Surgery.
We talk about livers, gallbladders, IV fluids and PE’s.
What ever happened to that acronym FIFE*?
I wonder. Is it purposeful,
This lack of reference to life?
I’ve gotten good at rounding.
Vitals. The 5 essentials: Pain, pooping, farting, eating, walking?
Good.
A poke here, poke there. Next.
I’ve become not a bad assist.
Retractors, laparoscope, snaps and cuts.
I’ve felt pretty proud of my single handed ties.
Sew up the abdomen? Why it’s just like needle point.
5 o’clock wake ups no longer faze me.
Surgery Podcast 101, my commuting companion.
On call again? Yah, I can take it.
I’m about facts and efficiency,
Nothing soft, no greys, don’t ask me how I’m feeling.
And between the OR and hopeful call room nap, was Mrs. B. She too wasn’t about soft, no greys, and just forget about feelings. It was a hernia repair. She was old. Not well. Bent on getting home. Maybe she had a grandchild? A cat? But all I knew of her social history was that she had smoked years ago. Quit. Rare EtOH. No drugs. Days of vitals; the 5 essentials: Pain, pooping, farting, eating, walking; cumulated in a page: respiratory failure. Huffing, puffing, eyes bulged as she looked at the yellow gowns placing central line, a new IV, another ABG. I tried to explain what was going on, prided by my patient centered approach. I was touched when in return she looked at me, with fear in her eyes. The softness and greys emerging, sketching in depth. Good medical student, I thought; remembering the patient. My ego continued the following morning, explaining our interventions, happy to see she was still alive.
Though the patient was not under my attending’s team, I continued to ask the nursing staff how she was doing. I had intentions to visit, to sit and what else? Well, just listen. To be there. Remembering her fear. But the days of pokes, podcasts, pain, pooping, farting, eating, walking, livers, gallbladders, IV fluids, PE’s, podcasts, retractors, laparoscopy, snaps and cuts; they continued. They melded and I again fell into facts and efficiency, and before long, my rotation ended. No subsequent visit made. Despite good intentions, my selfish needs and hindsighted-backwards priorities, chose efficiency and ego.
You see I’m in surgery.
We talk about livers, gallbladders, IV fluids and PE’s.
There’s no time and no use in that acronym FIFE.
For me, it has become purposeful.
This lack of reference to life.
*FIFE is an acronym that medical students are taught early to encourage effective and patient-centered communication. It stands for Fears, Ideas, Function, and Expectations.