The Post Has No Title

I've been admittedly absent from the web for quite some time. My email account has way too many emails in it, and the whole blog thing has been sadly neglected. Quite frankly, things have just been really busy what with gardening, playing vascular surgery resident, and more recently having been elected by the residents to a one year term as co-president of the Erlanger Housestaff Association.

I've spent the last month on vascular surgery, and will be there until the end of September. Unlike the trauma patients who tend to be young and reckless, the vascular patients tend to be old and worn out and have had the good fortune to somehow manage to outlive their circulation.

In other ways, trauma patients and vascular patients are very similar. Both sets of patients often get into the hospital due to lifestyle decisions they've made. Many of our trauma patients have altered mental status due to alcohol/drugs and then wind up doing something stupid. Vascular patients almost all smoke, or else did for a long period of their lives. Many of them also have high cholesterol and diabetes, both of which can be related to diet. Its somewhat disheartening to spend hours trying to open up someone's clogged arteries in an effort to save their leg from the pathologists specimen bin, only to visit the patient postoperatively to find that he has left the room to go outside and smoke. The empty McDonalds bag beside the bedside is no more encouraging. However, the bypasses and endarterectomies are technically challenging procedures, and are therefore very enjoyable to do. So its been a good month.

My favorite vascular procedure by far is a carotid endarterectomy. You have one carotid artery on each side of your neck, just beneath the jugular vein. Most of your brain's blood supply comes from these vessels. When they get clogged up from the toxins of living, blood supply can get comprised to the point where you have a stroke. In 1954, some brave soul figured out that if you took the crud out of the artery, strokes were less likely. We therefore perform endarterectomies in people with advanced carotid disease. There is something uniquely exhilarating about slicing someone's neck open, pushing the jugular vein out of the way, occluding the outflow and inflow of the carotid artery, cutting it open, grunging out the gunk, and then sewing the artery back together again. Its not a procedure I will ever do as a general surgeon when I'm finished with residency, so I'll live it up while I can I guess.