Index Title: MJCabahug’s MAR 06-3

Title: The Rising Sun 

Date of Observation: April, 2006 

Narration:

While growing up, I used to spend my days wallowing at the beach shore; watching the slow rising of the sun bathe the world with its magnificent rays.

With each passing second, the light of the sun slips past the horizon to greet the beginning of a whole new day.

This moment is utterly perfect. It is silent just as it is powerful. It cannot be commanded. It knows how to take its time. Not wanting to be hurried or rushed.

One particular duty day, as the other groups finished their endorsements, and bade their goodbyes itching to go home, we the duty group were left behind to do all other necessary things.

It has been this way for several years now, and I have gotten much accustomed to the fact that I will be spending a couple more years like this. But that day, I was particularly restless.

Having finished the rounds and was at the ER, I was so eager for the duty to end. So, I told my co-residents to book all the patients who were operable that night.

After having done with the regular appendectomies and amputations, we decided to operate on a pediatric patient referred to us earlier due to intestinal obstruction.

This patient had been complaining of abdominal pain for three weeks.  But I guess due to lack of finances, disregarded his discomforts.

By the time he was referred to the surgeons, he already manifested as a complicated case. His abdomen was tense and distended with a percussion note of a ripe watermelon. We were apprehensive of what we might find.

During the operation, we found that his bowels were obstructed by stricture bands. We immediately released the bands and found that his bowels were in good condition. But a cecal mass was noted. A resection-anastomosis of the area was in order which extended our procedure.

I was annoyed that the operation took ages to complete. I was exhausted, as far as I know, so was my senior. Much to say, we ended with our operation well past sunrise.

Much to our dismay, on the 9th post-op day, the patient was once again observed with tender and bulging abdomen; fecaloid material was coming out of the NGT.

The patient was immediately re-operated on.  Intra-operative finding of anastomosis breakdown was noted. We did as much as we could to manage the mess; we did an ileostomy.

Insights: (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcement)  

            This experience has suddenly made me miss my home and the sunrises I used to watch. 

Like the sunrises that slowly graces our world, I realized that being a surgeon cannot be hurried through as well.

Like the rising of a new dawn, each moment of our training is precious and must be savored.

Learning to operate is something not done in haste. And should never be. 

We must learn to be patient and diligent with our practice.

            And when we have done well, when the time is suitable, we will prove to be most deserving of our patients.