Thursday, March 31, 2011

just a couple days

A couple weeks ago I had a rather... surreal few days. It started in clinical. I don't mind telling you now that it's over that my last rotation was on a cardiac unit. For my second-to-last day my preceptor arranged for me to observe open heart surgery. I got to assess the patient beforehand and then go with him down to the PACU and then into the OR.
I got to watch as they prepped the patient and anesthetized and intubated him. I watched the physician assistant harvest the saphenous vein and the doctors saw open the chest. And then they told me to walk around to stand with the anesthesiologist at the patient's head. I peeked over the drapes, and THERE WAS THE MOTHERF*CKING HEART. Pumping away as they worked on and around it.
Mind. Blown.
I have never in my life tried so hard to just NOT TOUCH ANYTHING. I kept having nightmarish thoughts about what if I accidentally touch the sterile equipment? What if I trip and fall over on something important? Or what if I trip and fall on the patient?
I didn't, though.
Everybody was super nice and welcoming to me. One anesthesiology resident even draped me with a warm blanket because the OR is, well, freezing. And the doctor preforming the surgery gave me a running commentary on what he was doing "Now I just attach the vein graft so the blood can flow freely through. I'm basically like a plumber, I suppose." Um. Dude. If you are comparing yourself to a plumber you are seriously the most humble doctor I've met in a great while. Because, no offense to plumbers, but HE HAD THE GUY'S HEART IN HIS HANDS.
I know it is surgery that they do every day but I was impressed at how the doctors and physician assistants and nurses and techs were all steady-handed-chilled-out-ho-hum-just-another-day-at-work meanwhile I'm standing there having an internal existential crisis Is he alive? Is he dead? THE MAN'S HEART IS STOPPED AND HIS BLOOD IS GOING THROUGH A MACHINE. What does this MEAN?
Seriously. Mind. Blown.
The PA had taken me aside before everything got started. "Look," he said. "it's going to be really intense in here. There are going to be sights and smells that you aren't used to so if you need to faint then step away." He explained that I needed to stay loose and comfortable and not lock my knees and meanwhile I was thinking PSHHH I've seen surgery before I'm all over this. Seven hours later I could barely stumble through the front door before I collapsed and passed out on my couch. It was INTENSE.

The next day I had my site visit-- the director of my program came to see me show off my mad history taking and physical examination skillz. It was nervewracking but it went just fine. Apparently they think I'm doing an okay job at this nurse practitioning stuff. I mean, that was my last site visit and they're going to let me graduate, presumably. Anyhow after that stressful couple of days I was in serious need of some R&R.
My friend D invited me to come with her and a group of gals from her program (I won't say what specialty they are but here's a hint: it has a lot to do with lady business and wee, brand new people). Anyhow they were all going to this spa so I tagged along. We headed over to Japantown's Kabuki Springs & Spa which turned out to be JUST what I needed. I paid my $22 bathhouse fee, stripped down, and spent the next couple hours feeling like some kind of goddess.
Bathing in the heated pool, dipping my feet into the cold pool, cooling my face and neck with icy-cucumber cloths, exfoliating my skin with salt in the steam room, lazing on a wooden lounge. It was just lovely. "Wait what?" KC asked me later when I told him about my day, "I was at work all day and you were in a spa full of naked ladies?" YES. And then I went out for drinks with D and the other gals.

And then the next day we had our last palliative care class. The last hour was dedicated to student presentations. People talked about their relatives or friends or patients who had died. Someone read a poem she had written about her father who had died and their tenuous relationship. Someone played a song they had written about a patient. One woman, a pediatric oncology nurse, presented a collage she had made of things that reminded of her of the kids she had taken care of who died. It was basically an hour-long sobfest. It was a nice way to end the quarter (and I mean that sincerely).

I told all my friends in class about the open heart surgery. I'm still telling people. I told my new preceptor yesterday. It STILL blows my mind.