Friday, September 28, 2012

Primal Pleasures

There are a lot of things in life that everyone enjoys. For instance, taking a nice vacation someplace warm. Having a delicious meal. A fun night out on the town.

But there are a few very simple pleasures, primal pleasures if you will, that we sometimes forget about. Fortunately, my medical training allowed me to be reminded of many of these simple pleasures. I have highlighted five of them below:

1. Water

When I was rotating through surgery as a third year medical student, I would intentionally deprive myself of all food and water prior to my first surgery at 7AM (I was in the hospital since 5AM), because I was absolutely terrified of having to pee during the surgery. The nurses and surgeons were more terrified of my having to faint, so they would always ask me if I ate something, and I'd always lie and say, "Of course!"

My clever trick worked in that I usually didn't have to pee too badly during the surgery, but I would get SO thirsty in the morning. If I was really desperate, I would take a mouthful of water and just let it sit in my mouth for a few seconds before spitting it out. Or maybe, if I was feeling really gluttonous, I'd just let a single drop of water go down my throat.

Then after that first surgery was over, I would go to the lounge and drink half a Styrofoam cup of water (not a whole cup, since I had another surgery coming up). Ah heaven.

2. Sitting down

An upperclassman once said to me at the beginning of third year of med school, "One of the hardest things about being a third year is learning to stand all the time." It totally is! I started my third year with the cushy psych rotation. Unfortunately, when you START with psych, it doesn't seem quite as cushy. 8AM is great if you just finished getting up at 4AM for surgery, but not as good when you're coming off a vacation.

Anyway, our psych rounds would last about three hours every morning and we would be standing the entire time. My feet and ankles would be on fire. But it was a big no-no to sit down during walking rounds, so I would try to "sneak in a sit". Like if there was a sink in a patient's room, I'd surreptitiously rest my butt on the edge to allow the pressure off my feet for just a few minutes. Ah heaven. And then when rounds ended and I could sit for real, it was like my feet were being licked by kittens (I'd imagine).

Of course, I didn't know what I was in for back in psych. Three hours rounds? Try seven hours holding a retractor and suctioning.

3. Post-call sleep

After 30+ hours awake, there is nothing more wonderful than turning your pager off (or flushing it down the toilet), pulling the shades, and snuggling into the blankets for a nice nap. Even though you know you're going to feel crappy and disoriented when you wake up.

4. Being able to scratch your face

There are a lot of things we take for granted when we're not sterile and one of those things is being able to touch/scratch your face (or body). Maybe real surgeons are so focused on the awesome task at hand that they aren't as bothered by random itches, but when you're holding a camera in one spot for hours, intermittently being yelled at by the surgeon who says you're going to make him vomit, things start to itch. Especially when you're wearing an uncomfortable mask and cap. The second those gloves came off, I really went to town--rubbing my nose, scratching my neck, etc. Ah heaven.

5. I+D

Maybe it's not a primal pleasure, but there are very few things as satisfying as sticking a scalpel blade into a huge abscess and watching the pus pour out. The patients usually like it too. Therefore, fluctuant is one of my favorite words. Fluctuant.


  1. This HAS to be the funniest thing I could possibly read on the internet today! HAHAHAHA Great start (ish) to the day!

    Thanks for the laugh. I'm in 2nd year now, still kind of far from 3rd so maybe that's why I'm laughing.

  2. Nice one! Once I had to do 54 hrs continuous duty... Oh! How I value sleep!

  3. I remember working in the surgical ICU and being so busy that we couldn't eat the food we ordered. It was the middle of the night and I had been there since 3 in the afternoon - I would be there until 7 a.m. I put the burger and fries in the autoclave cum blanket warmer and ate them at 3 a.m. They were, at the same time, the worst and most delicious burger and fries I ever tasted. Tricia

  4. I second your I&D vote -- free-flowing pus is one of the most satisfying things in life.

    Never limited my fluid for Surgery tho' scrubbed in on some long CABGs/AVRs and renal transplants. Drank a glass of water on waking each morning. Emptied my bladder before and after surgery and was fine. I do have a tiny bladder.

    I don't think voluntary dehydration is a great strategy for health and optimum cognitive function. I actually needed 3 liters of IV fluid for dehydration and BP in the 70s when I got upper gastroenteritis during my Medicine rotation. Had I not been relatively dehydrated from not drinking on my rotation I think I could have avoided the ER visit.

  5. I don't think I've ever had to scrub out to pee, but I *need* to have at least a few big gulps of water before going to the OR. Whenever my throat gets dry, I tend to start coughing, which becomes very noticeable and (possibly) distracting while scrubbed in.

    And I completely agree about I&Ds, though I might add IVs and art lines and central lines to that. Though I don't know how satisfied my staff was today when he got spurted with blood from a very well placed art line.

    As for sitting, I tend to add "sit when you can" to the adage "sleep when you can, eat when you can". Fortunately the ICUs here have lots of comfy rolling chairs around so you can sit for at least some of rounds.

  6. I get SO THIRSTY when we're busy, and there are never any cups next to the cooler. You'd think I'd learn....

    I've yet to find the perfect standing boots for surgery. I wake up in the middle of the nights after long surgeries with the bottom of my feet cramping. It sucks.

  7. I sneak in sits on sinks and tables. Also I wear shoes that don't have to be fastened, so I can pull my feet out. The cold floor feels nice, and then the shoe cools off and feels nice too. And coffee has become so special, especially when you can sip it slowly and not have to inhale the cup and have a burnt throat the rest of the day.