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.