Mr. Tyrone Laces

Each morning, after passing through the hospital doors, I avoid the urge to take a left and follow the hallway that leads to the ER. I feel the pull, but fight it, and head straight to the belly of the hospital, the OR. Passing through a few more doors gets me to the inner sanctum: The Surgeon's Lounge, complete with leather wrap-around couches, a large flat screen TV with ESPN on, and donuts. I pause to watch SportsCenter's attempt at making pre-season football seem dramatic. Perhaps I scrounge some donut action. Then I continue a few more steps to grab scrubs, cap, mask, and shoe covers.

That's about where my freewill ends for the day. After that I am at the mercy of the surgeons, nurses, and staff. I hold things when I am told, I let go of things when I am told, I cut things where I am told, I sew things up in the manner that I am told, I follow surgeon's to the ICU when I am told, and I go to the cafeteria when I am told.

Actually for 10 minutes in the middle of each day, I am granted some more freewill in the form of a Salad Bar. I enjoy choosing which cherry tomatoes to plop next to the chosen carrots. I enjoy not choosing mushrooms, opting instead for chopped egg.....

Then it is back to reality. I am told when to stop eating and when to head back to the OR. I am even told when to be told.

So far I think I am doing a pretty good job of doing things when and how and where I am told. But is it a problem that it took me 20 minutes to tie my shoes this morning because I sat there staring at them for 19 minutes waiting for somebody to tell me to tie them?

Horse vs. Wasp

"Can you come to my place and ride my horse once a week while I recover from this surgery?" asks the rancher with diverticulitis and a fistula (connection) from his colon to his bladder, causing frequent infections and air to be expelled from his penis.

"I also have a beautiful daughter, but she's as ornery as a wet wasp," he says trying to sweeten the deal to the young (appearing) PA student who has to take his wedding ring off for surgeries.

I almost take him up on the non-ornery horse riding half of this offer, as I picture myself saddled up, trotting around the Oregon foothills with a piece of straw dangling from my lower lip, or maybe a Marlboro. I could trade in the scrubs for Levi's, the frigid operating room for the August sun.

Then he starts talking about hay bales, heavy lifting, and general barnyard type work, and I decide to just let the ornery daughter get her hands dirty for once and help her poor rancher-dad out.

Croakies, stat.

OK enough about the destination. Despite my assessment of this town and my unending search for the perfect place, this rotation is actually about surgery.

Lots of gallbladders, hernias, breast biopsies, and colonoscopies. First part of the week it was a lot of watching. The HR people were not convinced that my negative TB test from May meant that I didn't have tuberculosis. They wanted to feel no induration for themselves. Once they did, I was allowed to "touch patients", as the lady put it. That's good, I thought. While shadowing this whole time, I have been breathing on them. But never mind that TB is transmitted by air droplets. As long as I don't "touch" them.

Once I was allowed to scrub in, TB-free, things got more interesting. I basically act as the first assist on all surgeries. I stand across from the surgeon and hold retractors, suction fluid, and cut knots. Only once did I contaminate the entire sterile field and the patient by having my completely unsterile safety glasses drop off my head onto the patient and the drape. I followed this with a short expletive and a thorough apology. I was glad to not get kicked out of the OR and they told me they would get me some croakies.

Other fun moments:

• Holding a gallbladder in my hand
• Totally sucking at the subcuticular suture
• Watching the surgeon sort through small intestine, like so many sausages
• Eating PB and crackers for lunch as I chase the surgeon through 13 cases in 12 hours
• Having today off, after a really fun weekend with Audrey, exploring all the places from the previous post (a trip that may deserve it's own dedicated post, and may be found soon at chipandaudrey.blogspot.com)

Rose Colored Lenses

To catch up a bit on the last few weeks of bloglessness:

• I finished my prison rotation with mixed feelings. Overall very good experience to have so much autonomy, have a fun classmate to share the ups and downs (and the 1.5 hour drive) with, and great to be living at home and seeing Audrey every day. But for the most part, Tom said it best: "Its time to move on, time to get going ..."
• Had a week of "class" which was a nice vacation. (Stayed up past 8:30 pm on more than one occasion!)
  
• Onward to Roseburg and a rotation in surgery. This town of about 20,000 has potential written all over it. A nice historic downtown, a river running through it, free concerts in the park (I drank beer with the surgeon and an anesthesiologist as we listened to Susan Tedeschi), and a veritable hotbed of recreation opportunities in the nearby Upqua River corridor. For example....Not to mention the whitewater kayaking, an 80-mile hiking trail, proximity to the Pacific Ocean, and the arid climate (compared to soggy Portland.)
  

This place is destined for an Outside magazine exposé entitled "America's Top 10 Secret Towns You Should Move to Now". You know the article. We've all read them. Where is the next cool place? It's too late for Telluride, CO. It's over for Burlington, VT. Bellingham, WA? That's so 7 years ago. Authors dig deep these days: Salida, CO, New Paltz, NY, Boone, NC....Enter Roseburg.

But something is just not right. Like many of the obscure locales, there is a reason why it remains a secret. The economy here seems like a sinking ship. Vacant storefronts outnumber the operating businesses. A Friday evening in the historic town center reveals an eerie silence. An aging population may keep the hospital busy but the overall vibe here is one of decay. The new subdivision I reside in has halted construction. The developer brought his cows down to the pasture that was supposed to house new homes. The coffee shop is only open Monday through Friday. Time will tell if this town can truly become an Outside Magazine posterchild. Or will remain the impoverished Douglas County Seat, with bad schools, no jobs, and vacant storefronts? Either way, the river, the mountains and the lakes will be here when you arrive.