Thursday, 21 February 2013

Cream crackered!

This week has been pretty tough for me emotionally. I had my first venture into a surgery on Monday. Here's how it went:
  • Got kitted out in scrubs, rubber clogs, a hairnet and surgical mask-very exciting and took a few sneaky pictures!
  • Headed on into the Minor Operations theatre and had a look around. 
  • There are two beds so two patients were brought in
  • I stayed by one and his wound was uncovered. He was a 13-year-old boy with an infected and very painful looking sore on his upper thigh.
  • They started injecting saline all around the wound to flush it out without using any anaesthetic, local or otherwise. The boy was shaking and crying in pain and all of a sudden my stomach didn't feel like it was where it should be, I had buckets of sweat running down my face and I had to run out. I collapsed against the wall outside for a few minutes before a confused nurse found me and took me for a sit down in the doctors' room. 
  • After cooling down, having a cold drink and resting for a good 20 minutes I headed back into the theatre.
  • Queue next patient and his wound. It was on his foot and he was missing half a toe and the rest was messy and rotting. "Ok," I thought, breathing deeply, "this is gross but it's fine." They started to flush it with saline, the man cried out and once again my stomach turned. I didn't faint this time but I knew what was coming so I went to the doctors' room.
  • I panicked. Sitting in the room, taking deep breaths, all I could think was "I'm never going to be a doctor. I'm definitely not going to be a surgeon like I was sure I wanted to be. I won't even be able to be any kind of doctor. I'll never make it through medical school if I get ill from this!" It was one of those moments where the future you had seen vanished.  I felt like I'd wasted the last however-many years of my life trying to get into medical school only to realise now that it had been a waste. 
I spent the rest of that day feeling quite miserable. I tried to reason with myself. It was my first ever surgery, it was in Sri Lanka where the conditions are questionable (think hot theatre, two patients, clinical waste just dropped onto floor etc), the thing I was finding hardest was knowing the patient was in pain etc. It worked a little.

I also emailed my amazing sister who reassured me that I was just human, every medical student goes through it, it doesn't by any means stop you from going through medical school etc. With her words and my good old determination, I went back into surgery the next afternoon.

This time it was the Major Operations theatre and they were doing hernia repairs. I was terrified. I edged up to the locally anaesthetised patient, peered cautiously at where the surgeons were operating and took a breath. I felt fine. No stomach turning, nothing. I stayed in that theatre for 2 hours and saw 2 hernia repairs. I was fascinated, I didn't want to leave. There is something very different about a surgery where the cutting is clean and intentional and a known procedure is being carried out. I loved it and have been in such a good mood ever since. I even popped back into Minors to see some wounds and, although it was still really gross, I managed to stay and watch the procedures (I didn't enjoy it half as much but I was so proud I did it).

Today I was back in and saw a couple of manipulations of dislocated joints, a removal of an cystic ovary in a 12 week pregnant lady and 2 cesaerean sections.

The ovarian cyst case was an emergency procedure and the surgeon had been on-call when he was summoned. The cyst was putting strain on the woman and if the ovary wasn't removed immediately she would definitely miscarry her 12-week-old feotus. When we first went in we were told by a nurse that the mysterious mass (actually the ovary that was swollen to the size of two fists) that had just been chopped out and dumped in front of us was a feotus from an extrauterine pregnancy. We were somewhat relieved when the surgeon told us that, no, it was just a necrosed cystic ovary.

The Caesereans were an incredible experience. I have never seen a real birth before and, although the delivery conditions in Sri Lanka are pretty horrible and Caesareans are not ideal in the first place, it was magical. I won't lie, a few tears escaped, seeing the miracle of new life being brought into the world. I am really looking forward to going to the Labour Ward next week!

So yes, a very testing week so far but right now I am feeling so happy, very proud of myself and fascinated by the things I have seen and experienced. I am learning so much about myself out here and finding out things that will stay with me for life!

On another note, last weekend I spent a day in Colombo (very nice and enjoyable) and then a morning at Bentota beach. On Sunday afternoon I went to a cafe in Panadura to say goodbye to Liv and Sophie, two fab volunteers from the UK who have headed off to continue their adventures! Jeanie and I have a new housemate, Lisa, from Holland. This weekend is a Poya Weekend (bank holiday on Monday due to full moon) so we have been busy planning! Speak soon!

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