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Authors: Kellee Slater
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aftermath of this meant I usually had 20 ward patients to look after at any one time. Many of them would have complicated problems with some combination of poo or pus running out of their bodies. My experience working in this unit isa big part of the reason why I enjoy operating on the most difficult of cases to this day.
The real specialty of this unit, however, was anal surgery or proctology. For such a small part of the body, the anus can have all sorts of interesting things go wrong with it. The old surgical adage goes, âIf you donât shit, you die,â and part of our job was to make sure this would not apply to any of our patients. One way or another we would always manage to get them going again. I was taught a great deal about the anal challenges of patients, quite common problems as it turns out, not frequently discussed in polite company. Excess skin, warts, abscesses and incontinence â we dealt with them all. I learned that repairing bottoms could offer a surgeon the greatest of satisfactions. If you got it right, that person would think of you kindly at least once a day while they were sitting on the toilet and you could make a massive difference to their quality of life. After working in that job, I found it all so interesting that I started to think that I might want to be a bowel surgeon specialising in proctology too.
Looking back, those days as a surgical registrar were some of the best of my life, although it was hard to see it at the time. It passed me by in a haze of sleepless nights, study and stress. The greatest thing about it was that I got to behave like a specialist with the safety net of having a boss only a phone call away. It was really easy to attack surgery with all the enthusiasm of a baby Labrador becauseI always had someone there to guide me away from trouble and bail me out of my inevitable mistakes.
General surgery on-call days were tough. There was no such thing as âsafe working hoursâ for doctors during my training, and being awake for two consecutive days was worn like a badge of honour. The longer you could stay standing and still appear fresh, the more awesome you were. Part of the reason surgeons are so revered, I think, is that they can often continue to function after being awake for a long time, fuelled only by cups of instant coffee and a few shortbread creams. âDonât upset her, sheâs been up all night,â the nurses would whisper, feeling very sorry for me at times.
The sleeplessness was a difficult but vital part of my training, because the more hours I worked, the more cases I saw and the better I became. Surgery is an apprenticeship where on-the-job training is important. If Iâd seen something before, it became pretty easy to make the diagnosis when the same thing walked through the door the next time. I really worry that now junior surgeonsâ work hours have been severely restricted by well-intentioned laws, as it will be difficult for them to ever get the experience they need to become really good. Surgery has to flow through your body and unless you are fully immersed in it, it will never happen. This is typically why surgeons are so cocky. We know our stuff and we can handle a crisis no matter what the situation.
I had a night on call every third day, and this would mean staying either close to or actually in the hospital overnight, so I could be immediately available when a trauma came through the door. On those on-call days, I would arrive for work at seven in the morning and I would not go home until seven the next night. I caught some sleep when I could in tiny on-call rooms that all looked the same with a noisy air-conditioner and a foam mattress on a creaky metal bed frame. This was the lot of a surgical registrar and no one thought to complain about it. It was the least I could do to repay my bosses who had to put up with assisting me while I fiddled about taking hours to do an operation that they could do in
The real specialty of this unit, however, was anal surgery or proctology. For such a small part of the body, the anus can have all sorts of interesting things go wrong with it. The old surgical adage goes, âIf you donât shit, you die,â and part of our job was to make sure this would not apply to any of our patients. One way or another we would always manage to get them going again. I was taught a great deal about the anal challenges of patients, quite common problems as it turns out, not frequently discussed in polite company. Excess skin, warts, abscesses and incontinence â we dealt with them all. I learned that repairing bottoms could offer a surgeon the greatest of satisfactions. If you got it right, that person would think of you kindly at least once a day while they were sitting on the toilet and you could make a massive difference to their quality of life. After working in that job, I found it all so interesting that I started to think that I might want to be a bowel surgeon specialising in proctology too.
Looking back, those days as a surgical registrar were some of the best of my life, although it was hard to see it at the time. It passed me by in a haze of sleepless nights, study and stress. The greatest thing about it was that I got to behave like a specialist with the safety net of having a boss only a phone call away. It was really easy to attack surgery with all the enthusiasm of a baby Labrador becauseI always had someone there to guide me away from trouble and bail me out of my inevitable mistakes.
General surgery on-call days were tough. There was no such thing as âsafe working hoursâ for doctors during my training, and being awake for two consecutive days was worn like a badge of honour. The longer you could stay standing and still appear fresh, the more awesome you were. Part of the reason surgeons are so revered, I think, is that they can often continue to function after being awake for a long time, fuelled only by cups of instant coffee and a few shortbread creams. âDonât upset her, sheâs been up all night,â the nurses would whisper, feeling very sorry for me at times.
The sleeplessness was a difficult but vital part of my training, because the more hours I worked, the more cases I saw and the better I became. Surgery is an apprenticeship where on-the-job training is important. If Iâd seen something before, it became pretty easy to make the diagnosis when the same thing walked through the door the next time. I really worry that now junior surgeonsâ work hours have been severely restricted by well-intentioned laws, as it will be difficult for them to ever get the experience they need to become really good. Surgery has to flow through your body and unless you are fully immersed in it, it will never happen. This is typically why surgeons are so cocky. We know our stuff and we can handle a crisis no matter what the situation.
I had a night on call every third day, and this would mean staying either close to or actually in the hospital overnight, so I could be immediately available when a trauma came through the door. On those on-call days, I would arrive for work at seven in the morning and I would not go home until seven the next night. I caught some sleep when I could in tiny on-call rooms that all looked the same with a noisy air-conditioner and a foam mattress on a creaky metal bed frame. This was the lot of a surgical registrar and no one thought to complain about it. It was the least I could do to repay my bosses who had to put up with assisting me while I fiddled about taking hours to do an operation that they could do in
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