Dry Bones

"ORGANIZE YOUR THOUGHTS... THINK SYSTEMATICALLY."

Week 2. Right now, I’m typing this entry on the our hour-long ride back to Portsmouth. I usually spend my morning ride looking over some board material, while on my way back I usually end up falling asleep after a long day at the hospital... thus, risking my head falling over and plopping on top of one of my friends shoulders. However, I got some stuff on my mind, so I decided to take the time out to pre-blog.

On my mind this week are our rotations in Anesthesiology. Right now, the job seems to be exactly as I had painted in my head: come in during the beginning of a surgery, do some needle poking, talk to a few nurses, check that the patient is responsive to the treatment, and then head out the door to perform the treatment on another set of patients… Perhaps its just the Dominican way of doing things?

Remember that picture I painted of Princess Margaret Hospital last time? Little did I know that beginning my work in the Operating Room department would be so completely… different. The operating room facility is located in the same building where we have our fifth semester lectures, but on the second floor. Outside, it’s a giant cold-looking white colored building, with a tin-sheetmetal roof. To get to the operating room, we need to enter two glass doors, with their glass panes painted over in white. However, after entering, it literally is a different world. The décor features modern pastels, modular plastic cabinets, a standard glistening white floor, and most importantly updated and modern equipment. According to the poster located in the hallway to the three different operating rooms, the site was remodeled in 2001 (in fact the ICU I visited last week was in the old set of operating rooms).

Anyway, back to what I was thinking. Our rotation group was standing in our scrubs, gowns and caps in front of a patient about to undergo an obturator nerve block in preparation for removal of his medial meniscus ligament in the knee (The Dominican's looove their Cricket). Our attending Doctor looked me directly in the eye and asked me, "Tell me everything you know about Propofol." So I started saying, "Well its quick acting, and used to initiate anesthesia, and its better than Thiopental..." and he stops me saying:

"That's right, but ORGANIZE YOUR THOUGHTS... THINK SYSTEMATICALLY."

Remember that childhoold song, Dry Bones, which goes: "The toebone is connected to the anklebone..." and so on and so forth? I remember singing - and annoying the hell out of my classmates -with that song all the time. Well, medicine - even the hardest stuff - can be thought of in that manner. A good example in Anesthesiology goes like... "The Haloflurane goes with the Succinylcholine to make 'Malignant Hyperthermia' which results in Metabolic Acidosis, Accelerated Muscle Contraction, Tachycardia & Hyperthermia."

(Now try to sing it to the tune of the aforementioned song!)

Okay, medical blabber to some of you, but to me it makes complete sense because the logic is there! The point is Everything in medicine links together. I believe that's one of the best parts of medicine, its a never-ending web, but the essence of it can actually be captured by categorized, systematic thinking... Organized thought makes going through the "files and files" of thoughts in your head easily accessible in one sweep. Imagine disorganized thinking: it's like trying to find a needle in the haystack... Well, I still need to get acquainted with this way of thinking, but I see this as the reason why your doctor can just look at you and tell you what's wrong with you with the snap of two fingers.

Now don't be amazed if I shoot medical thought blabber at you next time I see you... you can always shoot the lyrics to Dry Bones in return back at me... We'll call it even.