A Day of Trauma Call

I thought I would take the opportunity to share what a day in the life of trauma call is like for anyone interested... these are based on, but not actual, events that occurred. (On trauma call days we can't arrive before 8am or we go over the 30 hour shift... pre-call days we're at work between 5 and 6 am).

6:15am Alarm goes off
6:45am Actually get up (I'm really bad at getting up)
7:15am Leave for work
7:45am Arrive in surgery resident's lounge and start writing down: vitals, labs, radiology/pathology results, and medications for patients I'm responsible for seeing
8:00am Start seeing patients
9:00am Rounds with the Chief Resident (the senior most resident)
10:00am Get work done; wait for the page to round with the staff; possible case in OR
??:??am Rounds with staff
11:00am-5:00pm Get work done; cases; wait for trauma codes
Sometime after 5:00pm Trauma Code: MVC vs. Pedestrian, eta 5 minutes (this exact call happens about twice per night... Detroiters love playing frogger on the major roads).
8:00pm Dinner with the team
10:00pm Evening pre-rounds
11:00pm Evening rounds with Chief Resident
12:00pm Trauma code 1; GSW or stab wound; eta 2 minutes
2:00am Grab a nap if you're lucky
4:00am Pre-rounds
5:00am Rounds with Chief Resident
7:00am Rounds with Staff
8:00am Some random OR case
10:00am Finish work
12:00pm HOME!

Trauma codes of course come in at any time during the 30 hours, with a few actually ending up in the OR. For "getting work done" there are a lot of things involved: consults from other services; bedside I&D (cutting open sacral decubitus ulcers); ER consults; pulling lines; walking patients; checking up on labs, etc.

This week I got to see and do some cool things: 1) saw my first external hemorrhoids and cut to cut them open, 2) saw compartment syndrome and the emergent four compartment fasciotomy and positive crescent roll sign*, 3) had a combative patient who had to be held down by 7 people and admitted to having alcohol, cocaine and heroin on board... there's more, but I'll stop there.

And on that note... it's time to get back to my research...

*Crescent roll sign: the rapid expansion of the compressed muscle upon fasciotomy, much like the release of dough from the crescent roll can.

because it's worth watching.

"It's so cold in the D"

This month is my elective month, which means that the masochist in me came out and I signed up for an extra month of surgery... trauma surgery, at Detroit Receiving Hospital... which means all sorts of craziness.

When I first arrived everyone asked why the crap I was doing an extra month of surgery in my 3rd year, including one of my attending (who happens to be a god of trauma surgery.. more on that later). My answers... I wanted to make sure surgery was right for me; although I was almost positive I was set for surgery after my surgery rotation, I wanted to see if I could cut it at a "harder" hospital (So far it's only made me want to go into surgery more); I wanted to learn about medical management of surgical patients (which I knew I'd get on the Ls team); and I couldn't imagine having the opportunity to do surgery for a month and spend the month doing something else... Plus, there's always the goal of getting a potential letter from any elective you do in your specialty (not gonna lie there...).

More on my team... I'm working with the legends of DRH: Charles E Lucas and Anna M Ledgerwood, also known as "The Ls". Both of them have published tons of papers on trauma and the effects of trauma. They are both BRILLIANT. They expect excellence. They are amazing surgeons and compassionate physicians. Basically, they are who I want to be at some point in my career.

Not only are my attendings on the service great, but I have to say that my senior (top resident) has been a great example. He is calm through everything and expects a lot. He does a LOT of pimping (which in the lingo for asking questions), but it's forced me to study and actually learn. I think I've learned more in the past week and a half than in a comparable amount of time on any service. Not having a shelf exam hanging over my head helps...

Needless to say, the past few weeks have been an amazing experience... and only confirmed my passion for surgery. So here's to being a pseudo-sub-I* and taking q3** call on an elective. Bring it. :)



*a sub-I is a month long rotation during your 4th year, where you're expected to act as an intern and cover the ICU patients... we don't have a 4th year, so I'm covering the ICU patients
**q3 means spending every 3rd night in the hopsital.