Make sushi not rice 

It takes 7 years of cooking rice before a sushi chef gets his hands on the fish. 

Replace rice with “appendixes, abscesses, hernias, manual evacuations” and fish with “major cancer resection” and you have the model of surgical training we are all labouring through. 

My kids can make half decent sushi, but they can’t make rice. It’s about the training! 

Make sushi, not rice. It’s my new training motto. 

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Spot on John Humphrys; that’s how I feel too

Spot on John Humphrys; that’s how I feel too

The lovely, clever and doggedly determined John Humphrys is the man who wakes me up in the morning. I was sad to read in yesterday’s Sunday Times that he is contemplating retiring soon, although the rest of the Today programme presenters are also first class and I enjoy listening to them all. I like to imagine that if I met them in the pub I would get to hang out with them and join in their clever and amusing chat; they would probably not want to hang out with me though, when they discovered I couldn’t define Keynesian economics and sometimes get muddled between gross and net pay.

Anyway, John Humphrys is quoted as saying;

“Sometimes the programme they present you with at 4am is just absolutely brilliant and you think, ‘Wow’. But mostly it’s not. So you have a moan and a whinge and then after half an hour you think, ‘Actually, I am bloody lucky doing this’. Most mornings at some point I think ‘God this is fun’. Don’t tell them but I would do it for nothing.”

And that is what my job is like, that is what other people don’t get when they say to me “I don’t know why anyone would be a doctor nowadays”. Good, I am glad you don’t, it is because it is often the most marvellous fun.

today-programme-presenter-005

Some of the Today show presenters, which I think my work colleagues are a bit like, but we know about surgery… as opposed to knowing about everything. 

 

Reading between the lines 

Reading between the lines 

We do not always mean what we say…

To the anaesthetic team 

“I think they moved/coughed” 

They most definitely did move or cough. 

“Are they relaxed?”

They are not relaxed 

“We still have to close, are they relaxed?”

Right, I’ve been at this for 4 hours and now, in the final five minutes, you have let the paralysis wear off. You’ve had your lunch and several coffees and you’ve spent all day texting and emailing someone (fucking theatre bloody wifi) so you WILL paralyse them so I can finish and I don’t care that you will then be stuck here for 20 minutes until you can wake them up again. 

“Is it possible that they aren’t fully relaxed yet”

I saw you pretend to paralyse them, that wasn’t sux, that was saline.

“This is a bit more difficult than we thought”

This has the potential to turn into a total disaster and some lack of foresight on my part is now quite clear to me, which is doubly disappointing. 

“We have got rather a lot of bleeding here at our end”

There is a massive black pool of blood that is sucking at our sleeves and seems unstoppable. You should prepare yourself for some drama. 

“Would you please be so kind as to fill in the frozen section request path form/intraoperative cholangiogram request”

My registrar should have done this and she hasn’t. She knows this is a terrible and shameful error. I won’t look at her, you look at her for me and then sigh. She will then know that she is a disgrace and we are aware of her incompetence. 

“We will be done in 40 minutes”

An hour and a half. 

“We are nearly done”

We have reached half way. 

“It’s absolutely imperative that we get into emergency theatre next” 

I want to go home before midnight, fuck the urologists and their stents. 

“The anastomosis was perfect, they leaked because they had a low blood pressure”

From your completely unnecessary epidural. 

“Yes, I think we have a sample, certainly  they should have been grouped and saved”

I have no idea if they have been or not but we both know they should have been, in 3 minutes I’ll be scrubbed and sterile, so I’m not going to check. You can do it. 

“As far as I am aware of, no, I don’t think that they are on anticoagulants”

I have no idea if they are or not and I don’t massively care because they need an operation right now for their dead/perforated guts. 

“It will only take me an hour”

It will take an hour to do the bit I consider  most difficult. Total operating time is about 2 hours. 

To the scrub nurse

“The usual stitch I use here”

I don’t remember what I use here, give me what someone else uses here.  

“I did give you back the swab from inside”

Not sure. I want to carry on closing. 

“Yes I will need more wash”

Don’t roll your eyes at me, go and get the wash

“These needle holders are unusable”

I am stressed and want something nice to hold 

“This is broken, send it back”

I have broken this. 

“This wash is too cold”

For fuck sake, can’t you give me warm saline 

“Can I have a bit of quiet please in theatre just now”

Shut up, this is hard. 

To your assistant 

“Can you pull a bit harder please?”

You puny little shit. I held onto a Lloyd Davies for 7 hours once. 7 hours!!!

“Whoa! Watch the spleen. Your hands are a bit too rough”

They are like shovels, you useless lump. You should be a bricklayer. 

“Did you tie that properly. That is the IMA, are you sure you tied it right?”

I’ll kill you if they bleed post op. I will exsanguinate you, slowly

“are you ok to close?”

I’ve had enough. 

“Show me that properly and nicely”

You have no idea what I am doing here. 

“What’s that big vein there?”

If you answer this correctly you can take over. If you don’t know then you will only be closing the skin.