Saturday, April 19, 2008

Pediatric surgery

This past week I circulated pediatric cases in the OR. For some reason, it surprised me how much surgery is done on children as the result of premature birth. Preemies are very tiny, and very fragile. It made me nervous. I think it makes everyone in the OR a little nervous. When a baby goes down, it can happen quickly, and without a lot of warning. Not a good feeling. Some things are done differently with premature babies and infants, to help them get through the surgery. The room has to be kept warm because babies lose heat very quickly. And everything is tiny. Instruments need to be scaled down to fit the baby’s anatomy.

I feel a lot more comfortable working with adults. Even the really sick patients. Give me a nice bloody abdominal case, an adult laparoscopic case, or an eye case, and I am fine. No problems. I love those cases. For me, those are sort of fun. But put me in a room where they are operating on a baby, and I get grumpy. I just do not want to deal with it. I know I will have to, at least sometimes. I will eventually take call, and our hospital gets pediatric cases and even pediatric traumas. I know I will have to work on those cases if I am assigned to them. When I am in those cases, I want do the best I can to make the case go smoothly, and hopefully have a good outcome.

Do not get me wrong. I like children. At one time, I even considered going into peds nursing. But children in the OR are a whole different ball game. For me, it is a lot easier to see a sick child on the floor, than it is to see a child in the OR. I want to see them whine and complain and cry because they feel miserable. Most of the time in the OR we work with the child while they are asleep. When we take them to PACU, they are usually still asleep. We may need to call the parents to let them know what is happening in the OR, if the case is really long. Parents are usually worried about their children, and not at their best.

Maybe I am just jealous. I felt surrounded by babies and mothers this week. It felt like everyone I worked with on these peds cases had children, or they were pregnant. I felt out of place, like I was imposing. I do not have children, and there feels like no possibility of children or babies, at least in the near future. It felt awkward handling babies this past week. I have not had a lot of experience holding children, and we would usually carry the babies into the OR. My infertility was very apparent to me during those moments. I want a baby of my own, but I am unable to have one. I found that caring for other people’s children does not give me a lot of comfort, and only makes my childlessness more apparent, at least to me.

Next week I do not have to deal with children. I am off on different adventure in OR land. I start my ortho rotation. I get to learn about operating on bones and joints. I am trying to keep an open mind, but it can be difficult. My previous experiences with ortho were not good. I also like my pathophysiology. I think you see more of that in the general cases. Ortho seems to be mostly repairing structure, using a lot of tools. We will see what happens.

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