4, 3, 2, 1
August 22, 2019
Day 14
Wake-up, work-out, eat-up. That’s how our morning went again today! The only deviation was the delayed arrival of the coffee, much to everyone’s dismay.
We practiced our adaptability today, like all the other days. When we arrived at the hospital at 7:30am, we had four cases planned. By about 8:00am, we were down to only two remaining. One patient decided not to have her operation late last night, so we were not aware until this morning. The other patient we had scheduled for the last case today, but we were waiting on receiving MRI scans this morning before deciding on what we would do. Unfortunately, the patient had a large tumor in addition to some other issues that were going to make the operation extremely dangerous. He had some kyphosis of his spine that the doctors believed his body developed to compensate for the obstruction of his airways. Therefore, correcting this would potentially take away his breathing abilities. Drs. Lieberman, Hisey, and Schaffer were worried that attempting a surgery would do the patient more harm than it would good. So, despite brainstorming many possibilities, they ultimately decided against doing the operation. This was a hard case—we all so desperately wanted to think of a way to help this patient, but we had to think realistically about the possibilities and risks involved. Then by about noon, we were down to only one patient. Our fourth surgery scheduled was a three-year-old girl with congenital scoliosis. She had a hemivertebra at L3 ad was going to undergo a L1-L5 instrumentation and fusion. The plan was for the child to get a CT scan that morning so that the physicians could have better imaging before going into the surgery. However, despite given the child some medication to calm her down, she refused to sit still enough for the CT scan. Ultimately, Drs. Lieberman and Hisey decided it was too dangerous to do the surgery without a thorough understanding of the anatomy before starting the case. She would get the surgery next summer instead when she was a little bit older.
Despite our three cancellations, we still had a very full day. We also had a packed OR filled with a very captive audience. Our remaining case—a TB patient—ended up taking longer than expected due to difficulty during exposure in the first case. He was getting an anterior L5 corpectomy and a posterior instrumentation and fusion. The fact that this surgery involved both an anterior and a posterior approach added some additional difficulty to the case. The patient also had a lot of scar tissue in the abdominal area, making it a difficult dissection. While the first half of the surgery was underway, Drs. Schaffer and Hisey rounded on some post-operative patients, followed up on some scans and medications we had ordered, and saw a few more patients in clinic. For the week, we have seen about 80 patients. When it was finally time to flip the patient over, it was already past 3:00pm. At this time, Dr. Hisey scrubbed in and took over on the latter half of the surgery.
The captive audience for the long surgery ahead.
Dr. Hisey teaching some of the residents and medical students about the surgery taking place.
The patient did incredibly during the operation. He woke up from anesthesia very nicely and then was transferred back to the ward. We finished up around 7:00pm and decided that we would head back to the Hotel Triangle where we had dinner last night—the food was just too good! After the rave reviews of the whole fish last night, seven out of the eleven of us ordered it tonight.
Dinner selfie!
We wrapped up with more “Lessons of the Day.” An overwhelming theme has been how thankful we are to have a full team that works so well together. Everyone is likeminded in their goals and priorities. Dr. Benton said it perfectly (she is 2/2 on the last two days of Quotes of the Day). She said how lucky (and maybe a little crazy) it is that we can put together a group of people “that want to take two weeks of vacation to go somewhere and work twice as hard as we do at home.” She’s right—everyone is so hard-working and we are all so lucky to be a part of this awesome team and awesome mission.