Cutting

I haven't posted in a little while, mostly because I am too tired when I get home to try to entertain the 3 people who read this blog on a regular basis. However, life in the hospital is great. I have been able to spend a lot of time in the OR, and the attendings are handing me the scalpel and allowing me to operate quite a bit. I have done a ton of melanoma excisions and sentinel lymphadenectomies as well as breast biopsies, lumpectomies, appendectomies, and cholecystectomies. The laparoscopic procedures (using small incisions for the tools and a camera to look into the abdomen instead of making a big incsion) are still challenging for me because it is like playing a video game and to be honest, I have never been much of a video game guy.

Last night one of the interns was called about a patient who had a big operations two days prior and was now acting very agitated. The nurse requested an order for a sedative which the intern agreed to. A few hours later a code blue was called on the patient after he went into respiratory arrest. It looks like the patient was already having a hard time breathing and the sedative ordered by the intern tipped the scale enough to send the patient over the edge. In retrospect, the intern made a bad decision, but I think it is a decision that many of us could have made in similar circumstances. When you are woken up in the middle of the night by a nurse and asked a question about a patient you don't know very well, it is easy to grant the nurses request without thinking more about it. The seemingly straightforward decisions we make have potentially lethal consequences.