Winding down medical school...

I have 3 more days of this internal medicine rotation at UCI medical center. So far in medical school, I haven't felt as much as a doctor until this rotation. This is probably the busiest service I have been on, and I have been on many busy months. (most of my rotations are pretty hard core) As a fourth year medical student on the team, I was given responsibility as an intern (first year resident). I was given just as much patients to manage as the other 2 interns on my team. It is the first time I had to be the primary physician for all my patients. Previously, I had always act as a helper for the doctors on the team to get things done and to learn as much as I could about every case. However, this time, I am solely responsible to admit the patient, to order all their tests, talk to specialists about the patient's care, talk to social workers, case managers, families and educating the patients about how to understand their illness and how to care for their needs, and to discharge them from the hospital when I feel they are ready. I felt that the attending physicians and my senior residents trust my assessments and my patient care.

For about every 15 minutes I spend talking and examining patients, I spend another 1.5 to 2 hours every day doing everything else for that particular patient. Imagine if add all those hours up for 5 patients, I end up spending most of my day arranging consultations, following up on tests and imaging studies, and looking things up that I don't know. So, I have many patients, and it keeps me very busy. However, I felt rewarded in many ways to have the responsibilities to take care, arrange resources for someone and to see them go home healthier than the way they came it. (for the most part)

So, after this week, and after my last test in medical school on this Friday, everything is down hill from here. I have a month of easy rotation in Phoenix and then hopefully a month in South America to learn Spanish, if it works out.

As far as residency matches goes, I have submitted my rank list of programs that I desired after careful considerations and prayers. I feel very good about this list. I know that God will direct my path and He will guide me to wherever He wants me to be. I will find out on March 19 where I will go for the next 3 years for residency. I am so excited!

I am right now listening to some music that I bought from some youths in Cambodia. The group is called Olive Productions. It is really good Cambodian Christian music.

Ahkun Preah Ang!

Beauty of Red

So, for the past 2 days I have been working over night shifts at the ER, which gave me time to be up in the morning for some very nice hikes and bike rides in Sedona, AZ... land of beautiful red rocks and weird spiritual things, such as vortex, aliens, and crystals... and also an pretty cool looking church. Sedona is a place I reminesce about. This trip back is some what bitter and sweet. Bitter part is letting go, sweet part is enjoyment of beauty unmatched. If that doesn't make sense, don't ask.


A catholic church build on the side of the red rocks. Sitting quietly in the pews listening to sounds of monks chanting hymns almost took me back to the dark-age France. I remember myself in the monestery of Southern France a few years back, sitting in the old 12th century monestery off of the beaten path... walking by rolls of lavender and grapes... Times of solitude and peace.

A 6 mile hike around Bell Rock and Courthouse Butte . Bell Rock was the center of the universe as thought by some New Agies that the Commet was going to fly by and pick them up. No joke.

WHAT!? No bike... you've got to be kidding me... I can't believe this! This is an out rage! Fines! What! I can't believe this! .... ok, I better simmer down...

Look at those red sand... aww, such a beautiful and serene hike.

Memories... Now looking back... shadows... and a stallion with a small package. Don't ask.

My favorite rock... SNOOPY! A picture of Yours Truly at my favorite dig "The Wildflower Bread Company"... if you are good, you can see Snoopy behind me.

Ahhh... my bike and I and some red dirt makes great romance... or some pain in the crotch from all the rough ridin'

That was scary! See that slick rock path? That was what I had to ride on. I was scared. You see, I am no world class mountain biker and I don't have guts to fall 60 feet... so, I went about 10 minutes on this trail and I had to turn back. NO, I can't do it. Perhaps another day. The view was good though. I will be back!

Hey look... my alien friend! I can't believe that he/or she has been in that tin-can all these years. I can't believe I got to take a picture with 'it' or he or she or ... um... let's go find some aliens.

So, adding on to all the wack jobs that I saw... here is a crystal castle. First of all, it just looks like a broken down house. Then, I heard about these 'awesome vortexes' around Sedona... well, you see many people don't know about these vortexes, they literally will change your life! So, I've decided to interview a few experts... including my green friend above.... here is what transpired, you also have note the nervousness in their voice and the twirling of the hair and head and the inability to look you in the eyes:

• Me: So, what are vortexes?
• Them: Well, they are 'scientifically studied' areas that have 'positive or negative' electromagnetic energies beaming from the earth because of the rich iron or spiritual deposits.
• Me: So, are they marked that I can experience and see it for myself?
• Them: No, they are not, but if you happen to pass through one, you will feel it.
• Me: So, what do you feel?
• Them: Well, one time I was hiking in through the vortex and I decided to take a rest, and when I sat down, I noticed that everything around me and the earth beneath me was sort of humming and vibrating. And, you feel somewhat renewed. It was sort of different for everyone... it was awesome!

Alright, enough of that... if that make sense to you, I don't know what else to say. So, other than all the 'interesting' things I saw in Sedona, I still love the red rocks. I still love the hikes and the biking trails. I love that this environment encourages stillness and quietness. Peace and beamed out.

Thanksgiving thoughts...

Today is Thanksgiving day and I voluntarily worked a 16hr shift in the ER. I remember last year on Thanksgiving Day, I was in New York, off of Broadway Avenue crowding with the several hundreds of thousands of people at the Macy's Thanksgiving Parade. I remembered floating in the streets with seas of people and buying chestnuts and 'street dogs' from street vendors. I remember the festivities of "Christmas in New York," the picture of the dreamy 'American Christmas' depicted in all the movies about Christmas. Christmas in New York is a dream.

I realized that without a dream, without family and loved ones around, it is really easy for me to not celebrate a holiday. What would a holiday mean anyway, if you cannot recall it later and share it with people who actually know what you are talking about?

I remembered festivities of Thanksgiving Day in years past. The extravagant 'mom prepared' dinners with a smorgasbord of food: juicy ham and turkey, yam, beans, cranberry, handmade mash potatoes and gravy, hotpot, special bread roles, fancy salads, homemade dressings, delicious desserts... and much more filled every corner of the table. Around the table would be a gathering of all sorts of characters from grandpa to aunts and uncles to family and friends and guests. The Thanksgiving tradition usually included my dad reading the story of the original Thanksgiving feast with the pilgrims and their first winter at the dinner table. Then, we may get together afterwards to sing songs and share what we are thankful for during that year. We would usually make part of sharing God's goodness to invited guests who were not believers in Christ. Sometimes family games would be involved. Then, the evening would usually conclude with giving thanks to our Lord in prayer and then all our friends and guest and family get a box of food to take home. (Or, it would be turkey for 2 weeks straight for us)

As we have grown up and moved all over on our own schedules, I don't remember having a usually family Thanksgiving feast in a few years. I must have to admit, I really missed that. I miss being able to share special memorable and unforgettable moments with those that I love and those that pour their love on me.

For this season in my life, I am finding myself, a little bit more grown up, and a little bit alone. Holidays and special occasions are merely just a memory and topics of brisk passing conversations in the hallways at work.

Today was an interesting day. We had had a lot of rain up here in Cottonwood and Sedona area. As a result, there was a huge pile of car accidents that plugged up our ER for the entire day. Many people came in with life threatening illnesses are necessarily admitted to the hospital for observation and treatment... and having to miss out on their Thanksgiving family gatherings. Lots of car accidents, car flips, substance abuse, and lots of other sick people... Some we just have to medically clear them to leave the hospital and go on with to rejoin their family for the Thanksgiving dinner. Many people, however, do not get to enjoy the festivities, which included a whole team of doctors, nurses, ER techs, respiratory therapists, radiology techs…

When you are enjoying your Thanksgiving feast, do give thanks for those who continued to work on holidays to provide the rest of us the peace of mind to enjoy special time spent with family. Be thankful for things you don’t remember to be thankful for! That was my new appreciation…

My new home... Sedona, AZ

After a month in the ICU in Phoenix, I am moving on. I have just moved into a 6 bedroom house in Cottonwood (a small town right next to the beautiful Sedona), and I have this huge house all for myself for this month... Anyone want to join me? Free house to stay. I am always looking for good company :)

This rotation is E.R. I hear that there are some really good mountain biking trails, world class, kinda like the ones in Moab, UT. So, I can't wait to take my crossbike and my mountain bike out for some good ridin'. *Pictures of my new house*

I have a busy year coming up: Medical Acupuncture class in Phoenix in 2 weeks; 2 residency interviews in Northern CA in 2 weeks; 1 interview at Ventura County MC; Cambodia in 1.5 months; 5 weeks in South America in a few months; 1 week of Osteopathic training in Chicago... Well, what else can I add to my itinerary? Oh, graduation from medical school in June...

Amazement!

I was so ecstatic today! I paid a visit to one of my patients today. Remember the girl I told you about in a previous blog, who survived a plane crash and suffered burns all over her body. Several burn surgeons and I spent countless hours debriding and skin grafting her 2 months ago. She continued to have more grafts… Today, I had an opportunity to visit her in her room in the Burn ICU. As I entered the room, I had to take double looks! She was beautiful! She was setting up, chatting with some nurses… her deep green/blue eyes were open, looking around. Her face was flawless, little to no scars (her whole entire face was burnt). I remember doing surgery on her 2 months back, with her completely frail, hanging on by a thread, and her eyelids sewn shut. I prayed for her each day that she would survive and be there for her children and husband. God answers prayers! As I stood there, I was too much in shock and amazement to approach her. I was too shy to introduce myself to her to say how much I was a part of her recovery and how much I had prayed for her even shed tears for her. I thank the Lord and simply slip out of the room, in complete amazement!

Another day...

Another day in the ICU… Between rounding for 5 hours at a time, learning about fascinating physiology, learning to managing the ventilator, placing in central catheters and arterial lines, lumbar puncture, engaging in discussion about patients with the neurosurgeon/ gastroenterologists/ cardiologist/ nephrologist/ infectious disease specialist, I had another chance to witnessing patients dying today. Timothy, my friend, I really appreciated your comment in my last blog about ‘Death…’ I feel that to do the ministry as our Father called Christ and also us to do is to actually do something that is out of the ordinary. In essence, ‘going against the grain.’ To fight the urge to be the ‘status quo.’ (Btw, I like how you infer ‘status’ as ‘dead’ or ‘no influence’ as if the ‘status quo’ means ‘idle’ and ‘doing nothing’) How do I know that the patient needed to be left ‘alone’ to deal with grief? We assume that. May be we don’t need to expect ourselves to extend comfort and compassion to family at times when no comfort seemed to be enough. However, we need to show people we genuinely care. We also need to show people there is hope.

Death...

As we run down the stairwell from the Medicine Intensive Care Unit (ICU) to one floor below, the attending physicians and our team of 12 ICU residents, interns, and me (the fourth year medical student) arrived at a chaotic scene. There was a surgeon doing chest compressions so vigorously, it seemed as though he could have touched the floor, through the patient and the bed, with each pump. There were respiratory techs managing her ventilator, there were nurses standing by to push medicines to revive her heart, and other nurses with the electric shocker near by. Patient’s husband was at her side, grasping tightly to her hand, and fighting the flood gate of tears that was ready to explode as if the dams are crumbling.

She was young... actually, not much older than I am. I am sure her life was clean, and she hadn't tried everything to destroy her body like many of our patients before they end up in our unit. She was dealt a pitiful lot. Her vice was one that she didn't ask for, or earned. It was a very rare kind of cancer that had spread all over her body. She was so young.

Just as we stopped compression and almost stopped all the meds, her heart got stabilized. A few minutes passed by before her heart rate started to show signs of the peculiar rhythm that we are too often familiar with before patients breathe their last. At that moment, as I tried to fight back the tears in my eyes, the following image was burned into my mind: there was silence in the room... There was nothing to be said... well, nothing can be said. The husband had his head buried in her neck, his cheek to her cheek, in their ‘essence’ saying the last goodbye... One dying heart and another left forever broken and crushed. I can't help myself; I don't know what to do...

Then, as cold and manner-of-fact as we came, we left the scene. The patient’s heart was still beating, but, not for long. I knew the Lord was taking her home.

I have seen at least a patient die every day or every other day since I been here. Other than doing the best we could to help patients maintain all of their vital functions, what else could we do to help them and their families transition into the next chapter of their lives? What do I do when I see the husband’s heart break and bled out right in front of me? Why were my feet so glued to the ground that they won’t move an inch even when my heart wanted to be next to his? How do we become compassionate for the patient and their loved ones? How do we not become a machine, an ‘artificial intelligence’ filled with medical knowledge and algorithms? How do we apply ourselves in ministering to God’s Beloved in their last moments? How do we deal with all the sadness and brokenness we see? How do we deal with the feeling of being inadequately prepared to respond to the broken heart?

Quick note

Just a fast line on my where abouts... I am doing a month of intensive care unit at the Maricopa Medical Center in Phoenix, then I will be in Sedona for a month of Emergency Medicine. Then, I will be home for Christmas. I think I got spoiled by Ventura's good weather, now I got back to Phoenix, I'm feeling hot and dry.

I went out for a bike ride with my friend Larry yesterday at dusk, it was very nice. Other things going on with me: preparing to start my acupuncture course, preparing to go to Cambodia, and getting ready for a couple of residency interviews.

That's it for now. I am going to take a little nap now...

Hanging out with Ben, eating some ribs!

Chicago Ribs at Ventura

Saturday morning farmer's market in Ventura!

Ventura County Medical Center

Hello guys, here is a quick update from me. I have officially passed all of my five medical boards exams. I have applied for 20 family medicine residencies (14 in CA, 1 AK, 1 IN, 1 WA, 3 AZ). I have already gotten interview requests from 15 programs (had 1 interview, and 10 more already set up to go). My first one is going to be in Anchorage, AK. I already have a good idea of which ones I want to rank in my top 7 programs, so I may not have to do all the interviews.

I am currently in the Intensive Care Unit at the Ventura County Medical Center, working with residents from their Family Medicine Residency program. I am very much enjoying it here. It is about 1 mile from the beach and some of the best surfing areas. Very nice weather. The residents here all seemed very happy about their choice to be there, and they also tell me that they work their butts off. Now, 'residents' does not mean people who 'reside' there, but it means 'doctors in training.' However, may be 'reside' is closer to the truth. So, as you know, I love procedures and doing things with my hands. So, name a procedure, and you'll find that their residents get training to do it here. They do all the deliveries of babies, c-sections, and running trauma codes. If there are surgeries to be done, they do it with the surgeon on call. I am also hearing that if you show interest in any area, the doctors will train you to do it on your own. A lot of residents here want to serve in rural and developing world communities. I am interested in being trained to do surgeries and being good at deliveries, and they do all that here. I have met many attending physicians and surgeons and they are all very eager to take time out to teach. I feel like I am in school again! There are nothing like being taught right in front of the patients... things you'll never forget.

My new buddies: Lewis (head down) and Clark (head up)

The Beach...

I am in Ventura, CA! I am renting a room from a very nice older lady. She has a cute country like house. Walking into the house today, I passed by the trickling water in the garden, through the kitchen that's filled with the smell of freshly baked lemon bars and apple casserole in the oven, then by the living room with soft jazz of the Titanic theme song playing, into a very clean room with 2 beds. After I met the 2 baby orange tabbies (Lewis and Clark), introduced myself to the African-gray parrot named Mona, I decided to take a bike ride down to the Ventura Pier. It was a lovely ride.

Leaving the Burn Unit in Phoenix, I felt a little sad. It is the combination of 1) leaving all the patients that I've come to feel so much for, 2) leaving the OR, 3) I won't have another surgery rotation for the rest of the year, 4) and, out of all the surgeries I've done, I like burn surgery the most. I wanted so bad to see the patients recover and heal. Perhaps one day God would use me to help people in that situation again.

Turning over a page... I am excited to start a rotation here with the Ventura County Medical Center's Family Practice residency program. I am doing ICU and Peds this month. Along with In His Image, I am ranking these 2 places at the top of my list. Oh, did I tell you? I have finally decided to choose Family Medicine as the specialty I want to go into. Though I had wanted to be a surgeon for awhile, I feel there are many advantages of becoming a Family Doctor:

1. Get training to take care of obstetrics/gynecology, pediatrics, medicine, minor surgeries, emergency care.
2. Additional fellowships trainings in wilderness medicine, tropical medicine, sports medicine, and osteopathic manipulative medicine.
3. Family doctors are very well suited to work in the mission field.
4. Family doctors see everything first, then decide who gets what types of specialty care... so a good family doctor could potentially 'try' to do as much as possible before referring. So, a family doctor could potentially be all that a patient would see in their life time.
5. I am very well suited for those things mentioned above, because I am very interested in a broad training program.
6. Family doctors has more time to spend with family and hobbies... more vacations!
7. Family doctors can offer spiritual care in a much thorough way compare to any other specialty.

So, I have many reasons of why I want to be a Family Doctor... I know there are many that have encouraged me to do something else, but after much evaluation, I still think that Family Medicine would be the best fit for me. Thank you for all your prayers... this process has been very difficult, so, thank you for your supports and prayers.

5 hour surgery... "Cultured Epidermal Autografts"

I was involved in a surgery today skin grafting a patient who had a lot of body surface areas burnt in a horrific accident. So, I learned something new... CEA = Cultured Epidermal Autografts. So, there are several types of skin grafts: autograft (from self), allografts (from a cadaver or another human), and xenografts (from another species, most commonly a pig). The main purpose of grafts is to provide coverage for open wounds and to protect patients from fluid loss and infection. So, CEA's are a type of autograft. It was approved by the FDA on Oct 25, 2007. To make CEA's, the company that culture them and produce them takes a biopsy of the patient's skin. Then, they prep and place the parts of skin in a culture medium to 'grow' the new skin. The new skin is consisted of about 10 cell layers thick of keratinocytes and takes about 12 days to grow. (10 cell layers is about 1/2 of the thickness of the grafts harvested from the patient) Each of these new 'autografts' swatches are about 2''x3" and costs about $1,280 per swatch. So, in a person like me, I probably need about 300 to cover my entire body... so, you do the math. Let's say we use 300 of them... it would be about $384,000 for just the autograft swatches alone. This does not include surgeon fees, OR fees, and all the material that goes into it. The surgery took about 5 hours and a lot of swatches!

Then you can ask, why CEA's? Well, when patients have more than 30% of total body surface areas burns, they may not have enough of their own skins for autograft harvesting. So, one way to go around that and still have your own skin coverage is to grow them in a lab then transfer them to your body.

Then you can ask, how much of this CEA are we expecting the body to take and incorporate into the tissue and have it survive? Well, the literature supports the success of CEA grafts to have a mean graft survival rate of about 65%. Some studies state the graft survival rate up to 80-90%. There are several good studies out there: French Study from 1997, Slovenia Study from 2001, Pediatric burn from 2000, and Recent Study 2006. There are lots of good articles in the scientific journals, but they all require subscriptions.

Here is the package insert from Genzyme, the company that produces the CEA's we used today: http://www.genzyme.com/business/biosurgery/burn/epicel_package_insert.pdf

So, I think the surgery is going to give this particular patient much benefit. I do pray that her body incorporate these new cells. God is the healer, we just do the best we possibly can.

The Burn Unit

I am doing well in my Burn Surgery rotation. I am very much enjoying the rotation. I think it comes very naturally to me to be doing procedures, whether it be handling the knife, doing excision and debridement of burns, skin grafting, sewing grafts in, doing wound vacs, performing venous and arterial access and line placements, and anything I can get my hands on. I am absolutely loving it and very comfortable in the Burn Unit. I know the people I treat will most likely never recover their appearance 100%, but, to help them to be able to function with the least amount of disfigurement leaves me feeling very satisfied.

One thing about burn surgery that I didn't know is that usually the Operating Rooms are chilled and quit comfortable even under all the sterile gown and gloves. But, the Burn ORs are tuned to the patient's body temperature... because when we lose our skin, we lose our temperature regulating barrier. We also lose the water keeping barrier, so we dehydrates very fast. So, to keep the patients' body from dropping their core temperature, we keep the room at their temperature. Yeah, imagine operating in a room of 98 degrees F. I was totally drenched in sweat from head to toe!

I also have made some advances today on my own, I have successfully placed several arterial and venous lines today! Yay... I loved it. It is all for the patients' benefit. I am among some really good surgeons here.

That's all for now, don't forget to check out the Sarah Palin video in the blog below. Good night!

My First Day in the BURN unit!

So, I have started my first day of the 4 week surgery rotation in the 2nd largest burn center in the USA: Arizona Burn Center at Maricopa Medical Center. This center admitted over 826 burn patients last year, cared for 1,500 patients in the burn E.R., and over 3,500 outpatient visits. This is also the referral center for areas including the entire state of AZ, western NM, NV, western CA, and northern Mexico. Let me tell ya, there is probably no better place to be trained in how to take care a burn patient than here.

As I started my first-day today, and considering how busy this place is, I was thrusted straight into the O.R. within about an hour of being introduced onto the service. Within 5 minutes in the O.R., I was holding up someone’s arm (skinless with escharotomies on both medial and lateral surfaces of both arms and forearms), the arm was oozing copious amount of serosanguinous fluids, while ripping out staples from the temporary grafts.

Ok, I am being really careful with my words here. I have to say that I have never seen anything in medicine that’s as graphic as this. I don’t have a weak stomach for things like this, and I am very eager to jump right in there and help with whatever needed help and to do surgery. However, I have got to remind myself that not everyone’s stomachs agree with mine. So, this is one topic I probably wouldn’t bring up around the dinner table!

I have seen what having skin grafts do to the patients, they are wonderful! Even though the surgery itself looks barbaric, the end results for the patients are life changing! I feel so interested in this work and at the same time feeling that I am contributing to these patients’ well-being that they otherwise could not have received. Simply Life Changing!!! Also, God really designed our body beautifully to heal itself, even at times under unimaginable traumatic stress!

My hours are very interesting, like all surgical discipline, they are long. I start tomorrow morning at 4:45am and the end of the day is “whenever.” Normally, I would start at about 5 or 6am, and ending “whenever.” No joke… this is how it appears on my schedule “0600 – whenever.”

I feel very privileged to be able to do a rotation here, because there is probably no better place to learn about burn surgery. And besides, I get to see people’s lives change right in front of my eyes. I have a lot of respect for these surgeons and the work they do.

Good night, I’ve got to catch some shut-eye before the rooster crows.

Test in Philadelphia: Conshohocken, PA

My beautiful room... too bad I didn't have any one to share it with :(

Train stop in Conshohoken

Stop in the middle of track; my train ticket

You know what Conshohocken means? It means "A pleasant place" in a Native American tongue. Well, I've just finished all of my medical board exams that I have to take during medical school. This last one in PA was the practical exam. Basically, it was a 6 hour test plus a 1 hour orientation and 30 min lunch break. During the test we rotated through 12 different patient encounters, in which we get 2 final scores: one from the patients and one from physician graders who grades our SOAP notes.

Let me tell ya, I was nervous... I don't know why, I've been seeing patients on my own many of times in this past 2 years, but, my heart was pounding so hard that I felt that it was going to jump straight through my throat. I think I did the best I could, of course, there are always things I could've done better, but, I believe I did my best. Thank you for all your prayers, I felt that God kept my mind clear and my tummy and bladder calm *very important!

Thanks for keeping me on your mind and walking through this anxious test with me.

Guess what?! Da Vinci Surgical Robot!

So, I'm half way through my general surgery rotation. I have been doing a lot of exciting surgeries so far. Being the only student working with a group of 4 surgeons, I am treated as an surgical intern. I have to pre-round on all the patients and present them to the surgeons. I also have to do surgical consults in the hospital, the ICU, and the ER. So far, I have been first assist for all the surgeries and also being on call whenever the surgeons are on call. I'm also expected to research and know all the procedures, complications, treatments, managements, and pathophysiologies of all the cases we see and operate on. So, needless to say, I haven't got much free time. Daily we evaluate abdominal pain, obstructions, perforations, and we do surgeries when we need to. I've assisted in removal of cancers, stitching the bowels when they get perforated from ulcers, taking out appendix and gall bladders when they get inflammed, draining fluid out of every infected orfices and wounds, saving people's lives when they get critical, and assisting doctors of other specialties (such as OB/GYN) with surgical needs. I have gotten to do a lot and starting to get a feel of what internship is like and what being a doctor is like. I've got to admit that many times I do feel like I can't ever learn enough. The more I ask questions, the more I've been asked questions, the more I realize that I don't know enough. At times I do get satisfaction to be able to answer questions that are asked, but I still struggle to find ways to retain what I've learned and to keep learning more.

So, today, I met Da Vinci! I can't describe to you how excited I was. Da Vinci is a robotic system that allows doctors to do 'minimally invasive surgeries.' What that means is that this robot allows complicated surgeries to be done with the smallest possible incision sites. The robot has four arms that inserts instruments into the belly. It also has 2 cameras that goes into the belly and projects the images to a screen. The 2 camera system gives the surgeon a 3 dimensional view so they can do abdomenal surgeries with the highest degree of accuracy, also minimize risks and complications. Right now, we routinely do laproscopic abdomenal surgeries with instruments and cameras, but this robot take surgery to the next level. The surgeon is doing surgery in a console. The potential is that you can literally do operations on someone half way across from the globe. How about doing surgeries in the field on wounded soldiers or astronauts in space? The draw back is that the machine is several million dollars to purchase and costs more than $10,000 per month to maintain. I guess for the time being, the art of surgery still involves human touch.

Seriously, the surgeon let me sit in the console and see through the 3D camera... it was so cool! If you want to experience and see what it does, click on this site:

http://www.intuitivesurgical.com/products/da_vinci_video_overview.aspx

I am thoroughly impressed! I want one. I want one NOW!!!

Be a surgeon!

Hey guys, I'm exhausted! I am pretty busy working at the hospital with several surgeons. My typical day consists of doing surgeries all day, assessing patients in the ER, talking to patients before and after the operations, and having to read up on surgical techniques and anatomy. I am studying hard, but very much enjoying myself. A surgeon is the El Capitan of the ship! An operating theatre functions as a well-oiled machine. The parts of this machine consist of an anesthesiologist, a scrub tech, an OR nurse, pre-op and post-op care team, and of course the surgeon and the asistant. The anesthesiologist give the magic cocktail that gives the patient a deep sweet dream; the scrub tech hands the surgeon all the instruments and keeps count on everything that is used; the OR nurse takes care of all the processes of the operation and gets necessary materials during the surgery and also record the timing of all the process; the surgeon and the assistant do the operation. When you enter the operating theatre, the surgeon is the 'chief.' It is quite a rush to be treated as one. A tyical operation for a general surgeon include taking out gall bladders and appendix, fixing all sorts of different hernias, taking out cancer from the breast/thyroid/bowel/skin, doing endoscopies .....

So, the surgical operative procedure has evolved to having to master the 'sterile technique.' Everything from 'scrub' (a special way of scrubing and washing hands from finger nail to 2 inches above the elbow), to putting on gown and gloves, and keeping the operative fields sterile. We owe much of the low rates of post-op infections to this obsessive/compulsive technique.

The surgical patient often is acutely ill. To be able to think and act on your toes makes a well trained surgeon stand out from the other medical specialists. What is unique about being a surgeon is that, when a ill person presents with a surgical problem, a surgeon is often the only one to offer a curative solution.

I have found myself to be extremely fascinated by this field, even though my eyes are constantly red from keeping them open all the time (don't want to miss anything), and my legs are stiff from having to stand hours on end. It is amazing that when we are so focused on something, we can actually ignore our regular bodily functions. I often have to remind myself to move my legs and blink my eyes... I'm glad God made us 'automatic' in many ways, otherwise, I wouldn't be talking with you right now. Ok, it's bed time for me. Talk to you soon.