“All good programs. Your senior resident this rotation is Dr. Hashemi. He’s a trauma surgeon with a lot of ER time, so when he gets a page, you should shadow him.”
“Thank you, I’m looking forward to that opportunity.”
“Good. FYI, I like students who can think on their feet.” She hands me the tablet. “Familiarize yourself with the patients on our service today. Pre-round on all of them. We’re in the OR by eight. Dr. Hashemi will expect detailed notes on each patient—overnight events, vitals, labs, physical exam findings. He will also ask you for an assessment. Don’t just regurgitate what’s in the chart. We want to know your thoughts and give you feedback on that. Any questions?”
“Not yet.”
“See you in an hour, then.”
I sink into the rhythm of the floor pretty quickly. Dr. Hashemi arrives with a third year medical student in tow, and then I have company as I dig into the cases in front of us.
The first patient is an elderly woman two days post-op from hip replacement who is complaining of increased pain.
“Differential diagnosis?” the senior resident asks.
“It could be normal post-surgical pain,” I say. “But we need to check that it’s not early infection.”
“Keep an eye on her blood work and keep me posted.”
I nod vigorously. “Yes, will do.”
“Next?”
This one is a middle-aged man with a complex ankle fracture who is very focused on when he can drive again. Which isn’t my place to answer just yet, not for six more months.
“Mr. Patterson in 5024,” I say, pulling up his chart on my tablet. “Fifty-two-year-old male, post-op day three from a bimalleolar ankle fracture sustained in a skiing accident. Vitals stable overnight, afebrile. Pain is well controlled. Incision sites clean, dry, and intact with no signs of erythema or drainage.”
“Did you do a distal neurovascular exam?”
“Yes. Strong pulses, intact sensation, and good toe movement.”
Dr. Chen arrives as I finish and holds out her hand for the tablet.
Dr. Hameshi encourages us to present what we’ve observed from the post-op patients, then we move on to the surgical cases for the day.
In the OR, there are more questions. Day one of a rotation is a lot of baseline assessment. As the second surgery is wrapping up, we’re paged to the ER for a consult on a fracture that needs to be set under sedation.
Dr. Chen sends me to follow Dr. Hameshi.
“Have you observed a ketamine sedation before?” he asks as we strip off our surgical gowns.
“A few times.”
He asks me a few more questions in the time it takes us to walk to the ER, and when we get there, it turns out the patient has two fractures, a broken leg and a broken arm.
The leg is probably going to need surgery, but we attempt a reduction anyway, and then I’m tasked with casting the forearm fracture, too, before he’s wheeled off to imaging to see how we did on the leg.
While we’re done there, a trauma comes in and Dr. Hameshi is pulled in for a consult, but there are too many people in the room, so I check in with the nursing station and see if there are any other ortho cases I can poke my nose into.
“What are you doing down here?” Sloane asks, appearing out of nowhere.
I jump. “Don’t scare me like that. What areyoudoing down here?”
Liz and I both have in hospital rotations this month, but Sloane has a month off for a research project. My research month is March, and Liz’s is in February. It’s also jokingly called vacation month, because while we do need to do a culminatingproject, it’s also our last chance to have some time off before residency.
And my bestie is just like me, so of course she’s spending her first day of that month off at the hospital. I shouldn’t have even asked.
“Having lunch with my dad,” she says.
