Almost game time

So I made it back from Ohio in one piece...it was definitely not a vacation... in an effort to impress or be seen as much as I could, I had to sacrifice any sleep or opportunity to explore the city and surrounding areas. I did get a good glimpse of the program, and I can tell that they are very strong didactically and they see a ton of cases. The first full day I spent, was in the OR from 7am until 9pm, watching 12 or so cases. The second day was pretty much the same in terms of how busy they were. The last day I was there was spent in clinic to see the other aspect of the program. I was amazed at the efficiency of the physician and his staff. In 8hrs, he saw a little over 70 patients, but none of his exams seemed rushed. He was a very good physician, had good repor, explained everything to his patients, including x-rays and the results of their operations and was able to do an inclusive musculoskeletal exam all within several minutes. At the same time he was able to ask me questions and do some teaching along the way. Overall it was a good trip, as far as really getting a chance to know people, it was difficult. With 15residents and 7 orthopedic surgeons, and only three days, I did my best to meet them all, and then I concentrated on just a handful to spend more time with and hopefully they will remember me. The bad news is, that statistically, the chances aren't that great. Last year they had 75 applications...12 interviews...all for 3 slots. So...I'm hopeful, but as always, I'm going to spread my seed everywhere (that wasn't meant to sound bad...but it just does) and apply to 20+ programs. An alternative if I don't get in this year, is to do a rotating internship year and then apply to the 7 orthopedic programs that only take intern applications.

Thursday, I had to get back into the grind of things with OB. Of course, the first day back was extremely busy. I assisted with a C-section and 3 vaginal deliveries. Friday was much slower with only a few GYN surgeries, and Labor and Delivery was slow upstairs in the hospital, so I decided to lounge around the OR, and try to see some other cases. Luckily, I was able to scrub in on an odontoid fracture (part of the C2 vertebrae of the spine, shown below) with a neurosurgeon. He was very good at teaching me stuff and letting me do a lot also. Having met me only once, he still let me do some cutting, cauterizing, and then left me to close up the incision. The case was interesting and rather rare. He stated that he gets one of these cases maybe in a year or two. Most of these cases happen in situations with great trauma...in this case it was a very elderly man, that slipped and fell in church.

The fracture that the patient had was the type II fracture, which is the most common. This is a view of the anterior surface of the C2 vertebrae as if you are looking straight at someone who is facing you. The C1 vertebrae sits on top of the C2, and because it is shaped as a ring, it pivots on the odontoid of C2 (the pointy thing that looks like a head and neck). With a fracture through the base of the odontoid, there will be a lot of instability between the two vertebrae. To fix the problem, a screw was drilled from the left base of the C2 body through the head of the odontoid that had fractured off. It was a neat case to see, and since I have two days left and he has surgeries on Wed-Fri, I'm hoping to scrub a few more spine surgeries.

The weekend was pretty lame, I mainly studied. I start my string of orthopedic surgery rotations on Friday for the next three months, so I've been trying to review a lot of stuff, so I can look somewhat smart. I'm a little nervous...but I know it's game time...and if I want to get into any of these programs...I'm going to need to work my @$$ off.

I do have a roomate now for the remainder of the month, which is kind of nice. Dan, one of my classmates (who went to school at West Valley with Uhlman/Peaches/Steele/etc) is doing urology here in town, so he moved in with me to Salwa's apartment...so it was good to have someone to rattle of the days details with.

That is all for now...I will try for one blog a week...mainly on weekends...that is my new goal...