The Wisdom of A Surgeon

“The knife belongs to the surgeon, while the endotracheal tube belongs to the anaesthetist.”

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Today, Sunday is the time where everyone spend time at home with their family. Some might go shopping to buy stuffs they need, while others might go for a picnic with family and enjoying their life after a busy weekdays of work or study. That is how importance for us to get a rest or leave aside the work for some time so that our body can recover the energy and gain the motivation to do any job or task the following day.

For me, today I had already taken my 2nd practical exam which is surgery practical. Although it is scheduled on weekend, I do not had any problem with it as long as I can finish the exam and go through it with the best effort I could try. It such a big relief when half of the pressure of exam had gone.

Surgery practical is not that intense like those of medicine. We have to take 2 cases, 1 short case and 1 long case. There are also table viva for instrument, x-ray and specimen. While for orthopaedic, we have to take 1 long case, and also table viva for instrument, x-ray and bone. So literally speaking, surgery practical comprises of 2 subjects including orthopaedics.

It started with short case of surgery, where I had been given a case of temporary coloctomy. The patient experienced bull horn injury when he was feeding the bull. There was injury and bleeding to the rectum. So, colostomy was done to give rest to the injured rectum so that it could be healed. Parts of the descending colon is brought into the exterior and a colostomy bag is fitted there to collect the faeces.

The proximal descending colon is brought to the exterior, while the distal descending colon is closed so that healing can takes place

Source

While for long case, I got the hernia case. It is bilateral direct hernia of an old man. For your information, as we get older, there occurs muscular weakness at some area and predisposes for hernia formation. On lying down, there is bulging of the groin area on both sides. The swelling increases in size during standing and coughing. On examination, the inspectory finding is confirmed that it is a direct inguinal hernia.

Some people avoid to take the hernia case. Maybe it is a complicated one, as from theory point of view, it may bring some confusion before it is fully understood. But personally I prefer this case because, it is always found in older age group. Even one of my uncle also had this hernia and had been operated few years back. So I am thinking that, in the future, if I face with such condition, at least I know how to examine the patient and diagnose it with full confidence.

It is not that difficult case, unless our theory is not strong and as clear as the crystal.

For ortho case, I had been given chronic osteomyelitis case. The patient presents with attitude of semiflexed left leg and shortening of the same leg. There is discharging sinus on the lateral aspect of the left lower thigh region. He had history of fall from the steps during labour work 3 years back. This is one contributing factor for the chronic infection of the lower end of the femur. The discharging sinus is one clinical feature of this disease.

The case viva for long case is quite fine although there are some ‘hole’ and uncertainty in giving the correct answers.

I hope, the table viva of x-ray and specimen could help me score some marks to cover the ‘defect’ of the long case viva.

Overall, it is still a ‘high pressure’ practical exam although I finished the exam earlier than expected. That’s why I like  to do exam on Sunday..hehe..Yeah, it’s still not 3 pm you know, when I went out of the surgery ward. I feel like a little bird who can fly and swing here and there freely with free mind. =)

But beware myself, there are 2 more challenges to be faced after this. Still I get 2 days gap before my 3rd practical exam which is obstetric & gynecology followed by paediatrics after 1 day gap. I plan to start studying the paediatrics first as it is one of the toughest exam here. So many measurement to be taken and a lot of calculation to be done. Plus, the cases are also as tough as the medicine cases.

May the coming days will be better than today.

All the best for those who are having final exam, wherever you are and whichever courses you are taking. If we have strong faith with the God, and believe in ourselves and our own capabilities, I am sure success is reserved for us.

So, just do your best in everything!