Day seventeen - Wednesday

Alarm goes off 0720, I can have another 10 minutes. Alarm at 0730, grab my phone, see got message on Whatsapp. Tutorial at 0745. Crap. After legging it down the road without breakfast I ran up the stairs to the tutorial room and nearly collided with the consultant who was just walking into the room, made it with about a second to spare! 45mins on intro to ATLS, was pretty good. Recapping lots of stuff from our EMTL block, with some extras thrown in. Board round at 0830, the most ridiculously crammed room yet! Quick whizz through all the patients admitted overnight and expected in today and then the various ward rounds split off . I seized the day and nipped upstairs for breakfast, scottish style = canteen fry up! Awesome, and exactly what I needed. Also had massive dejavu on seeing their toaster, one of those continuous track things that only takes about 20 seconds, hadn't seen one since halls!

Mmmmmmmmmmmmmmm...

Fuelled up I went into surgery. One of the F2s scrubbed in for the first op, a laparoscopic cholecystectomy = removing the gall bladder using cameras and small incisions in the abdomen. For some reason I'd managed to avoid lap chole's for 5 years, so thought I might as well see what all the fuss was about! It's a very common op, and went smoothly. Pulling the gall bladder out of a small hole at the end results in the possibility of bursting it, and I thought they'd use a bag like I'd seen some gynae pathologies removed. But no bag, just gently pulling it through the hole and hoping it doesn't pop! After that the anaesthetist was called away to deal with a patient on the ward, so the list order shifted and an op was done using only local anaesthetic. This is pretty cool really, the surgeon just injecting local as they went. The patient's awake (albeit with a bit of midazolam/fentanyl sedation) and wiggling their legs around while I'm holding some retractors and the surgeons chopping away inside them - bit mental! Great for the patients though as pain free post-operative, none of the risks of general anaesthetics, can go home sooner etc. Didn't even need any diathermy, as there was no significant bleeding.

After that there was an operation in the abdomen which I assisted with again. My break came at the end after the surgeon had sutured up the deep layers of peritoneum and I asked "How do you feel about me suturing?" - they were a bit hesistant initially so I thought I wasn't going to get the chance. Then they started taking off their gown and said 'there you go', motioning towards the 15cm incision wound on the abdomen. Right then! Tied off the suture at one end, did continuous stitches all the way along and tied up. Was a bit nerve wracking, felt like everyone was watching me as I was fumbling with the needle holders. Is so satisfying, actually getting the chance to practice some skills. Was pretty happy with the result, and everyone was very complimentary. Hard to tell if they're just being nice or actually think it's OK! Want to try doing the subcuticular stitches, where you use a straight needle and the sutures all go just under the skin so you can't see them once you've finished. Had a go during my obs and gynae placement on a C-section but the patient started feeling ill (nothing to do with what I was doing!) so the consultant finished it off. I found it ridiculously difficult, but gives a better cosmetic result for the patients I think.

Satisfied I headed up to the canteen again for lunch. The afternoon saw more ops under local, which I scrubbed up for a few of. Interspersed were some trips to A&E which had been very busy, with 3 complex head injuries, a Colle's fracture and some penetrating finger trauma, and those were just the ones the surgeon I was following had been called to review! Finished off the day with a patient who had come in for some very complex wound dressings, which were done it theatre enabling the wounds to be inspected and cleaned more thoroughly before dressing. I'd never seen such extensive 'cavity' wounds, was definitely a learning experience.

So all in all a great day in the hospital. Back to the house had a quick 30min violin practice before baked spud (/tattie, when in Rome). Headed to Crofters in town for the England vs Scotland football match - at least I had Brett as a fellow Englishman. Quite an experience, seeing first hand the 'passion' of the scottish fans. For a family pub there was quite of lot of lairy language flying round, with the occassional c-bomb dropped in for good measure. Needless to say when they scored around 10 minutes in the pub exploded. Pretty funny! Thank god Walcott equalised, then half time. Queue second half, Scotland score again pretty quick - eruption from the publicans! Great equaliser quickly silenced them again. From 2-2 it was all one way traffic and when we got the winner the atmosphere became a bit deflated. I kept trying to hide my celebrations, didn't really want to get bottled. Made a swift exit afterwards! Great game, good result for both sides I reckon, Scotland made a go of it, but result that counts. Good day all round!