Good or bad?

Last night I was in OT around midnight debriding a wound on a patient's ankle. He was using one of those portable grasscutter and the metal blade broke off and hit his leg.

He sustained an open fracture and some muscle cut.

Now, I love being in the OT. Even at 12 midnight - but it is something else when my nurse keeps going somewhere else in her mind (Eh, I have been working for the past 16 hours, you just got in three hours ago, ok) and the drill bit was so dull it took me one minute to drill a hole in the bone - urgh. Everything that could go wrong, went wrong - and to top it all off, a HUGE fly decided he would come a visiting and landed on my operating site!

Seriously lah!


My hospital started to have houseperson (trying to be PC here) about a year ago - and some are good and vice versa and I was remarking to my colleague that after about 20 or so of them, how one barely remembers some of them.

and of course, there are the memorable ones and funny ones and really knowledgeable ones that they sometimes put us MOs to shame.

I am not really sure how I should be with my housemen - I've worked in the district for so long without having them that I have gotten used to doing things myself. I am, though, extremely happy with having them around when a two-week abscess or one-month, foul smelling foot comes in at ridiculous hours (and by that I mean, 12 midnight on a weekend).

Sometimes I am torn between letting them close up an incision because that is the part I love best about operating - seeing the two edges of skin come together, signifying, (I hope) a job well done - but I realise that if I don't let them do it, then how are they to learn?

I would get so exasperated when I tell them, these are the things that the specialist loves to ask and explain to them how to tell when the closed manipulative reduction is acceptable and yet, get a blank look when the same question comes up the next day.

but then, I tell myself that I was worse when I was in their shoes. I hated going to the clinic and hate having to change quickly into OT scrubs when my tummy is growling for food and I hated Grand Ward Rounds that I wanted to take an EL each week - so I think about that and I cut them some slack.

I envy the fact that their housemanship has become easier due to the fact that there are so many of them (I used to be in charge of a ward with just one or two other housemen - and now, about 4 or 5 of them share a CUBICLE!) yet I tend to worry because they end up being so underexposed. A big part of being a good doctor is experience: you can't really counsel a patient properly if you haven't gone through and seen what a procedure entails. What you see in a book is never the same with what you see in life. We used to do everything and saw everything and I was talking to a houseman who has never seen an operation to excise a ganglion, despite being in the 6th posting and have been in Ortho for the past 2-3 months!

I worry sometimes, you know. and I think a lot of people should be too.