My hands still smell faintly of Povidone-Iodine as I type this. Today was probably one of the few great days this year. I got to scrub in and assist on a small (minor) procedure! Nothing grandiose. This 70 year old Jannat Bibi had something like lichen planus (guessed wrongly about it being of fungal origin) in her mouth and we needed a biopsy. So I scrubbed in with the Doc, and the nurse gave me size six and a half gloves which proved to be too small but I pulled them on anyway. And we used local anaesthesia (xylocaine with epi). Doc asked me what the epi was for and I got two out of three right. Anyway, the surgery. He just cut a small circular area of the ulcer and then he stitched it up (with catgut sutures that dissolve by themselves, also they've been banned in England now) and bang, we were done in twenty minutes. There’s a ten hour case he’s going to be doing here in three weeks time, which I’ll hopefully get to observe too.
Yes, the maxillofacial surgeon from before was here again today. I was called upon to be his “shadow assistant” and spent most of the day in the outdoor. The cases? There was one with an open bite and mandibular prognathism that had been corrected by orthognathic surgery without pre op orthodontic treatment, so naturally it wasn’t doing very well. The open bite was still there, but the post op ortho had corrected most of the aesthetic and functional problems. Then there was a case of hemifacial microsomia. That guy, or kid really is going to have that ten hour surgery in which half his mandible’s going to be added to and then something to do with his ear too, cause hemifacial microsomia affects five things. Orbit, mandible, ear, nerves and soft tissue. OMENS, for short. Hang on to that. High yield point, that is! Also, they’re going to take some cartilage from his ribs and put it in his TMJ. Then there was this kid from Karachi who needed a functional brace. Blah, blah, blah. Some aphthous stomatitis. Some TMJ disorders. Some myofasical pain syndromes. But I’ve saved the best for the last.
So this guy who was a police officer brought in his sister, who had, guess what, a bullet stuck in her head! Apparently, she had not been fired upon, it was a ‘stray’ bullet, they claimed. Anyways, medicolegal had cleared it at Mayo, so we took a look. The bullet was intact, and it had entered from above, and hit the side of her head near the ear, (missing the brain, thankfully) and had prolly tunneled its way through from behind the zygomatic arch and come to rest somewhere between the lateral and medial pterygoid plates. We really needed a CT scan to get the exact location so it could be operated upon but they’d left that at home. Pah. The interesting thing about the bullet though, was that it was facing outwards. Had probably hit bone and turned, we thought.
That’s about it. Discovered that the car was leaking gas on the way back and had to go get it fixed it from across the river.
At night on my pillow the syncopated stagger
Of the pulse in my ear. Russian roulette:
Every heartbeat a fresh throw of the dice . .
Hypochondria walked, holding my arm
Like a nurse, her fingers over my pulse . . .
The sudden lapping at my throat of loose blood . .
- Ted Hughes, Birthday Letters
Want more? Here.
The Microscope knows not of this nor the Telescope: they alter
The ratio of the Spectators Organs but leave Objects untouch'd
For every space larger than a red globule of man's blood
Is visionary, and it is created by the Hammer of Los:
And every space smaller than a Globule of Mans blood opens
Into eternity of which this vegetable earth is but a shadow.
The red Globule is the unwearied Sun by Los created
To measure Time and Space to mortal Men...
- William Blake
I read these two gems somewhere and I was saving them for a post like this but then winded up sending them to my friend Samuel who was in dire need of some poetic comfort at that time but Samuel wouldn’t have any of my gallantry and called me silly and told me to post them here too. So, there.
I got this new book on Personality theories from the library today. Lots of Freud in it, so far. Little Hans and the horses stuff, ya know. Which reminds me, we were in the changing room today before scrubbing up and doc says to me that its alright if we all change in here because that’s the way we do it as long as you keep talking or listening because everybody’s wearing briefs anyway but the rule is to keep your eyes up. Hah. Also, interesting anecdote about a friend of his from the northern areas who was invited to the same ritual but turned out he wasn’t wearing briefs but that didn’t stop him from er, yep. You guessed it. Bummer. He prolly thought it was a modern thing.
p.s. Zoey said I was breaching doctor-patient confidentiality by disclosing her (Jannat Bibi’s) age and name. Needless to say, I sectumsemprified her. Which reminds me of the time I asked Ghole about his response should a patient fancy him and try to put the moves on him. His reply? “Forget the ethics… Let’s go out sometime!” Ironic, since the only lecture we got on behavioral sciences all year was delivered by him.
p.s.s. In case anybody’s wondering, my exams which were due this month, got postponed because of the dengue hype in Lahore and all, and now 12th November is the new date. Haven’t been studying et all since the delay. Today was a big jolt back to reality, so its going to be all Robbins, Katzung and Phillips from now on. Yes, my girlfriends adore me. Quite a love-hate relationship, we have.