Indexing Title: JGGuerra’s Medical Anecdotal Report (05-04)

MAR Title: "More than a Herniorrhapy"

Date of Observation: February, 2005

Narration:

It’s been almost one and half years since I started my residency training in surgery here at OMMC. For the time period, I was able to imbibed as much knowledge and skill a second year general surgery resident must possess. More or less, I am pretty confident that I can do Incision and Drainage, Debridement, CTT, Appendectomy, Amputation, hemorrhoidectomy, fistulotomy and herniorrhapy as it is illustrated in operative atlases. With the bulk of diverse cases we have in hand, we have a fertile ground to nourish our surgical skills.

How many times we are called upon to operate on such aforementioned cases? How do we prepare for such procedures?

I can vividly recall my first herniorrhapy. It was my second month as a rotator of Team Three when my senior resident tapped me and said, " Are you ready to do herniorrhapy? "Go over the topic and you will be assisted to do the first case tomorrow". Excited as I was, I looked for Hernia book and reinforced my knowledge.

I was not able to go on a deep sleep the night before the procedure. This is because I believe that perhaps the most important part of an operation is how you prepare for it days or nights before it is done. I am pretty much preoccupied on deciding what is the best technique to employ, what sutures to use, and how long will the procedure last. I already have a clear picture of my operative moves the night prior to the OR. Before I retire that particular evening, I was able to read innumerable times my hernia and atlas books. More or less, these are the preparations many surgeons on training make prior to a surgical procedure.

With all these preoccupations in mind, are we missing something? Dig deeper, surgeon. Its more than the usual run of the mill case...

INSIGHT (Physical, Psychosocial, Ethical)(Discovery, Stimulus, Reinforcement)

It is true that as a young surgeon in training, we are always excited when we are called upon to do new procedure. More often that not, we are caught delving too much of our attention on the technical aspects of the operation. Not realizing that we have a patient to take care of. In this set-up, its sad to say that we look upon our patients as mere cases one can learn from.

We must always bear in mind that we are not just treating his hemorrhoids, appendix or hernia for that matter, but more importantly paying attention to his individual needs as a person. This brings us to the training being emphasized by our department: the wholistic approach to a surgical patient, a training to be a "wholistic surgeon."