Marketing

One of my 'toward the end' patients on surgery required, among other things, a colectomy. Generally, when you're doing surgery that involves cutting the bowel, you want to do a 'bowel prep' to maintain asepsis to the extent possible.

In other words, to keep shit from getting everywhere.

There are a few products that will do this, with fun names like GoLytely. A gentler option, apparently, is 64 oz of Gatorade with Miralax dissolved into it. We had cause to wonder if the Gatorade people knew about that, and if so did they have initial branding disscussions in which they had to choose their marketing path. I.e.:

"Gentlemen, we can market this product one of two ways:"

A) Gatorade is a tasty sport beverage.

B) Gatorade is a conveyance of dissolved nonabsorbable osmolytes that will purge your bowels and scourge your mucosa of any solid remnant.

It must have been a tough choice - I bet the hospital can charge like $20 per bottle...


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Jealousy

Four days left on surgery. Home stretch.

I like when I can help with things. That is, I like to be assigned useful tasks I'm good at. For example:

1) Page me when the patient goes to the OR - Good task, can do, serves a purpose.
2) Hold this retractor with your left hand - Another good task.
3) Write a note that we can't use and no one will read - Not such a fun activity.

Useful busy work is okay, un-useful busy work annoys me. Recently though, one of my main jobs (retracting) has been outsourced to this bizarre piece of equipment that looks like a spider (retractor). I guess it's actually called an 'Omni-tract'. My list of useful, doable jobs is being encroached upon! The worst part of this is that I am then left with no task to do, so I steal some other piece of equipments job - such as holding the suction hose closed (thereby stealing some clamp's job... it's a vicious cycle).

I'd like to wipe that pretty extender off the omni-tract's smug lode bar, if you catch my meaning.


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Two Rules

I've lost about 5 pounds on surgery.

I'm not the only one with the weight change. I can think of at least a few others who have gone up or down a few pounds since this thing began 7 weeks ago. They're asking us for feedback; I want my time to feed back.

Feedback? Feed back!

I think it might actually be pretty sensitive. Rather than solicit everyone's subjective and inane interpretation of whether they have been overworked or given adequate time for activities of daily living outside work - I think they should just have a 'weigh-in, weigh-out'. The data is there.

In any case, I have definitely learned to eat when I can, because sometimes you are stuck in surgery (or worse perisurgery) through two consecutive meals. But what can you do except grin and bear it? Right of passage, and all that jazz? Sometimes, you scramble home with a bag of McDonald's that you eat as fast as you can so you can get to bed and be back to work in seven hours. It happens, and all you can really do is count the days down until you get to eat like normal people again.


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Crossover

This is the beginning of a little project I'm dabbling with. It's a fake, fake children's book titled ABCs of Bovie. Fake (1) because it would make a horrible idea for a real children's book - kids don't need to be exposed to electrosurgery until they're at least 8. Fake (2) because it's not really a book; it's a powerpoint presentation I'm whipping up to satisfy the humanities requirement for my surgery rotation and get out of doing some H&Ps.

Really though, the bovie is arguably the most ubiquitous surgical instrument. I'm not sure I've done a surgical procedure (some fistulagrams notwithstanding) where the bovie did not get significant playing time. It's not a classic like the scalpel, or as awesome as the argon laser, but it's a damn fine cutting tool all the same.

I expect the book to follow on the heels of my previous bestsellers in surgical/childrens literature: A Beginner's Guide to Tying Tiny Knots, The Grumpy Attending and the Lost 'Long Richardson' Retractor, and Your Stepmommy's New Face.


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Zeus and/or Jupiter

I think the best tool is the bovie.

For those not in the know, a bovie is an electrosurgical device that uses step-up voltage and alternating current to create a stream of electricity that heats tissue at the point of the instrument to 750 degrees F. Hot enough to stop bleeding, cut through skin, and create a smokey plume for the JMS to corral with the suction.

It's pretty neat, and ubiquitous. I think for how much it gets used, there should be more said about the bovie. Popular media is letting us down! The age of the scalpel is over, long live the bovie!


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Latinized

I found out the other day that I had been spelling 'flatus' wrong. I don't want to go into it, but I thought it had the old fashioned double 'u', as in Equus. It doesn't.

Luckily, since my notes are not binding, not legal, and not read, it is not such a big deal.

Effing Latin.


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Wierd Fact

I figure I know about 10,000 human beings.

Not that I necessarily know them all well. I just think I have met about 10,000 people and been around them long enough to make some quick judgements. I have met, out of the 10,000 I know, the most terrifying human being on the planet. Granted, other people also have a 'most terrifying', and I expect there will have to be some kind of double-elimination runoff system to truly decide the contest. But I am confident that I found the guy, the Most Terrifying Human Being on the Planet.

And he is a surgeon.

A lot of surgeons are nice, caring people who will gladly take a moment to teach you something when they discover a gap in your knowledge. The majority are like this, in fact. But the field also breeds a type of person who has so thoroughly refined their own expertise as to alienate themselves completely from the relative incompetence of all other human beings.

Then they get mean.

I suppose the other part of this equation is that an OR is a special situation, in which there is not always time for pleasantries and manners. But I like to think that I would not be the kind of person who had to yell at someone for not having a tool. Especially not if 99 times out of 100, they can turn around and slap it into my hand within 2 seconds.

I wish I had someone like that. That would be handy. Hasta la vista, pockets.


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COPD

Staff asked me the other day if I could imagine what it would be like to be a pair of sick lungs. Not to have a pair of sick lungs, mind you, but to BE a pair. I can imagine that. Represented above is my best attempt at recreating the image that popped into my head.

Actually, this sort of thing happens to me a lot. Do you ever get that feeling where you're trying to suppress a laugh about something stupid, which just makes it funnier? I find the best bet is to let it out and fake a cough or two, personally.


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Prognositcation

Somebody told me the weather was changing. I suppose it has been slightly darker when I go to start my car in the morning. It is difficult to say. Mostly, I haven't been privy any alleged change in atmospheric conditions because I spend my days inside. Insofar as it is not raining on me when I get in my car, I suppose.

Indoor cat.

When we want it a few degrees warmer, a few lumens darker, or a few 'dew points' less humid... well, there are buttons for that in the world I've been thrust into. So far I haven't seen anyone adjust the precipitation, but I'm not entirely sure if there's a thermostat for rain or not.

I mean, there could be. They have a fridge that gets warm. Warm!


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