CEO of BUMC, which is pretty cool. He knows every surgeon I've worked with this month, and his kids when to high school in Lake Highlands with one of my favorite attendings, Dr. Derrick. So it was totally cool to chat with him for an hour or so. Then he paid for my drinks, wished me good luck, and left. It never ceases to amaze me how I tend to bump into these people. It's further evidence that my life is actually a version of the Truman Show, with these "random" beneficial events occurring every so often. I hope and everyone at home watching their television sets and enjoying my life thus far. Then Charmaine (of The University of Texas Medical School-Houston), Mary Mathieu (of the University of North Texas Graduate School), and Mary's two friends (Kaley mentioned previously and Nicky) arrived. We had a few drinks, then Charmaine and I left for an Irish Pub. The place is called The Tipperary Inn, and it's outstanding. I was totally amazed with the whole presentation. We were joined by Ryan Ricks (of Club 1948), Kristin Ohlenforst (of ohlenforst.net), Baseball Jim (working in Dallas), Katie Sternweis (of The University of Texas-Southwestern Medical Center Graduate School for Psychology), and two other friends of Kristen. I really enjoyed this place and plan to return at some point in my life. Then I went home and fell asleep.
3 Comments:
just found out my dad is advised to have Whipple surgery (biliary stricture, cholangio carcenoma found) que caranba. Saw on line U-Illinois uses a Da Vinici robotic surgical system in such a procedure. Then, you made me smile with your blog and the beauty of chance. Any recommedations for a doc (or who to avoid))in Houston?
...only a Texan would look for a margarita in England...cheers.
Wow, I wrote that 4 years ago while still in medical school. Fun to look back. Sorry to hear about your dad. The only surgeon who I directly worked with who does the Whipple procedure in Houston is Craig Fischer. But unfortunately he's no longer at UT Houston. I don't know who currenty is specializing in hepato-biliar surgery. Sorry I couldn't be of more help.
xulYou are so sweet to respond. Dad is freaking...understandably. Thanks for the comfort of your concern. Yes, rereading the joy and bravado of our earlier adventures always lightens the responsibility of life we inevitably come to bear. 4yrs, you are surely in the thick of things now; God bless your future. Not to worry, the internet is my friend. I am sure to discover that brilliant someone who will be the hands of God. Abrazos!
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