Great Balls of Fire....

So I am completing my 2nd straight day of Burn ICU call. I shit you not, we have had exactly zero admissions.  In fact, I have only been called 1 time at home with a stupid question from an intern.  Talk about a white cloud.
I am thoroughly convinced that 99% of people that get burned were doing something stupid.  Whether it was smoking in the car with a can of gas on the front seat next to them or dickheads trying to steal copper from electrical substations and touched the wrong wire, Darwin could not be happier seeing his natural selection in work.
Now I am not talking about these brave men and women soldiers, marines, air and seamen that we get back from the war.  In that case, they were injured by some chicken shit jackoff usually planting an IED and running away, not even being men enough to stand up and fight.
So in closing, thank you central Texas for not being dumbasses the last few days, you may continue starting 0600 tomorrow.  And remember, lighter fluid and gas are not the same so if you use it to light your Weber.....stop, drop, and just lie there 'cus now you're the grill. S'mores anyone?

thank you mommy

So the momster and step dad were down in San Antonio for Thanksgiving.  And, of course, I get the normal questions...."What do you want for x-mas?"  Now, honestly, I don't need anything.  I have a great wife, a beautiful daughter, and a nice house.  But mom being mom (and my step-dad, Mario), they wont take no for an answer. 

The day after turkey day, Mario and I, are at the local watering hole grabbing a beer while we wait for our take out.  Some guy next to us has an Amazon kindle.  He asked me, and I quote, "What the fuck is that thing?"  So, I explain to him that it is Amazon's e-book reader and how they work.

They next day, they leave for home and 2 days after that...a package from UPS shows up at the door.  Now, I am at work when it gets there and I spoke to my mom that morning.  She says that a package will be coming and don't open it.  Being the good son that I am, I say OK.  That night, my wife says UPS dropped something off so I take a peak.  Now, nothing against online shopping for x-mas, but when the package that comes says the name of the contents inside, it kinda ruins the surprise.  I mean Kindle was splattered all over the outside of this box.

Being the little shit that I am, I call mom and tell her what just arrived. She was a little upset but that didn't stop me.  "Since I know what it is.....can I start using it?"  Well, after a few please, please's...she said yes.  I felt just like the kid and his Red Rider B-B gun from a Christmas Story.  I tore ass into this thing and started downloading books.  Let me tell you, this thing is SO COOL.

I always wanted to read more non-medical books but never bought anything because 99% of my reading life is learning about surgery and critical care.  You can download almost anything you want...and the best part, a lot of the good stuff is FREE.

Even though this thing was a gift, I highly recommend it.  Well worth the money. Get one.

Holy big whack Batman....

So...took call with the trauma team yesterday. Felt great to be back on the service again. The day started off great. Got back to the OR and had some good cases to include an ex lap for a bowel obstruction. It was sweet, got to sew on some intestines again....been forever. I know, weird shit to be happy about but I was training for 5 years to do that stuff.
Suddenly, we get a call that a major trauma is incoming. Car vs. bike and the guy is really dorked up. Just as the ambulance hits the ER door, the paramedic says they lost vital signs. Now, as surgeons, this means one thing. We have to cut this poor bastards chest open to see what the hell is going on. So, with big ass knife in hand, we put a whack on this cat's chest from is sternum to the table and with a couple of big chomps of heavy scissors, we are looking at lung. Rib spreader goes in to give us room. Open up the pericardium (the sac of tissue that holds your heart) and blood gushes out. Then we see it, a huge hole in this guy's heart. I call for a stapler (yes, a stapler) but he has no cardiac motion. He's dead and we call it. And in my demented mind, all I can think of is GODDAMNIT. I didn't get to cross clamp his aorta...oh well, good anatomy lesson I guess.
Then we get 2 assholes who were shot "minding their own business of course). Both shot in the chest. Now whoever shot these two Mensa members has to be the luckiest bastards ever, they hit nothing important...nothing. We sent them home from the ER but judging on the number of tattoos and lack of teeth they had...we will be seeing them back in the ER any day now. I guess it is better to be lucky than good. I'm neither.

Cam didn't know...C'mon man.

Are you serious? Did the NCAA just do that? Does anyone outside of Auburn campus really think that Cam didn't know that his father was pimping him out for $100+ thousand? This kid is a dirty as an overweight stripper's thong after a 12 hour shift. First he had someone's stolen laptop. Then he cheats at UF. He leaves because Tebow came back for his senior year. Right..that team would have been his this year. He left because the hammer was gonna get dropped on his head and he was going get thrown out of school. Then his father goes and tries to pimp him out to other schools. Do you think MSU was the only team he contacted? But he didn't know....I got one word for that....BULLSHIT!

Once more into the breach dear friends....

I don't know why, but I look forward to the UF v. FSU game all year. I used to tell my friends that I didnt care if UF went 1-10 if that one win was against the seminoles. And now, once again it is gameday and I have butterflies in my stomach. The Gators have a good but not great team this year and no Tebow. I cant tell you how much I miss watching him play in orange and blue. Anyway, lets get down to buisness and show that POS truckstop of a school who's boss in this state. If you're not a Gator, then you must be Gatorbait....

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My own worst enemy

So, this month I am on "research" but I get to take call with the trauma/acute care surgery team once a week. I was like SWEET, I can get back to the OR. So I was on call yesterday with them. Now, in terms of medical jargon, a white cloud is someone who brings good luck to the team... i.e. NO WORK. I have had this title for awhile now. Therefore, 24 hours on call wanting nothing more than to get to operate, we get NOTHING. No appys, no gallbladders, no anything. Really...really....My white cloud is becoming my own worst enemy. Damn it, need some OR air!.....

Ace of suck my sack

Oh..."Ace of Cakes"got canceled....I used to come home and tell my EX-wife how I saved some guys life by doing whatever and she would swoon over this asshole's ability to make a CAKE..he was a genius, and I was just some jackoff saving lives. FU ace of your canceled show.

Blowing money on BBQ

So, I got my general surgery bonus from the Army. I did the correct thing and paid off some bills, put some money in savings and the like. But then I figured I should spend a little of that hard earned cash on me. So after the wife gave me the OK, we were at the BBQ Galore within the hour buying the Big Green Egg. Now, I have been wanting this grill for years but never got the nerve to drop that kind of money on a charcoal grill. What made it harder was the fact I bought a top of the line Weber gas grill over the summer. But being a man, I had to get another toy.
So back to the BBQ store. We walk in and I look at the salesman and say, "I want a BGE and everything I need to go with it." Now, I have given people alot of good news as a surgeon. But, the look on this guys face was priceless. And $1500 later, I had the same look. So, after waiting a week and a half for them to deliever it, I had it.
Within 2 hours, I had a pork butt somoking on it for pulled pork the next day. After 22 hours of waiting, the pig was ready. Holy jesus...this BBQ was the best I ever had. I am hooked.

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so if i was too harsh

I have recieved a few calls about my post last night. Therefore a couple of points:
1. I wasnt really pissed at the resident that misdiagnosed the hernia. Just annoyed.
2. A dick doctor is a urologist
3. Surgeons do curse as much I do
4. No, I wont get in trouble by doing this

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Wow..

Eventful week. Just as I was starting my shift, I was told by the 4th year resident that we had an incarcerated hernia to do. Now, that isnt a hernia that is in jail but one you cant reduce. So I told her that I want to exam the patient before going to the OR and she informed me that the patient was already on the table and ready for his operation. OK....I was ready. I havent repaired a hernia for probably 6 months but I was sure I could take her through it. So we start the operation and get to the portion where I was sure that I would be able to see intestine in the groin.....but there wasnt any there. So, now I was scared that I fucked up and will look like an idiot but... I had to call another surgeon into the OR for a quick intra op consult. He agreed that this wasnt a hernia but a testicular mass. WTF.....the resident told me a PERFECT story for a hernia and I wanted to examine this guy before he was going to the OR. So what was this grapefruit size mass in his scrotum? Well, I called the urologist into the OR and he quickly, dx this thing a a huge hydrocele. Now, I look like a moron to this dick doctor for not being able to dx this mass. Goddamn resident. WOW, was pissed. So the next consult was this Greek tragedy of a small bowel obstruction. I mean this guy had to be the worst operative candidate I have seen in a long time. I went a pushed on this guy's abdomen and he is jumping all over the bed and I was thinking HOLY SHITBALLS. It was just one hour before I was off and I was seriously thinking about whacking this land monster's stomach open. Then I look over and he is talking on his cell phone laughing a joking with whatever asshole was on the other end. I was like.....FUCK HIM. I walked back over, and he started back up again...."oh doctor, I hurt so bad!" So I decided to watch him, all his labs and his story fit to watch him...the ONLY thing was his exam. Now I'm sweating because a jr. surgeon making that call to watch a bowel obstruction that MIGHT have dead bowel is always a risky proposition. And, of course, it is almost time for morning report where we have to present the previous days business. To make things worse, the MUCH more senior surgeon who taking over for me happen to walk through the ICU and happened to see this guy. So he catches me before morning report and says, "Ron, that guy should be in the OR right now." FUCKBALLS...did I just make a huge mistake already? So I tell him about this guy and what I saw him do with his exam and everything...and he says, "I would have taken him." Now this senior surgeon is one of the premier surgeons in San Antonio. So, of course, I feel like a shitbag. Well, we go morning report and the chief resident, who wanted to take the guy to the OR, is standing infront of the other attendings giving the story like this guy should be getting his belly whacked open and I sat on him. So, being the attending on call, I present my case about how he didnt meet criteria for a complete bowel obstruction and his labs and vitals were completely normal. And after a few tense seconds, I hear the other staff thinks that it was the correct plan. So, the guy was gonna be observed over the day and if he got worse, he was gonna go for a bitch if an operation. My shift was then over. I went home. Today, I went up to the ICU wanting a story of what happened to this guy. The ICU resident tells me.......oh he looked great so we sent his to the floor. WHAT? NO OPERATION? NO horrible decision by the most jr staff even in the face of the most senior staff's saying that he would have operated? I was amazed. More than that... I was justified. Content with my apparent victory, I go to get on the elevator to go downstairs and who is waiting there...the attending that told me I should have been in the OR operating on that guy. He looks at me and after about 20 seconds I say, "So...that SBO did ok." And he looks up at me and says, "This time."

First night of trauma staff call

You know, when you leave residency, your staff tells you not to schedule big cases right out of the block. Well, being in a critical care fellowship, I haven't been operating very much at all. So, last night I was able to take trauma staff call at the level one trauma center in San Antonio. Needless to say, I had some butthole pucker thinking of some trauma disaster that might roll in to my trauma bay. "Don't schedule big cases"....yeah right! There isn't scheduling in trauma. Well, out of 15 traumas, I took none to the OR because they were all blunt. I did have 4 acute care surgery cases however and it felt great to get back to the OR.

Smoking meats

As one of the Earth's great carnivores, I have a new hobby. I have a mission to become a master at smoking meat. I bought a cheapo Brinkman smoker, made the modifications, and have smoked some type of meat every weekend since I bought it. In fact, these past 2 weeks while I have been on paternity leave, I have gone a little crazy. In fact, as I write this, it is 12:30am and I am smoking a pork shoulder for Saturday football tomorrow.

Busy week

This has been an amazing week. I cant believe that I am a daddy again. My daughter, Seraphina, was born in a crash c-section and mom and baby are fine. Wow, as a surgeon, to see what was going on in the OR and to get her out in time was amazing. the baby catchers did a fine job.

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Baby Day

Well after laboring all night, the baby catchers have finally decided to section my wife. It only took 24 hours of decels for them to make that determination. Lets hope they dont hit her bowel on the way in. Well if they do, i guess i will get a case out of it.

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Saturday with the Gators

Sweet game today. Watched it with the Alamo City Gator Club. Highlight of the day, other than the Gator victory, I won 4 raffle prizes on 10 tickets.

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just another Thurs

Well, the rain has stopped and the ICU is full. I had to take an anest resident through a chest tube this morning...scary. Otherwise, just trying to keep the gomers from dying.

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Rain, Rain

Nice tropical storm rolls through San Antonio today. Streets flooded, 50 mph wind, general chaos on the road....not a problem. As a healthcare provider, you get your ass to work.

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El Chepo Brinkman

Bought my $40 Brinkman smoker, cant wait to try it next weekend.

OMG

Pulled pork turned out great. If this trauma surgeon thing doesn't work out, I'm gonna open a bbq restaurant call ed Fat Ronnie's

Easy Sunday Afternoon

Got an easy rotation at the VA right now which gives me the weekends off. Spent yesterday watching football (my Gators won but were not impressive) and today, smoking a pork shoulder for pulled pork.

Gameday

There is no more scared day then the first Saturday of the college football season. Even better, a cold front moved through San Antonio and dropped the temp about 20 degrees, so it is really starting to feel like fall.
God bless football and Go Gators!

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Notes on a trauma fellowship

Hey. Just wanted to drop a blog and discuss my experiences as a trauma surgery/critical care fellow. Just coming off my surgery chief resident year, it hard not getting to operate like most of my classmates. In this fellowship, you are mostly a medicine doctor (know as fleas) cause all you do is round. BTW, we call the medicons fleas cause they are the last thing to leave a dead body. So far, I am 3 months into this experience and the most invasive thing I have done is a perc trach.
You do meet some interesting characters however. I have one attending who is a medicine critical care doctor. One day he heard me mention that I was frustrated cause I havent been operating. He tells me, "Your not a surgeon now, you are a critical care doctor." I was shocked and pissed so I replied, "Sir, I am ALWAYS a surgeon first so please never say that again." Do you believe that shit. Fucking flea.
Anyway, will try to make some post from time to time to enlighten those who might be interested in the life of a trauma doc. Hopefully, things will eventually lead to the OR.