I Like Surgery

Today we had several surgeries. Again it was a 13+ hour day but I am loving every minute of it. We had 2 tonsillectomies, 1 uvuloplasty, tracheotomy and a mandible reduction. Good times! I really like doing surgery and the residents who run the ENT program are more than happy to let me help with the surgeries. I feel like I could work all day in the OR, which is a good thing because that is what they require.

The first case we did today was a 22 year old male who over the weekend found himself in a fight and his jaw was broken into pieces by a fist. So we had to put it back together again and wire his jaw shut. Throughout the entire procedure I kept thinking to myself that his mouth is going to kill for the next week or so. In order to work on the jaw we had to use metal retracting tools to keep his mouth open and his tongue out of the way. You can't be gentle, so we were tugging and pulling and I have to imagine his mouth / tongue are going to be bruised. In order to wire the jaw shut we took wire and pushed it through the gums between the teeth, then you wrap it around a tooth and come back around the tooth through the gums again. It looked painful. I hope to never break my jaw.

The tracheotomy was a sad case. The patient is a 44 year old male with aggressive esophogeal / laryngeal cancer. We were doing a tracheotomy to insert a breathing tube. Basically you cut through the tissue and into the trachea about 2 finger widths above the sternal notch. We then insert a breathing tube. This patients cancer is so advanced that his entire neck is 2 - 3 times normal size due to all the cancerous growth. He is going to die shortly. I was looking at him after the procedure before the anesthesiologist woke him up and he already looked dead. His life has been sucked out of him by the disease. It is certainly hard to see and even difficult to comprehend. The guy probably has less than 6 months to live but could last longer so the torture will continue. Do you want to go for a smoke break?