Finally climbed out of bed at 6:30, got dressed, washed my face, grabbed a shake and walked out the door at 7:00. I'm never going to be able to get up at 3:00 for Peds Surg.
Went into Intersession blind, choosing my default Business Casual dress to go, brought my stethoscope just in case.
(The stethoscope is more than just a badge of office; approximating a talisman in the eyes both of the patient and of the doctor. A stethoscope means that you can tell what's going on inside the patient, not just on the outside. You can hear the inner workings of the heart, assess the condition of the lungs, give reassurance that one's bowels are working properly...and all that with such a simple instrument. What do you see when you see medical things? Caudecus and stethoscope. And there is power in it, in the same way that there is power in the medicine man's rattle - power to hypnotize and heal. With my stethoscope around my neck I am a different person, someone who knows what's going on. Without it, I am lost, feeling the student I am. Such a curious thing to require.)
I don't need it, but knowing it's in my bag makes me feel better. I was hoping for an intersession that got me out by 2 or 3. Instead I am faced with two days of 8 to 5. And today - today started with a workshop on suturing. Spent two and a half hours working with rope to practise tying knots, and then watching a miserable video and trying to suture on scrub sponges. My left wrist is still sore, but it doesn't seem to be affecting my ability to suture - I'm just really really bad at making straight, even stitches. Mom, however, will be gratified to know that I still remember how to tie knots with even tension, back from when I used to macrame. I should do that again. I should get some fabric or some chicken and practise.
The suturing practise room is down in the basement of the library, where they keep the animal labs. The air there is thick with the scent of drugs and anaesthetics, spiced with microwave dinners days old or more, cold as a morgue, the hallways sterile grey walls and white tiles, brightly lit. We had to have someone buzz us through the heavy steel double doors into the labs - protection, one assumes, against animal-rights activists getting in, not against medical students learning to suture - and then follow signs hastily posted to the walls, past offices and doors marked with pro-animal-testing propaganda: "Thanks to animal testing, they have 20.9 years more to protest." Take it with a grain of salt, O Best Beloved. Take it all with a grain of salt. We do not live in a world of moral black and white.
We found the suturing practise room as a chorus of barks and howls accompanied by cage-bars clanging rung out through the halls and then quieted again, the only time we heard evidence of the animals in the lab. It was cold in there, as I have said, cold as a morgue, icy almost, and we were convinced our newfound clumsiness was the result of chilled fingers - no fault of our own inexpertise. It's different on real tissue, they told us. It's easier. It's harder. It feels different. I have sewn real tissue. The surgical sponge is but a pale approximation of the pull and stick of flesh, the knots won't lay properly on the sponge, the fibres rip with the least tension. It's really nothing like sewing real flesh, in which I am no better at making my stitches straight and smooth. But at least the sponge isn't watching you - only the residents ("I never let students start a subcutaneous stitch") and the surgical company rep ("That's good enough for practise. Good start.") who seem to know everything and yet you know that they too were once as clumsy and inexpert as you were.
Three simple steps to tie a knot. The instrument tie is easy, they say. I have a piece of suture here, a string of knots crooked and warped, transformed mysteriously from lovely square knots to slipknots that wobbled and...well, slipped. But the instrument tie is easy. My hands cross the wrong way. My fingers refuse to obey the dictates my mind is giving them. And holding the pickups like a pencil and the needle holders across my palm... By the time the hour and a half was done, my back was knotted and cramped, my fingers were bruised at the knuckles, and I felt as incompetent as an infant doing needlepoint. But I can close a wound, O yes, Best Beloved. I can close a wound.
This afternoon, I spend two hours learning to start IV's, and two hours practising Sterile Technique. I was shown how to scrub once before, when my arm was in a cast and I couldn't practise, but I need a refresher. Keep the hands up. Let the water drip off your elbows. Don't touch anything. Don't drop your hands. Don't move, don't breathe, don't look wrong. Be Clean.
I can Be Clean, O Best Beloved. At least...I think I can.