医学生日记2016年3月23日 – 一天的总结
阿山 （庞静译）（原文在译文之后）
【注：文中所谈手术是一个再发性皮肤癌切除手术。六十多岁的男性病人，脖子上有一个网球大小的恶性肿瘤。由于以前有过手术，做过化疗放疗，现在的手术难度很大。这次手术之后的切片活检说明手术很成功。】
第二次，又一个疯狂的耳鼻喉星期三。
嗯，今天，我早晨六点半到了医院，先检查了一个病人，然后抓紧时间读了一下今天的手术资料。上午七点到九点是每周例行报告会。八点的时候，我抓了一个抹了起司的硬面包。尽管早餐我已经吃得很饱了，因为上午九点半要参加一个手术，我觉得现在最好再填补一点。
手术计划用四个小时。手术进行到两个小时的时候，实际情形已经显明要比预料的复杂的多。整个过程我的主要任务就是“撑着”，也就是当手术医生操作时，我把周围的皮肤拉开。这是个体力活，无菌的条件下，整个时间我们都得站着，手臂不能放到高于胸部的位置，不能低于肚脐眼，不能放到身侧或后背。移动不能超过距离手术台两英尺。
手术进行到七小时的时候，将近下午4:30，我终于得到了一个休息。我去餐厅迅速地填补了一些垃圾食物和可乐。这之前，我只是在报告会中、上午八点的时候吃过喝过。整段时间我一直站着，还出了很多力气。我抓薯条往嘴里塞的时候我的手一直抖。我狼呑虎咽了一堆食物之后，马上回到了手术室。我的休息时间，从我撂下牵引器到又拿起牵引器，总共十五分钟。这已经比手术医生和住院医助手多了五分钟。
刚开始，大家精力充沛，信心满满。在手术第二至第六个小时的期间，大家倍感挫折。从第六到第九个小时，因为看到了接近完工又有些兴奋，而且轮流去了厕所，吃了东西。第九到第十一个小时，大家真是累惨了。
除了“撑着”，我今天还有机会做了几件我第一次上手的事情：插导尿管；切断一根神经（这是手术计划的内容）；第一次缝合伤口，然后把外皮切口钉到一起。
我离开医院回到家的时候（已经快晚上九点了），我的脚膝盖后背和肚子都没知觉了。我必须强迫自己吃点东西，要不然的话，我要是直接上床睡觉，醒来的时候会更惨。手术医生和住院医助手说这可能是我医学院第三年临床学习最惨的一天，但对他们来说，再正常不过了。做为一个职业医生，我学到了很重要的两条：1，要找到一双最舒服的鞋，不用在意它有多难看；2，因为你不知道下顿的时间，只要有机会就吃。
原文
Wednesday March 23, 2016 – Single Day Summary
Crazy ENT Wednesday, Round 2
So today, I arrived at 6:30am to check up on a patient and do some catch-up reading for the surgery today. We had weekly Grand Rounds from 7-9am. I grabbed a bagel with cream cheese at 8am, thinking it would be a good idea to eat before going into surgery at 9:30am. I had already eaten a big breakfast that morning.
The surgery was only scheduled for 4 hours. About 2 hours in, it became apparent that it was going to be a lot more complicated than anticipated. My main job during all this time was to retract, which was basically pull back on the skin while the surgeons did the work. To get an idea of the physical stress, sterile conditions require us to stand the entire time, we’re not allowed to put our arms above our chest, below our belly button, or to our sides and behind our backs. We could not step more than about 2 feet away from the table.
I was finally offered a break about 7 hours into the surgery, at close to 4:30pm. I went to the cafeteria and stuffed some quick junk food and Coke in me. The last time I had eaten or drank anything was at 8am during Grand Rounds. I had been standing and using a decent amount of force during that entire time. My hands were shaking as I was picking up my French fries and trying to get them to my mouth. I wolfed down my food and get back to the operating room. My break, from the time I put down the retractors to picking them up again, was about 15 minutes. That was 5 minutes longer than what both the surgeon and resident took.
The energy at the beginning of surgery was laid back confidence. At about hours 2 through 6, it was a tense frustration. Hours 6 thought 9, there was more excitement because we all could sense we were getting close to finished, also we took turns having a meal/bathroom break during that window. And hours 9 through 11 were exhaustion.
Other than retracting, I had the opportunity to do several things for the first time today. I put in the Foley catheter, cut out a nerve (it was supposed to be cut out), put in my first sutures, and stapled the outside incision together.
By the time I left the hospital and got home (close to 9pm), I could barely feel my feet, knees, back, or stomach anymore. I had to force myself to eat some food, otherwise, I would have just gone straight to sleep and woke up in an even worse state. The residents and attending surgeon told me that this would probably be one of my toughest days of third year, but was fairly routine for them. Two important lessons learned in the life of a doctor: 1) find the most comfortable shoes possible no matter how ugly, and 2) eat whenever you have the chance because you don’t know when your next meal will be.