Be Still My Heart

What's the difference between a cardiothoracic surgeon and God?
God doesn't think he's a cardiothoracic surgeon.

Love it.

The coolest part of anesthesia (besides intubating people...4 for 4, yay!) has been seeing all the different surgeries. Today I saw the beginnings of a lobe resection for lung cancer (a live view of a disgusting, black, cancerous lung would probably help people quit smoking) which involved preferentially ventilating the healthy lung and collapsing the one to be resected. Very cool. And yesterday I got to see a mitral valve replacement involving cardiopulmonary bypass. Modern medicine is pretty amazing. First we got to do a tracheoesophageal echo and get a really clear view of the heart in action, dysfunctional valves and all. Then I got to watch the surgeon cut open the guy's chest. It kind of freaked me out to see all the monitors flatline when the patient was switched over to the bypass machine, but obviously everything was very controlled. All I could think was...VAMPIRES!!! All that bright red blood going through the machine, being oxygenated and pumped back in...even Angel might not be able to control himself. Fortunately the patient made it through with flying colors.

I also saw a supraclavicular regional block for an arterio-venous fistula surgery (type I diabetes sucks). It was cool to see the brachial plexus on ultrasound but even though everything seemed to go smoothly, obviously the block wasn't effective enough because once the surgeon cut into the patient's arm he started moaning. Yikes! I mean not screaming bloodly murder like someone was cutting into his arm, but he was definitely feeling sharp pain. Awkwardly, the resident I was with didn't seem to want to admit that the block wasn't everything it should be. Every time the patient let out a moan he would lean in and ask "is the pain tolerable?". Okay, it's nice that he's inquiring...but pain is a relative thing and tolerable can mean many things to many people. I can certainly imagine that an old military veteran might not want to complain about being in a lot of pain. Man up. But there's no reason he should have to suffer when he's surrounded by pain killers. The surgeons kept injecting him with local anesthetics, but eventually the attending anesthesiologist came in and knocked him out. Not ideal, but it was probably best for the patient at that point.

Sadly I'm now done with my anesthesia rotation/amazing vacation. Next up: Ophtalmology!