46 things I think I learned during my surgery rotation

One. Surgeons always button their white coats.

1. Surgeons always wear ties.

2. Women who are surgeons do not wear ties.

3. Surgeons never wear stethoscopes around their neck.

4. Contrary to what you might think from watching Turk from Scrubs, surgeons only wear scrubs in the operating room.

5. It is very important to understand and mimic how surgeons dress when one is pretending to be a surgeon.

6. The concepts behind heart surgery are easier to understand than you think they are.

7. The time it takes to do heart surgery is exactly as long as you think it is.

8. Sometimes it takes even longer.

9. Riding in a six-person Learjet to harvest organs is sweet.

10. The private jet terminal at Raleigh-Durham International requires you to pay for parking. Sorry sir, but you're going to have to pay $22.75 for parking so that you can get on your $6.8 million jet and head to the south of France for the weekend.

11. The box marked "Human Organ Transport" sitting on the tarmac at the Greenville Airport actually does contain a human kidney (or pancreas or liver) packed in dry ice.

12. It is perfectly appropriate to put a box containing a human kidney into the trunk of a Jetta and drive at the speed limit from RDU to the Duke hospital.

13. It doesn't matter how early you go to sleep, waking up at 3:45 a.m. still feels like waking up in the middle of the night.

14. So does waking up at 4:15 a.m.

15. Patients are less than thrilled when you breeze into their room at 4:30 a.m. and starting poking at their bellies.

16. Probably because no matter how early they went to sleep, it still feels like the middle of the night.

17. Especially when they had surgery there the day before.

18. There's no medical condition that can't be diagnosed with anoscopy.

19. That's probably not true.

20. The answer to any question about surgery is, "Get a complete history and physical."

21. The answer to the follow-up question is usually, "Optimize the patient's volume status."

22. If they ask you what type of fluids you want to use, the answer is, "Lactated Ringers."

23. Bizarrely, Lactated Ringers solution contains no ringers.

24. It does, however, contain lactate.

25. If anyone wants more information than you know, running out of the room and crying is not an appropriate answer.

26. The answer to a question about surgery is never, "Go straight to the operating room."

27. Unless it is the answer.

28. Surgeons call motorcycles donor cycles. (Get it? It's an organ donation joke!)

29. A surgeon asked my scooter-driving friend if he could just tattoo his blood type on his chest so that they'll know which patients to transplant his organs into when he suffers massive head injuries as a result of crashing his scooter.

30. My friend is not J.D. from Scrubs. 32. Only parents who hate their children buy them motorcycles.

31. Despite their fantastic gas mileage and the fact that I'd look super-cool riding in one, I do not want a motorcycle or a scooter.

32. Even if it had a sidecar.

33. Always wear eye protection in the operating room.

34. Be nice to the nurses. They were nice to you first.

35. It's kind of nice to get yelled at, because that means someone cares.

36. The alternative to being yelled at is being ignored. That means no one cares about you.

37. If you can't deal with a problem, someone else in the hospital can. Send the patient to him or her.

38. If you did surgery, and your patient has a problem, it's your fault until you've proven that it isn't.

39. "Cancer" is always an answer when asked what the diagnosis might be.

40. "Cancer" is rarely the answer that the person asking the question is looking for.

41. The answer is "diverticulitis."

42. Med students wear short white coats. Interns where short white coats and white pants. Everyone else wears whatever they want in an effort to confuse med students.

43. Med students spend a quarter of their time scared, half of their time confused, and a quarter of their time waiting to be told what to do.

44. The rest of the time is for sleeping.

I also learned at least 17 other things, one of them being the basics of managing a surgical patient (which may or may not be a single "thing"). Though I care deeply about them, I can't imagine that anyone else would since they involve science and stuff.

Alex Fanaroff, Trinity '07, is a second-year medical student. His column runs every other Thursday.