As a student, watching a surgery seems so easy. Especially when residents are performing the small surgeries. You think “oh that’s so easy. I’d have no problem doing that.” Then, when its actually your turn to do something for the first time, you realize quickly how wrong those thoughts were.
For one patient, we needed a bone biopsy to rule out osteomyelitis from a chronic wound on the 5th toe. I thought: “Oh, it’s a bone biopsy. How hard can this be? People do them in their clinics all the time.” The case is about to be started and the foot is scrubbed, prepped, and draped.
I thought: “Oh, it’s a bone biopsy. How hard can this be?…
The attending hands me the bone marrow trephine and tells me to make a stab incision with my 15 blade and get to bone. Piece of cake. Then, I was told to use the bone trephine to get a small plug of bone from the distal phalanx. The attending tells me to go through the entire bone to make sure I get a small tube of bone. I try and get nothing out. He tells me to try again. My trephine slips off the bone, and I again get nothing. At this point, I’m frustrated. So, my attending holds the toe to give me some counter pressure. I find the bone with the trephine and push harder than I did before. Of course, the worst thing that could happen, happens. I pushed too hard and the trephine goes through the bone, through the toe, and sticks my attending. I was so embarrassed. My attending scrubbed out, washed his hands several times, and reassured me that it was his fault. But all these thoughts of “Wow! I can’t believe I did that. Should I even DO surgery?” pop into your head.
But all these thoughts of “Wow! I can’t believe I did that. Should I even DO surgery?” pop into your head.
Thankfully, I have very patient and understanding attendings. This attending told me he shouldn’t have been holding the opposite end of a sharp object and that he knew better. It’s just one of those things you hear about, but never imagine happening to you.
I learned NEVER to assume a surgery is easy or to take a “simple” procedure for granted. If it was easy, everyone would do it; so, it’s pretty clear why not everyone is doing surgery. It’s vital to appreciate the skill and care it takes to perform EVERY surgery, not just the big ones.
Story by Dr. House.
All our authors names have been kept anonymous for this special edition. We hope you enjoy these great stories by podiatry residents.
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