Sunday, March 21, 2010

tutor


training as a surgeon where i trained was somehow secondary to supplying a service. often formal tuition fell away to a senior quickly showing you how to do a specific operation in a somewhat irritated way. half the time you felt embarrassed that you didn't already magically know how to do it so that you could take the immense burden of teaching off the tired shoulders of your overworked senior. the first haemorrhoidectomy i was shown fell pretty much into this mould.

i was still a lowly medical officer when we admitted a patient with a pretty severe thrombosed awkwardness in the nether regions. my senior, a final year registrar, asked me if i had ever done a haemorrhoidectomy. afraid that not having done one would not exempt me from being tasked with doing this one, i discretely pointed out that i had in fact never seen one. i could see the irritation in his face, but he remained calm and told me he would show me how it was done. he then added i'd better pay attention because after showing me one he was never again going to cast his countenance on another anus so long as i worked with him. not wanting to upset his countenance i determined to learn fast.

i remember that haemorrhoidectomy well. i was so on edge to gleam every ounce of wisdom from my senior seeing as though it was to be my only opportunity to learn the procedure. and yet even though he explained every step as he did it it just looked like a bloody mess to me. anyway, that was my training and it had to do. fortunately as the years went by i learned a few tricks, mostly by trial and error, and finally i think i became quite proficient in the procedure.

then, many years later when i had become the senior registrar in the department once again a haemorrhoidectomy found its way onto a list. i expected that i would be the one to do it as i had so many times before. then the boss perused the list. he asked me who had taught me to do a haemmorhoidectomy. when i told him he decided right there that if he had not taught me how to do it, then i probably wasn't doing it correctly. to be honest i thought he might have a point. i mean that operation i had seen so many years ago did simply look like a bloodbath to me. true i had made the operation my own over the years and i even think i had become good at it, but i hadn't really been shown the correct way to do it by someone that at least in his own eyes was an expert. i was actually quite keen to see the operation in the hands of the expert.

at the operation, the boss settled down in the hot seat and prepared to show me his masterpiece.

it was a bloodbath.

14 comments:

shadowfax said...

Well done. Funny.

rlbates said...

lq2m

Jabulani said...

hardy har har

Cal said...

At least you then knew that the first time you were taught it was the (in)correct way of doing it.

StorytellERdoc said...

LOL...too funny.

Albinoblackbear said...

I remember this massive bodybuilder coming in one day to the ED with huge hemorrhoids.

He was a complete steroid monkey and was totally abusive to his diminutive girlfriend the entire time he was waiting to be seen. Of course I always think--if people behave like that in public what do they save for behind closed doors?

Anyway, we consciously sedated him for the hemorrhoidectomy but he yelled and swore and frothed at the mouth the entire procedure.

I probably shouldn't admit it....but...I didn't feel sorry for him. At all.

Bongi said...

albino i too feel nothing for people that abuse other people. of course, like you, i wouldn't admit it in public.

p.s remember to keep out of the sun.

Albinoblackbear said...

Well, here in Ireland that isn't a problem! :)

Anonymous said...

On the subject of bloodbaths, did you ever have D.I.C. pop up unexpectedly during surgery?
Is it pretty obvious or a slow dawning that it is happening?
L.A.

academicobgyn said...

Hah!

Doing circumcisions was not so different in my training, which was pretty scary given that my subject would see the light of day far more than the literal assholes you were operating on. We did five supervised before we were out on our own to create beautiful circumcised penises. I think I did OK, but I didn't perfect my technique from a speed and grace point of view until about fifty. I had it down from every angle - when to do the block (while the baby is in the bassinet of course), what size gomco clamp to use, and which nurses were the most helpful.

The biggest thing I learned was that if I needed help, the best person to call was another intern, because the further up the chain I went the further away from doing circs my help would be!

academicobgyn said...

Hah!

Doing circumcisions was not so different in my training, which was pretty scary given that my subject would see the light of day far more than the literal assholes you were operating on. We did five supervised before we were out on our own to create beautiful circumcised penises. I think I did OK, but I didn't perfect my technique from a speed and grace point of view until about fifty. I had it down from every angle - when to do the block (while the baby is in the bassinet of course), what size gomco clamp to use, and which nurses were the most helpful.

The biggest thing I learned was that if I needed help, the best person to call was another intern, because the further up the chain I went the further away from doing circs my help would be!

academicobgyn said...

Hah!

Doing circumcisions was not so different in my training, which was pretty scary given that my subject would see the light of day far more than the literal assholes you were operating on. We did five supervised before we were out on our own to create beautiful circumcised penises. I think I did OK, but I didn't perfect my technique from a speed and grace point of view until about fifty. I had it down from every angle - when to do the block (while the baby is in the bassinet of course), what size gomco clamp to use, and which nurses were the most helpful.

The biggest thing I learned was that if I needed help, the best person to call was another intern, because the further up the chain I went the further away from doing circs my help would be!

academicobgyn said...

crap you better kill some of those comments. blogger went crazy. Maybe it has a painful hemmorhoid.

Plastic Surgeon said...

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