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The life of an assistant physician consists of ...

waiting.

And wait. Wait wait wait wait

wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait wait ...

Today I was once again a very great man in this discipline.
am still / again in the ISS, that is not for nothing that indicated hours. Given that surgical indications are provided.

And these are things that we as a simple little worker ants can not. Indications may just make (in most cases at least) only specialists. For this reason, it is a senior physician who is only and alone responsible for these indications.

Well, today? The OA was extremely difficult to grasp, while I ask him to simply read it and see how short are in turn summoned the patients. Continuously he is again somewhere instead of me fitting the patient to work through in order. That's annoying.

the end of the ISS (and my time) he told me explicitly that I should wait for him, he would like patients to discuss with me, he would come back in this space. Wait wait wait wait

wait wait wait wait wait wait wait wait

While I painted piece of paper called perused letters from boredom and even rehab clinics for patients and organized the meien periweihnachtlichen moves, the OA was not natural.

After 30 minutes I have called him what he was angry (?) From the next room (!) Came and said he can not now, he would discuss with a colleague patients. Also good, you can tell me, too, would do enough to stop.
This note was answered but only harsh and muttered that he could not indeed all good things.

Sure, I realize, but I can not rumwarten eternally stupid and then provide my station after midnight.

on which I am but then abgetigert and another 60 minutes later, the OA 5 minutes for my three patients. Effective today I am

become world champion in waiting. And why? Because I just am not a specialist still. Where exactly is my revision course?

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Nix medical, but still impressive

Today, some news from the realm of technology. 'm Pretty technophile (although this is not the right word) and am always impressed with difficulty.

had to fly again across the pond and he had the good fortune to actually get hold of a place in the new A380, the flight monster. While not directly
the maiden flight, but only a few days later.

That's for a plane, 538 passengers, 6 bars! (Who needs it), a full upper deck, alone in the prestige class luxury and a giant "Home" entertainment program because it's almost sad that the flight is no longer about. I enjoyed it very definitely.

And who now write what want of due Unmweltverschmutzung and so, the A380 consumes 20% less CO2 than driving the little brother and with the ship's not too practical.

So, starting tomorrow and I have been devoting the trials and tribulations of the ISS.

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lab coat check

I've behaved lately for various reasons (professional, private, health) more quiet.

To mark the occasion, I would like to call this evening for your lab coat check, was the trigger that I can not find in my overcrowded bag my key was and at first took a while before I came up, that I may find probably never could, because I on the surgical locker had forgotten.

For our house it does not matter whether or not wearing overalls, I personally find Kittel unpraktsch not just because I always so much stuff rumschleppe (n must be). Mine has three pockets, two down and one to the chest. In the U.S., had my coat four pockets, plus an inside pocket, plus surgery to strip his pockets, too bad there's not here.


find me in random order:

• paper (all colors and timeliness, while like old rosters, old transfer lists, notes on my part, operating instructions, etc.)
• pins (also available in many variants, the pen during the day usually vary in number and appearance, always there are a Edding and a grease pencil, with luck a red pen)
• badge (actually two;? in the event that I sometimes forget my name)
• protractor (actually two, a good and a not so good)
  
• measuring tape (never hurts)
• tourniquet (a separate storage tube has been found necessary, go with that stupid green and metal buckle so not at all)
• small Steriliumflasche feel (me so much safer)
• cough drops (which has given me a colleague last week)
• paper clips (the remains of medical records)
• red Nupsis (pocket the often without using it)
• Keychain (with different keys to me here to open the door)
• ibuprofen (fürn emergency)
• meal card (unfortunately not charged more)
  

what not everything in it is:

• stethoscope (I was pilfered after one year on station, the new one is stupid)
• flashlight (also gone)
• machine (unfortunately rather long gone)
• Clinic Guide was (no more room for )
• PDA (with digital guidance and Red List, currently due to switch to? replaced by mobile phone, which is located but in the Pocket)

whatever is pure should

• number list of colleagues (the change so quickly to me, the numbers are no longer remember all)
• money (then I would not have to before lunch always changing run)
• scissors (which is really lacking )
• gum
• list of common anti-infectives (which was also out there all I mean) tend
• hand cream (which, to always lose)

So what will be of useful and useless things in your overalls? Maybe I can still get good suggestions?

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Fabian printed his first shirt!

... Our intern Fabian today designed his first shirt and printed.

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Doc Blog is submerged

in the true sense of the word.

After 9 long, exhausting, hose ends and sometimes very frustrating months, I finally had my awaited annual holiday. Four weeks ago I was away and on a perfect holiday island has returned far far away, diving, snorkeling, etc. Just do what all swimmers Sun

It was just wonderful!

For three days I am back, since Monday 10 clock badly annoyed yet again wondering about whether the hotel of my holiday village will somehow bad need of a surgeon (the KH site are unfortunately sown far and few between).

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from now you'll find us from Monday to Friday 10:00-19:00 and Saturday from 11:00-16:00 clock clock in the field 191st Street

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Why am I not really become car dealer?

vielgeäußerte This was the statement in my grammar school German teacher.

That question I also, though in less variation and not just because I think the job of a car dealer (even in current times) is not necessarily brighter than the mean.

But why I'm not really become anesthesiologist?

Now it may certainly some anesthesiologists give this blog (would love) here read along, so I would like to make one thing: This is not a generalized representation or denigration of anesthesia, but the anesthesia, how do I do every day can / should / must.

Our anesthesiologists are in fact real hobby artists. Ever wary of very bad on it, raised for the break to be punctual and to walk. Since the envy speaks of me, for sure, but you have to deliver on the backs of the other departments? This way the
Anästhesistenteam may be time to go, surgical rooms (despite our part will present and equiv staffing on both sides) is closed, so that ONLY minutes a small 45th Point can then be processed by a surgeon in his spare time, whole 4 (!!!) hours after his regular working hours. Why is something allowed?
would have been easier but because it, a single anesthesiologist would have been 45-60 minutes longer. When the hall was closed, there was a further 1.5 hours up to the close of business.

hours in the operating room, I wanted the table is set higher. Anesthesia raised three times and the third time with no reaction, it can sometimes come to the extreme and looked behind the cloth. Which has sleep! Really! While sitting in her chair. Since I was really stunned. On the other hand, of course, if you do so much to do in his spare time, he needs to be so tired at work.

The anesthesiologist immediately Mosern around loudly, if not the surgeon about to come on time for containment, which is all well documented. But if a surgeon to wait over 30 minutes on the seat of anesthesia must be the something completely different. Something must not grasp it. The main thing, I let it all remain on station holterdipolter, because I must come immediately to the operating room for storage. Overtime I hang in the service of patients turn you.
calls when it suits to come, have heard nothing yet. Excuse me, but they have them but is too much work. This list could

I will probably continue for a long time, that was only after all the events this week (and today is only Thursday).

But I'm also still the answer to the initial question or its modified form of guilty

Because I would not have a job where I know that everyone else hate me either laugh at me oder als Freizeittäter beschimpfen. Außerdem will ich was bewirken, aktiv manuell tätig werden, und nicht nur danebensitzen und zusehen (wenn sie denn nicht schlafen, ich fasse es immer noch nicht), wie andere die spannende Arbeit machen. Das könnte ich gar nicht.
Das wäre mir ein 08/15 Job wohl doch nicht wert.

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Der Morgen wieder bis utze im OP stehen wird, vielleicht drüber jammern wird, aber im Grunde doch froh ist, den coolsten aller medizinischen Jobs gewählt zu haben.

Einzig bleibt die Frage, ob ein nichtmedizinischer Job (nicht à la Autohändler) allerdings nicht die schlauere Wahl gewesen wäre.

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Dr. Ross is back.

Sehe ihn hier flat and just standing there before me.
that women stand on, is really no wonder. He has genuine charm.

On the other hand, in the emergency room in Chicago to work as many pretty good looking people. Whereas, patients often look really good, well, granted, some women already, but is on the striking employees.

I imagine even the question of why we are not. Emergency room goes completely past the reality, or have I just caught only one department, where springs not any (r) second America's Next Top Model?

But on the other hand I collegiality and good cohesion with each other much more important than good looks of their colleagues. Really.
And, actually can I complain in my own department does not (as far as the look and collegiality). Really.

Before I knit here now in utterances that are possibly catch me sometime bad, I look rather continue my training.

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the right foot in front of ...

Today in the ISS, a patient actually said to me:

"If I go to follow suit, I must always first set before the right foot and then the left."

had to really pull together much in order not to laugh out loud.
insiders will know why. Keywords VPT.

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Have lost my license to practice ...

... at least I thought this speech, of course, of the document. Have found

in my records, only the license to practice AiP (yes, I am also one of the poor creatures had to get it over with the AIP).

then I was convinced to have NEVER get another Apporbationsurkunde. Colleagues I have it wrong. Whereupon I searched frantically (not found) have. Had they been written off and not be bothered to look for more, but now and then drives so the bad conscience.

Well, but countless maneuvers search later, I find it really my license to practice medicine again, so the instrument course. And right there (next to), where it belongs. Order is the spice of life. I wanted to ask just yet what it probably costs a new request in the AEK.

So, then Doc Blog sign up now so the board examination ...
wait, where is actually my surgical catalog down ...?

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Green Wave? Not likely.

over the WE, I visited my friend in one of the largest German cities. And because so WE must be worth so early in the morning and I / have to do late at night eh nothing better, I am still of night broken on Monday morning to cross to cucumber through the country and in time to appear for duty.

Roads the city were almost empty and I had theoretically unlimited travel. But only a theory. On the way to the motorway, there were an estimated 10-12 traffic lights. ZT I could see the next traffic lights even when approaching the lying in front of me, were really not far apart.

Although it would have definitely offered, none of the lights were switched complementary. Which means, every time I had accelerated comfortably to 50 km / h, and came within shouting distance of the next traffic light, turned the red. Every time! Really! Every time!
I found quite amazing, who can come up with a traffic light for so? And much worse. To permit the implementation of this? Since it is quite tame in the head. So each time had to slow down, waiting, speed and chop, red again. The game has been repeated 12 times.

The really short drive thus has not only lasted forever, but my nerves most considerable strain on again. I'm glad it where I live are no traffic lights. At least not this idiotic.

What has this to do with my clinic?
Well, in recent days and weeks (or even years, perhaps) it seems to me even before like I would after each tentative acceleration process again abruptly and rudely reset to zero, from which I can then fight laboriously forward to then one to get on the cover. Not pretty this

have the feeling that all efforts on my part and "investment" in the hospital / department are fruitless, nobody cares what I do (and whether I make them) and somehow I'm motivation standard in a small hole. The traffic lights have shown me that.

Unlike Steve Martin in LA Story I speak not with a billboard, but the lights of the city with me. Not safe.

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phrases in surgery III

It's been a while since I doe wise sayings of my colleagues have posted cheap, so I have in recent weeks again sharpened his ears ... Possible redundancy
I apologize.
But since you have

by surgery on demand!

This looks cosmetically entirely of shit!

kokeln Let me!

your cricket!

this question (meaning the cautery was) has now completely disqualified.

you collapse here and now, even a doctor is present.

Jag 'because once the internist it.

Do you actually a concept for this operation?

performance! But not the knot!

The patient has beaten me.

we doing now Knubbelektomie.

Have you bathed in Sterilium or why did it take so long?

Schnütt!

Sucking the steam off before I still get cancer, or fainting.

anesthesia ... Hello? Hello ... Anyone there ...?

Operates more quietly, the soup today is not worth it.

The welded but in every hole.

The colleague is status post service, which can no longer be trusted.



... to be continued.

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Schonmal someone something happened? Determined.

These stupid stupid mist containing vials filth!

Ok, please show who probably know this has been sliced in a thing like the finger? Oh yes, that is yet so few. Have

me but also smooth cut again on such a thing, but really. And of course, otherwise I always use a cotton ball, just in this case, had to go so fast. I promptly all Lustful with my (non-infectious) blood out and put on a glove and vollgeblutet.
to a full gross, second, it now burns natural as hell if I disinfect the finger. No, certainly not in the OR. But I'm such a fanatic disinfection that I for each room anyway and forth between going through. Has since the cut as arousal reaction.

Jammer, jammer, jammer, I know. But who the heck invented this shit glass? Where the advantage is with an ordinary plastic container shutter speed? Where the meaning is? Is there one?

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hydronephrosis

On this occasion, I wonder if the above diagnosis is probably even a recognized disease in BG-Lich surgeon. Had this problem today that is actually, though I was not even in the OR ...

It started at 7:58, when we were together (yes, we are surgeons who eat go, that is now, we complain on a high level?) Flying off towards breakfast. Easier urination, but one wants to miss the connection. Peer pressure wins over the other pressure.

8:13 I meet a colleague in the hallway (coming back from breakfast) and we discuss a
patient.

8:15 Some stations and waiting for higher floors have the head doctor for me and my
visit.

8:45 Short interruption of the visit, which I dispute with telephone calls (complete!)

9:00 Continuation of the visit (and growing feeling of pressure)
9:15
end of the visit and order, an emergency room patient for surgery today elucidated

9:20 Patient found and talked with her

9:30 reconnaissance and other paperwork ready, return to the patient, anesthesiologist there, argh
on the way to the toilet requested by the receiving station

9:31 first record in about 30 minutes including information drawn through

10:01 elucidation of the emergency patient to about 10:20

10:21 lege when I saw the documents in the file, the next shot is there

10:30 during the recording I am called in the ambulance, which I will adjourn

10:45 break Second admission half finished, I am starting to go in the ambulance

seen 11:00 ambulance patient must wait to the head doctor at the same time calling my
at station, my own take would be as

11:10 patient demonstrate

11:15 letter dictated

11:19 on my station, a hundred questions, most can be answered, looking at the
Clock, my record, I want to finish before 12 have

11:45 recording finished, all inclusive, but significantly increasing feeling of pressure

11:46 call the receiving station, the emergency even lady was the X-ray back as for
would proceed now further

11:50 Senior Physician found demo of the X-ray pictures of him

11:58 he sent me to the operating room for removal of the images to chief
12:07
short walk to the station, letters

12:12 in the operating room, search the boss, it means he would be out 12:13

complete before a dizzy spell, I use the opportunity to lower my creativity, my kidneys before death and me prior to the uremia

keep my bladder Mathematically good 4 hours, or more properly filled, sound can not be so. Of course, I could walk between them, sure, but one wants to "just" what work off today and always was something new. Here's how. But not today.

Was not that the bar muscles (or whatever it was in the bubble) out it do? Should we be more or less or will you incontinent? Urologists present here? I soooo did not aufegpaßt in Uro ...

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heroes of my youth

seems to look as if I had the inspiration for this post at Resident stolen, but in fact we have almost the same time, this idea has had. Ultimately have a problem when one's RSS reader does not regularly updated and then missed a thing.

In a reasonably quiet moment I could use a few days ago that is the time to ponder the various medical series that have accompanied me in my youth, inspiring and categorize my favorites. That would be as in (less) chronological order:

St. Elsewhere (p. Elsewhere) :
I found class in former times, have almost all the episodes seen Denzel Washington was because my hero and Others Could today probably hardly still look at (similar did it to me at the A-Team and Knight Rider, is not so!). For
Trapprr John I think I'm too young, I never liked. Was not the series, where a doctor lived in the camper in the parking lot?

Black Forest Hospital:
little influence might, just the dog (really) and the head nurse scared me, certainly not the reason why I became a doctor. Have not looked elsewhere
German doctor series, in all friendship, but once tried, but soon abandoned is not at all, so many intrigues, for which I am very good person. Is not true of Hi Uncle Doc.

Chicago Hope
long time, my absolute favorite doctor show (if I do not see the OP already in kind, then in the series, which it said "to" realistically depicted). My favorite was always Dr. Shutt, and therefore wanted to really be serious neurosurgeon, is (fortunately / unfortunately) nothing came of it. Dr. Geiger was always a lot to me crazy, but I still liked Dr. McNeil, Dr. degree, Billy and this tough neurosurgeon Lisa.
Like the other U.S. series, of course, see as often as possible in the original.

ER: Must have
eventually replaced Chicao Hope, or at least turn came to be near. Mag neither Dr. Ross (on groomed) or Dr. Greene (just so), but Carter, of course, all the more, as the poor little as a wizard was flayed, we have to do well, my sympathies were so very honest ;-), other favorites: Dr. Neela (still handsome), Dr. Abby (ditto) Dr. Luca Kovac course, the one that was stabbed, whose name I have embarrassingly forgotten, Dr. Romano only because I could remember me by the Romano-Ward-and Long-QT syndrome, Dr. Lewis continues and the poor Dr. Gates. Already
pity that the series is about to end, for it has really influenced me and helped me in many medical issues, but the English nomenclature was worth gold for my missions abroad, to the many well-stated Diseases.

Scrubs:
Did find and I continue to be excessive and exaggerated. Since I now live Scrubs yes, I do not watch it anymore. If I had to call a favorite, that would be JD.

Grey's Anatomy:
Well, I liked the pun at the beginning of the series less, had hoped for much more, but the bias can indeed look back deep. Even if the medicine is not a complete side issue, the main focus is still on interpersonal relationships. Well, watch it still. May endure but only George and Dr. Bailey.

House:
good beginning, now with more abstruse cases also bugs me that ALL of his team (whether old or new) everything, Hirnops, cardiac catheters, everything. Well, I stink at maximum contrast. Since the new team lacks the drive and dynamics, and since it is anyway hardly relates to my youth (ditto Grey's Anatomy), it is rather out of competition.

running out of competition also MacGyver , no doctor, but a genius "craftsman," I was totally impressed, and he is still my hero. And I'm proud to be one of the few well to know his first name right away, well, at least one of the used. And I'm fully on MacGyverisms in the OR.

Once out of competition, as veterinarian Danger Bay (in my opinion was not on German television, right?), Then I really wanted to be veterinarian, marine biologist and Canadians. And what happened? Gar nix, thrice wrong.

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Being Privateer!

Well, now it has caught me. I had this month the dubious honor of being used on the private station.

I've seen in my many years of "career" no hospital in which this job was popular, because somehow it is indeed as Privatassi always the stupid one. The boss is always dissatisfied with the senior residents are constantly fussy because you know more than the boss, the patients are charged, because it is not every day the boss be.
for the wizard a classic Catch-22 situation.

sad, actually, one should think they can benefit from the proximity and direct line to the boss, but more training, surgical operation should coincide (what a travesty) gives or declarations are now definitely NOT. I know it is not the first (or last) time that I am Privateer.

in my PJ-house it was at least so that the private-Assi received an additional pool participation. Is not so. It would be really justified in my eyes. After all, private patients are several times exhausting than "normal people".

If I continue not fully baked Eat yeast particles, has done this with the Privateer for tomorrow maybe before.

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Toronto Doctor Notes Clicnic

legend Børn

Tjaja, one has started's (in this case probably Pharmama ) and then there are very many others on the train jumped (eg sick sister , Monsterdoc , Krangewagefahrer , Doc Brown , just to name a few). This is called peer pressure well.

why I now!
(In essence, we are truly all legende børn yes, right? To play here long ...)


As surgeons yes always attribute to the blood eye Rimage ... (Taking Let's all love).
And so pale, of course, all because we have to do so 24 / 7 either the Broad or Sideways-A in the operating room 1 ...
But - like war, I head to give me such a cool cape?

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positions in surgery

It is not about positions you can play through career. Or other more-or more distant positions.

No, this is about body positions. In the operating room. And mine is on my rare, but always immensely popular surgical operations, have noticed how expensive sets itself up as an Opera, first and second assistant. So actually intraoperatively to the physical location of the doctor.
In my (not evidence-based) examination, various positions and correlating types can be distinguished.


Straight-A
The dynamic operator (preferably head or senior doctor) is very upright, legs apart just slightly right on the operating table, knees and back straight. Did everything correctly in view and at any time is the situation. This position can be retained in the longer term.

Broad-A
The less dynamic (because sometimes under) called assistant doctor is clearly wide-legged as the operator. Thus it is may view the level slightly lower than the surgeon, but can still see everything important, in the "emergency" support but also at the table with the lower body (Caution, may be painful to hide under the cover sheet metal parts of the table). This position can be long sustained. It is varied with some colleagues by hyperlordosis, but it can make properly train on the facet joints and afterwards in postop bad back pain. can be felt (or maybe I'm wrong and I have really something structural in the back).

Locked-In
My personal favorite position. Leg Halted Broad-A, but an inversion and slight supination of both feet, thus limiting the knee fixed in extension, without having to focus too much must. I have often had it that the stability of the knee insufficient was, and who have suddenly given way. Dangerous if you then stumbles off the table. With locked-in, the m. E. not happen. To prevent unsightly supination and train on the lateral ankle bands, I recommend an additional internal rotation of the hips.

Sideways
The expression used by the surgeon is often "pure challenge. Is (necessarily) be used when two assistants are on one side and from the conquered, who stands at the patient's arm. Since he has no choice, he is not related to the wide side, but only with his side profile to the table, leaning (cave trochanteric bursitis).
If you have wide impact in the level is, the longer endure. Then sometimes alternating one leg. Can I also assume when you are alone on one side, then you can stretch out the feet better or fold. Main problem is the somewhat limited view (in the fencing position anyway).

Over the top
My most hated position, because the power really back. The surgeon is seated, the assistant leans over the leg forward, which is operated on the side facing away from him. No matter how it turns and turns, this necessarily be occupied position is definitely not pleasant.

easy rider
Sounds good, is good. The second assistant of the hip in one hand, the easy rider hooks his feet on the stage is set as desired, and (because it does nothing anyway) and certainly in a position to observe everything possible to others. Disadvantage: It looks really nothing of the OP. Niente! Already badly. But
pleasant to endure. If it ever must be, to be enjoyed's at least. Who knows, already, when over-the-top flourishes again.

Inbetween
also not very popular, the "jump" between the legs of the patient in preparation for the anastomosis. Alternatively, to call it Bottom cloth. As one can share, but the air down there is really not good. And then one is also sterile.


one leg, as a variation of the above like to use to relieve their own bruised joints. Since this leads to increased stress on the other joint, a two-way game is recommended.

I think this would be the most common. Now should not only think, we Flez in the operating room just kind of rum Sun Sterility is and will always the first concern. But when 4, 6, sometimes 8 hours a piece needs to stand in need sometimes alternatives on the table. For it is indeed the case that (especially if you do not own the surgeon's) began after a few hours, the patient's own bone to notice. Since they are pleased about each X-ray image, because the movement means.

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