The first day of my new assignment: orthopedic surgery and traumatology. This time my partner was De’Ryonne, and we hurried over to the first-floor meeting room for the daily report on consultations. The first thing I noticed was that most of the physicians in the room were men and most of them only spoke Spanish. The head of the orthopedics department, a cheerful man in his 60s with glasses, welcomed us into the room and announced that we were American students learning from the best surgeons in the hospital.
The orthopedic surgeons start every day with an hour of socializing in the staff cafetería. We were told that we would follow Dr. Nacho, a tall funny bald man and Diego, a young dark-haired resident.
Our first surgery was what Dr. Nacho called a “Hutchinson’s Fracture”, a radial fracture of the left wrist. He told us that because of the way the patient fell, he would also need to repair the ligament on the dorsal side of the wrist. In a serious ligament tear, he would remove the palmaris longus (a vestigial structure that 14% of the population does not have) from the forearm and substitute it for the torn ligament. He would then put wires between the lunate and scaphoid bones of the hand, which were separated by the fracture.
After Dr. Nacho had finished fooling around and spanking all the other orthopedic surgeons in the room, he scrubbed in and began the procedure. Dr. Nacho, Diego, and another male surgeon gathered around the drugged patient, his wrist suspended from a stand that allowed the surgeons to manipulate it into any position they wanted. The first step of the surgery was inserting an endoscope into the hand and clearing the connective tissue with a metal tool. De’Ryonne and I watched on the TV screen in anticipation. He pushed the scaphoid bone back into place and checked it with the CT scan. He then used a drill to cut into the bone to place the wire. Each time he started drilling, he yelled “radio!” and the radiologist took a picture with the CT machine so he could make sure he was drilling in the right place. The surgery didn’t seem that long, but when I checked the time it was already 1:00! We had been in surgery for about 3 hours!
Orthopedic surgery is known for the physicality of the specialty. Most of the surgeons are men because of the amount of hammering, drilling, pulling, pushing, and popping that has to be done just to realign the bones or replace the parts with prosthetics. It is easy to think of the body as a machine: when a machine breaks, you buy new parts and fix it. An orthopedic surgeon is like a mechanic, but each time the injury is different, and the mechanic has to figure out the best way to fix it whether its inserting new parts or repairing the parts already available. The other things the surgeon has to take into account for each patient is their age, mobility, and risk of a second injury.
I could already tell that orthopedic surgery was going to be a lot of fun, and a lot of work. I can’t wait to update you on what happened on Tuesday! Ciao!
Anna-phylactic Shock 