Cutting Things Open

So my rotation group finally got our assignments!  I’m in the smallest group, so I’ll be with just 1 other student – and the two of us are starting on Surgery.

I’m.. actually super excited about this.  I get to get Surgery over with right away!  Every other rotation will seem easier by comparison!  Merry Christmas to me!

And yeah, I know you’re supposed to keep an open mind about specialties, but guys – I faint whenever my blood pressure drops 5 points.  I have the worst vagus nerve in the history of crummy vagus nerves.

(And yes, I have tried shifting my weight around, tightening and releasing my calf muscles, bending my knees, and drinking lots of water.) (Though I am considering begging my internist for salt pills.)

Still, no matter what I do, just putting on the surgical mask makes me feel like I’m struggling to breathe, then the extra layer of the surgical gown + hot OR lights make me feel light-headed, and next thing I know?  I’m backing away from the table and crumpling into a ball of autonomic failure.

So I feel it’s safe to say, somewhat conclusively, that surgery is not for me.

(Technically speaking, all of this IS actually due to a medical diagnosis by my cardiologist.  But it ends in “syndrome” and is a diagnosis of exclusion, so it basically doesn’t count.)

But, right, back to my point:  Thank god this rotation is first.  I have all of winter break to study my ass off so that “excellent fund of knowledge” has a chance to cancel out “This student upstages the patient in dramatic hypotension and then the scrub nurse has to leave to take care of her, so I hate your school and everything you stand for and equal out to a “Low Pass“.

… So.  Any suggestions for textbooks?

12 thoughts on “Cutting Things Open

  1. Our surgery faculty carry Greenfield to church.

    Every pimp question starts with “what does greenfield say about…” It’s a pretty good one.

  2. so, i didn’t want to be a surgeon either, therefore all I cared about was getting a 70 on the shelf (a high pass at my school) so I could get a high pass in the rotation. I ended up with a 78. All I read was the kaplan surgery notes and the NMS casebook. If I’d known how little surgery there was on the shelf, I’d have read step up to medicine too. Surgical recall is okay, but I really didn’t use it that much. I really only got pimped on anatomy- I looked stuff up on wiki before each surgery lol.

  3. NMS surgical case book.

    Cate is right, the surgical shelf is a potpourri of all of the other fields with a ton of medicine on it as well. Step up to Medicine would be a great choice to help with that. A lot of people found surgical recall to be helpful for quick reading right before a case as well.

  4. I should add that it can be really tough having the surgery shelf first. Our surgery clerkship director recommends studying for at least 1 hr every day, and then 5 hours each day on the weekend (not including breaks). Bonus: if you prepare well for this shelf, it will serve you well on your other rotations.

  5. My school uses Essentials of General Surgery by Lawrence ( It’s a bit hefty, but I found the information well-organized and easy to understand.

    Good luck with staying upright during surgery. I had a huge problem with that, but somehow managed to get through and to pass the rotation. I’m glad my work as an internist doesn’t require prolonged periods wearing a face mask and gown.

  6. Surgical Recall
    Surgical Recall
    Surgical Recall

    Also, for surgery, a pack of spearment gum – coffee breath in a surgical mask does *NOT* help with vasovagal syncope.

  7. While my vagus nerve wasn’t as crummy as yours, it sure did have some problems. But I can tell you that after the first week of surgery, blood never bothered me again, so maybe the same will hold true for you! Surgical Recall is a great, easy to read book. It’s most just like a fast study aide….not super detailed, but it has every single question that your resident, attending, or Step is likely to ask you about surgery. You are definitely getting the most difficult rotation over with first, and that is a good thing! I did the same, and it was pure hell but I was a better person afterwards! Cheers! 🙂

  8. Whoa, you have POTS? My best friend found out she had POTS at the beginning of our third year after a battery of diagnostic tests. I myself have have Inappropriate Tachycardia Syndrome, which is the random bouts of tachycardia without the passing out. Hey, just because it’s a diagnosis of exclusion ( and a syndrome ) doesn’t mean it’s not legit. I mean, it bothers you, so it is real. A few tips that I’ve learned from my friend: carry gatorade with you everywhere, and swig it all the time. She kept some of the powdered mix in her locker so she wouldn’t run out. It’s super easy to get dehydrated when you’re running around the hospital all the time, so swig some electrolytes to keep you from getting so orthostatic. She would also add salt to her food (which she was not real thrilled about because she wasn’t used to eating salty food). And hey, if you need to sit down, do it. Surgeons would rather you sit down for a minute than pass out on their OR floor. My friend would sit at every possible opportunity – on the floor, on countertops, chairs if she could find them. Oh, and lean on/grab hold of the operating table so you don’t get so wobbly. It always helped me. Good luck on surgery!

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