Orthopaedic Surgery – First Day
I.IV.I
FIRST DAY
There I was, having just started my foundation programme, and suddenly I found myself in the fourth and final quarter of my first foundation year – orthopaedics.
On my first day I was met by Emily – a house officer in her second year with whom I’d be sharing the firm’s workload. It didn’t take long for us to break the ice. From the very start I could tell she was one of the coolest, most genuine human beings I’d ever meet. And with her being in her last quarter as a house officer, her knowledge and experience was bound to serve us both well.
We didn’t have much time to bond, or to meet the rest of the firm for that matter. A few minutes in, I paged down to the operating room by Mr Chaos, our new consultant. “Why isn’t my patient ready for surgery?” he barked, foregoing all sorts of pleasantries. Given that it was my first hour on the job, I had no idea what was going on, let alone why his patient wasn’t there. I told him I’d do my best to figure it out and started calling the wards to see what had happened. After sorting it out, I made my way back to the ward, where Emily and Blair – our gorgeous new higher specialist trainee – were waiting for me to start our round.
“He’s like that,” Blair told me. “Don’t mind him – he hates everyone and everyone hates him.” Great way to start a new rotation, huh?
With that, we kicked off the ward round. We had some post-op patients to check on, a few awaiting surgery, and a couple of long-term patients waiting to be transferred elsewhere.
I have to admit, it was hard to keep up with Blair. Mostly cause it was more of a sprint round, with each interaction lasting less than a minute. She’d ask how the patient was doing, examine their limbs, and that was it. So much for the biopsychosocial approach! Emma and I would point out one issue or another – low blood pressure, deranged bloods – only for her to tell us to consult the relevant specialties.
This was exactly what I had been warned about. Orthopaedic surgeons are renowned as glorified carpenters. They’re the go-to people to fix your bones, but when it comes to medicine? Oh boy. These were the same problems we’d deal with daily as junior doctors. By then, we didn’t really need to consult about much of these problems anymore. And we made sure to tell her that – sparing ourselves the embarrassment of calling a specialist over something trivial. While it might’ve come across as arrogant, I think it actually helped us earn her trust.
After the round, Blair headed down to the operating room while Emily and I split the few tasks we had and started ticking them off. By 10AM, we were already done. Now this was the life.
With it still being too early to leave, I decided to join Blair and Mr Chaos to observe some surgeries and maybe assist. It was a knee arthroscopy for a ligament repair – something I’d never seen before. Mr Chaos seemed almost giddy that I’d shown interest. He even asked me to scrub in for the next procedure. Hell yeah.
It quickly became clear that I could learn to my heart’s content when it came to orthopaedics. I couldn’t quite say the same about medicine though – Mr Chaos went as far as asking me what kind of drug valsartan is. At first I thought he was testing me, so I told him it’s an angiotensin receptor blocker. “What’s that?” he shot back. I explained the pharmacological mechanism. “So what does it actually do?” he asked, increasingly frustrated. When I finally said it lowers blood pressure, his eyes lit up. That was the answer he wanted. He genuinely had no idea what it was.
Much can be said about orthopaedic surgeons’ lack of medical knowledge, but watching them operate is something else entirely. So savage. So careless. No elegance to the technique. Just rough and messy. And that’s exactly how it’s meant to be.
I’ll never forget holding the patient steady while he hammered the prosthesis into their hip. My Achilles heel with this specialty quickly became clear – not knowledge, but brute strength. I had the brains, but definitely not the brawn.