Well, we're back again. Getting late, so this is sort of a wrap up. That was, without question, the biggest abscess I have ever seen. It extended the length of the thigh, and had 1.5 liters of pus in it. And it was under pressure, shot 2ft when I cut into it. Don't try this at home kids, I'm a professional. I'll plan on taking him back to the OR for the next few days to try to get this thing really cleaned up, and then it will have to heal from the inside out, because any attempt to close it would simply lead to another abscess.



It was a busy day. I started rounds in hospital B, then office for about 5 hours, then to hospital A to do a quick case, which of course then took twice as long. I'm on call today, so by the time I had finished the case, I had three consults to see back at hospital B, so off I went. I saw this big abscess and got it routed towards the OR, then saw the other two cases, and lined up most of their management, then down to the OR, and finally back up to the floor to finish off the second two consults. I'm now home as it approaches 11p, and this is definately a short blog night. A while ago, I promised the expose' on the beauracracy, but I'm afraid it's going to have to wait a little longer.

I did notice, glancing at the last post, that I talked about abscesses as most surgeons' first case, as it was mine. Now, how is this so? Pretty simple. As I said earlier, abscess tend to come in at night. This is when staffs are lower, activity is minimal, and residents can take a little time to teach the enthusiastic student. So here ya are, on your second night of call on surgery service, already almost falling over because you were up at 0300 that morning to round on your patients, and it is now around midnight. The resident sent you down to the ER a couple hours ago to see this patient, and do the history and physical, and now the junior resident, and then the senior resident, has seen the patient, and the two of them have talked about you, and decided you really are bustin your chops, and they throw you a bone. Your first procedure. Sit here. Hold the scapel like this (Oh my God, they're letting me touch the scapel!) Cut here. Course, they forget to warn you about that pressure thing, so a half second after the, "cut here," you're falling off the stool backwards as you try to dodge the pus squirting out. But it doesn't matter. You've cut your teeth, you've drawn blood. You're hooked. Never again will treating the common cold be enough for you. You're A SURGEON now.

Good night,