I recently heard a podcast on "Stories: The Moth" about a bassist who got his shot at the big time by playing with Freddie Hubbard. It was somewhat reminiscent of my time in an elective rotation I did for family medicine.
Prior to my elective in family medicine (the second-last elective of medical school, while I was in my fourth year) I was in my third year at a completely different hospital, rotating with a tough, Harvard-trained surgeon. One of these days, I'm going to sit down and give my "Experience in Surgery" a proper writing, but that day is not this day. So for now, I'm just going to talk about removing sutures.
Sutures are synthetic stitches placed in cuts in the skin to help them heal. Normally, sutures are placed in the skin after surgery, and then they are removed after the wound heals. One of the duties of the lowly medical student is to remove these sutures in a timely manner when the patient comes to the surgeon's clinic for their follow-up appointment. Our surgeon in particular did a lot (like well over a hundred) surgeries in the 6 weeks I rotated with him (following him I had another 6 weeks with a vascular surgeon husband-and-wife team) and my colleague and myself would alternate suture removal. I never got to place the suture, that would come later, but removing the suture was an everyday, all-the-time occurrence.
Fast forward to the elective rotation at the family medicine residency, and I was told by my precepting family physician attending at the time that he had sutures to remove in someone's face, so he had to go and find a huge magnifying glass to be able to do it because his eyes were not as good as they used to be. Being the upstanding 4th year enthusiastic medical student that I was, I volunteered to remove the sutures myself, and did so promptly, painlessly, and without any vision-enhancing device (my eyes are still young, thankfully. One day, I don't doubt that they will grow old). This was one of the few opportunities I received to prove myself on that rotation, infront of this particular attending who was actually the associate program director of family medicine there, and ended up writing me a letter of recommendation that led in no small part to my 5 residency interviews. I didn't end up matching there because I put the program below another, since it seemed as though that residency was running lower on funds and was a bit behind in technology than where I matched. If I were to decide with my heart, I would have gone with them, but when ranking residencies, students must always decide with their heads.
To remove a skin suture, one must wear gloves and open up a sterile pair of pickups (forceps with tiny teeth) and a sterile pair of suture removal scissors. Gentle pulling on a suture will expose one end of the suture below the knot and, when this end is snipped with the scissors, the knot can be removed effortlessly from the skin. Scar tissue and continuous sutures can complicate this endeavor, but that is the rudimentary technique. Suture removal, one of the many and sometimes overlooked reasons for which I managed to match to a residency.
PS. I've decided to scrap the inclusion of the "Perfect Day" tally into my journal entries. It interferes with the continuity of some of these entries, so I'm just going to keep my own tally.
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