EXPOSURE

 

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Medical Anecdotal Report

 

n      Index Title: EEstonilos’ MAR [08-08]

 

n      MAR Title:  Exposure

 

n      Date of  Medical Observation: August, 2006

 

Narration:

 

Many people enjoy thrills involving heights and speed. Roller coasters, bungee jumping, Hang gliding. The higher and more daring, the greater the thrill.

            As a first year surgery resident, given the chance to handle your own case equalizes the delight of an adrenaline pumping adventure. But more than that, I consider each case a learning experience

            I was from duty and still have an unintervened admitted  patient with acute appendicitis. With gusto,  I ask my senior resident if I could have the case, to my delights he agreed.

            I arrogantly made my incision, about 4 cm, as I expected to easily expose the appendix. As I entered the peritoneum and with few twist and turns I located the appendix. Intra-op findings revealed a perforative appendix which was plastered beneath the cecum.I decided to do a retrograde approach .  I was sweating hard as I tried maneuvers on how I can deliver the appendix, to my dismay I was unsuccessful.  I then referred to my senior resident and immediately as he saw the field he said “ lakihan mo muna incision mo bago ang lahat”. Then he instructed me how it should be done. The operation proceeded unremarkably after that, and it is of course worth mentioning that it lasted almost 3 hours! Whew!

 

Insights

n      Physical, Psychosocial, Ethical

 

n      Discovery, Stimulus, Reinforcement

 

             In this case I have learned a simple but vital technique. First, incision should be adequate enough, Second, in difficult cases, extending the incision 1 to 2 cm can greatly simplify the procedure

           

            Residency is a training ground that allows one to grow and learn how to be a good doctor. It requires a person who could accept challenges and learn from it.  Humility is a virtue in this field, and asking help is not a shameful act, proper referral is essential and it pays to learn from it.  I was very thankful despite that long and tiring day.   I went home thankful that I had a fruitful learning experienced.

 

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