post #100 entitled 'a bad day'

it's amazing how i can go from thrilled about my radiology grade to depressed in such a short time. ok, truthfully, i'm not depressed...but i'm down.

i had to do surgery today. i wanted to do a dog spay, since i haven't done one yet. i reviewed the video on how to do it. granted, i didn't spend a huge amount of time reviewing technique, but i felt confident in my abilities, etc. the dog i spayed belonged to one of my radiology professors (not yay!). good size, about 35lbs. her anesthesia was uneventful.

when i started the surgery, i felt relaxed and excited. i found my ovaries without difficulty and ligated them (used suture to tie off the arteries before cutting the ovaries off the body wall). once the ovaries were freed, i did my transfixing and encircling sutures around the uterine body before cutting it out. i checked my stump for bleeding - in case i somehow didn't clamp the artery off properly. everything looked good. i slowly let go of the body - and blood started to leak out of the stump (NOT good - this means i didn't ligate the arteries wholly). then blood started to squirt out. and i'm talking - fountain of blood here. not a huge, thick stream, but a thin little jet squirting straight up into the air like a hose. somehow, my encircling suture around the body of the uterus had come undone. and my arteries were bleeding into the body cavity. the long and short of the story is that one of the attending surgeons had to come over and help me locate and fix the bleeding arteries (this just meant finding them, after they slipped into the body cavity and suturing them again). once that was done - the dog was STILL bleeding profusely. she was in heat - and when in heat, dogs have a TON of extra blood vessels in and around the uterus. we (meaning dr hicks) dug around in the body cavity for a good -- oh -- 25 minutes or so, looking for the source of the bleeding. it turned out to be a vessel in the uterine broad ligament (a soft tissue structure that cushions, protects, and surrounds the uterus, as well as supplies it with blood). he had to ligate it (this wasn't something i did wrong, just happened because the dog had so many vessels). it just didn't go well. i felt bad that my sutures weren't up to par. it's really not that big of a deal - but i wanted it to go off without a hitch.

i'm starting to wonder (and NO, not just based on today's sx) if i'm not one of those people who is really booksmart and not practically smart. it's not just today's surgery, and yes, i concede that i've previously done 3 surgeries without trouble - but other things that happen. when i was working in ophtho - i had a run of bad sticks - jugular blood drawing, giving medicine IV, catheter placement - and today, after my surgery, i was drawing up meds for multiple cats- and i got confused and couldn't remember what drug was in which syringe. it just seems - sometimes - that i can learn the information and do well on tests - but that - when it comes down to it - technically, i'm going to be a horrible vet.

i'm probably being hard on myself. but some people seem so at ease and so competent in lab and in the clinics. i usually feel confident, but i make so many mistakes! and it's not because i don't try. i'm very conscious of my tendency to make stupid mistakes - drawing up the wrong amounts of drug, or the wrong drug, etc - and i try to be very cognizant when i'm working. but i still seem to make so many mistakes. it worries me a great deal.

on top of the surgery problem, another classmate of mine that i like a great deal had her cat die under anesthesia. and when i say HER cat, i mean her personal cat. she brought it in to spay - and the cat went into cardiac arrest during the surgery. it wasn't the surgeon's fault, the surgery went beautifully. the cat just had some sort of reaction or underlying problem that the anesthesia unmasked. it was so sad. my classmate broke down crying and had to leave.

then, on top of that, a classmate of mine informed us that he has to drop out of our class and move back a year. and why, you might ask? bad grades, personal struggles? no - no - the boy has a PHEOCHROMOCYTOMA!!! for those of you who have no idea what the hell that word means - it means a very rare tumor of the adrenal gland. what it boils down to is that this tumor is constantly producing epinephrine (adrenaline) - - so he is chronically stimulated. adrenaline mediates the fight or flight response - the one where your heart rate skyrockets, your palms sweat, your pupils dilate, and you get prepared to RUN away from whatever wants to eat you. well, he has that feeling ALL the time, due to this tumor. his heart rate is never below 130beats per min (normal is around 60). he can't sleep and he's sick all the time. so, he has to drop back to the class below us and have surgery. i feel so bad for him!! to be this far along, this CLOSE to the end, and to have to give up this past semester and go back a year.

people in our class are so chronically ill. we had one girl this year develop lung blood clots, another develop a heart problem called atrial premature contractions, this guy with his rare tumor, etc. i've been having stabbing abdominal pains sporadically after i eat for almost a year - and i'm convinced i have a huge ulcer that's eroding thru my stomach as we speak.

so yeah.

i'm studying for my cardiology final that's at 8am -- a mere 7 hours from now. it's going to be very hard, i fear. but then, aren't they all?? back to ruminating on the heart - and trying to not think about my future screw-ups...and all the sick people in my class.