Surgery was my last rotation. I was nervous going in since I had heard that it is a difficult rotation with long hours. The hours were definitely long and I was constantly exhausted, but I got to learn and experience so much over this 4 week rotation, and I am so grateful for the opportunity. 

Since I had not done a surgical rotation before, and only got minimal exposure to surgery in my OBGYN rotation, I was exposed to several new techniques, such as laparoscopic, open, and robotic-assisted surgeries. I was exposed to various techniques of suturing which I had never learned before, such as interrupted and running subcuticular, and the figure 8 stitch, as well as different methods of tying sutures. I learned about the different options, and when one method would be better over another one. I was very happy to learn about these different methods and to be able to practice them throughout my rotation. I also got to practice some laparoscopic techniques, such as positioning and holding a camera laparoscopically, as well as cutting laparoscopically, which was very exciting. 

Skills or situations that are difficult for me are delivering bad news to patients or patients’ families. Unfortunately, throughout this rotation, I was involved in several situations where things did not go as planned and we had to deliver that news to the patients and/or their families. Although I was not directly the one who had to deliver the difficult news, I recognized that these types of situations are very difficult for me. I think I can get better at them by role playing and practicing having to deliver difficult news. But I also believe that having difficulty with delivering this type of news is not necessarily a bad things- it shows that I am invested and care about patients, and when they see that it is not so easy for you, they recognize that you care. It is important to remember though, that if I am ever in this situation, I should offer full empathy and care to the patient/ the family that I am speaking to, and be there for them completely, keeping in mind that this is about them. I should then take time afterwards to focus and deal with how it affected me, since there can be lots of emotions involved in caring for patients when things do not go as planned, and it is important to deal with those emotions on your own time.

An unfortunately memorable experience I’ll carry with me is an experience I had in the OR my second week. I was scrubbed in on an elective laparoscopic sleeve gastrectomy for a young patient with morbid obesity. I had met the patient before, spoke to him, and he walked right into the OR. About an hour into the surgery, suddenly he became severely hypotensive. We stopped operating, attempting to figure out what had caused the hypotension. They thought he might have had a pneumothorax, so bilateral chest tubes were placed, but instead of improving the condition, he went into cardiac arrest and lost a pulse. After one hour of compressions and epinephrine, he finally got a pulse back, but even then, we kept losing it again, and having to do more compressions. His O2 sat was also very low. Overall, his condition did not look good. Luckily, this story had somewhat of a happy ending, since his condition did continue to improve. Yet, it was memorable because it showed me that we as medical professionals can do everything we can, but sometimes things are out of our hands and things do not go as planned. Noone is sure what went wrong, and they have a few suspicions. But the situation shows that sometimes medical knowledge can only go so far. On the flip side, it shows the importance of using all of our medical knowledge and doing whatever we can to save a patient. After a while of compressions, I had begun to lose hope. But the doctors did not, and we continued compressions until finally we got a pulse. This showed the importance of not giving up. 

I learned a few things about myself during this rotation. Firstly, I learned that I am very sensitive and tragic situations that I am involved with affect me very personally. The situation above really affected me emotionally and I had a difficult time coping with it. I do understand though that in medicine, as much as we are trying to help people, unfortunate things can happen, and I am learning coping mechanisms to better deal with them. 

I also learned during this rotation that I enjoy surgery! I really did not think I would enjoy this rotation, but I found it very exciting and fascinating to participate in various surgeries, and especially appreciated when I got opportunities to assist in the surgeries. It was very exhilarating, and I really enjoyed being in the OR and both observing and assisting in operations (especially assisting!) I am so happy that I had the opportunity to learn so much and to experience everything that I did throughout this rotation. I am definitely going out of PA school strong!