When you're in your surgical space suit and the nurse swaps out the battery thats been dead for a couple minutes...

Ask an orthopedic fellow (its pretty autobiographical)

Dear orthopedic adult reconstruction fellow:

I had a twisting injury to my knee a couple weeks back. The doctor diagnosed me with an ACL tear, but said I may still get arthritis even if they reconstruct it, is that true?
-Unstable in Utah











Dear unstable in Utah,

'hell…hello? Yeah, I guess I’m on emergency call while the residents take their yearly OITE… what time is it? 0240? Nice.

What do you got? A hand lac? Okay, what do the tendons look like? What you mean you haven’t off the dressing?! Is there arterial injury? Oh right.

What bout X-ra…nevermind, not even gonna ask. I mean, it sounds like a simple lac, you can sew it up right? What do you mean you can't. You went to med school right?

Uh huh.

Right. But you see, that’s a different can of worms, I KNOW how to treat hypertension, I just don’t want to.

Siiiiiggghhhhh. 

Fine. See you in a bit.


Dear orthopedic adult reconstruction fellow:

I have this knee pain that’s pretty bad, they say I need a knee replacement, but I’m hesitant, what’s our thoughts on stem cell therapy for the knee?
-Platelet rich plasma fan in Portland


Dear platelet rich plasma fan in Portland

Hi, I was hoping to apply for a new car loan.

Uh huh. Yeah, just something for my family to fit in, nothing fancy. Yeah, my income is... well it’s not a lot. I’ll making a lot next year though, does that count?

No? I see.

No, my wife stays home with the kids. Debt burden? well, that’s an interesting story… you don’t to hear the story? Okay, it’s about… (cough) hundred thousand.

Yeah,

Uh huh.

Assets? Oh I got some ASS-ets… no… no I don't, it was actually a bad joke. Does a white two door 2006 Hyundai accent that was donated to me with a 12 inch sub in the back count for anything? I see.

I see.

I see.

I qualify for that little huh? No, don’t worry about it, I’ll talk to my nursing friend about giving me a loan instead.


Dear orthopedic adult reconstruction fellow:

I sprained my ankle a couple weeks back, and its just taking a long time to heal, should I do some physical therapy, or keep taking it easy.

-Sprained in Cincinatti

Dear Sprained in cincinatti:

Yeah, the one on the left knows more than me about reading EKGs....

No honey, I’m not a real…  but it’s just that…  fine. (walking)

Hi, you asked if there was a doctor onboard? Yeah, what’s up.  Okay.  Uh uh.  Uh huh.  Sure, but you should know…  okay.

Sir? SIR! SIR!!! CAN YOU WAKE UP FOR ME?!....

You’re his wife? Okay.

Uh huh.  

Uh huh. 

When was the last time he had something to eat or drink? Well, in case we have to go to the… yeah I guess that’s not important. 

SIR DOES THIS HURT?! CAN YOU WIGGLE YOUR TOES?! WIGGLE YOUR TOES! MOVE YOUR FINGERS! GOOD!! 

Well he can do that so everything checks ou...--diabetes! Ma'am, does he have diabetes? No? Huh. ummmm…. That's kinda all i got....

Oh hi. You’re an emergency room tech? perfect. 

(nodding) Right. Right…. Yeah that’s totally and exactly what I was thinking too. Great diagnosis.

Excuse me, flight attendant? Yeah, do whatever this man says. He’s the most qualified medical person here. 

Thanks. 

When we uncovered the patient's 'man-bits' and there's a healthy cheese over said 'man-bits'...

When drive in early to template my case, but my attending has already done it...

When I see one of the residents about to use the saw singlehandedly...

When you're trying to template a total knee, but there's no calibration ball and the 4th guess on the oversize is giving you an implant size that's still nowhere near correct...

What's that one procedure when you fill a gap in the posterior humeral head by anchoring the soft tissues into it with a suture anchor?

(It was on the OITE 2008)

When an attending that you don't really like gives you 'constructive criticism'...

When my wife asked (after seeing the credit card statement) when I was going to tell her that I was out having a beer with my co-fellow instead of operating late a couple nights ago...

When I'm feeling super confident because my podium presentation is going awesome, and then an attending barges in and asks something I hadn't prepared for at all... (you kinda gotta wait for it)

Looking at a new patient's chart who's allergies are tylenol, motrin, and tramadol....

Whenever someone says the distal radius fracture happened after the patient experienced a "FOOSH"...

When my attending is reaming the resident for something I should have picked up on...

When I try and think 3 steps ahead of my attending...

When the patient is still asleep 30 minutes after anesthesia says they turned everything off...

The intern texted me at 0452 about implant choices...

When you're struggling surgically with your attending after 5PM...

Attending: You've seen Austin Powers, right?
Med Student: I think that was a little before my time.
Me inside:

When the second year says he could basically do a total joint by himself...

When you randomly forget how to assemble a jig you've put together a hundred times before...

My wife: "Just so you know, your society meeting coming up is for learning and networking, it's not just some week of bachelor'ing it up,"
Me:...

Anesthesiologist: "So I'm just starting to put some medicine into your IV that's going to make you a bit sleepy, it might burn a bit."
Patient getting a total joint: "Okay, um....what surgery am i having done again?"

Me and the anesthesiologist...

After finding out I passed the boards, and then seeing my percentile rank...

In lecture, the hand fellow had fell asleep and her hand fell onto my thigh, when she then woke up. I just smiled....

When a third year medical student asks why it's the patellar 'tendon' if it connects a bone to a bone...

When one of the rotating medical students asks if I'm okay giving them some honest feedback...

Us residents sat down with one of our former chiefs that's been an attending now for a couple years....this is basically how it went...

When the intern tells you that last night one of your patients got admitted for a partial wound dehiscence...

Included in my lecture about DDH... snaps abounded.

My thoughts of pathology when we have to send an implant to path, and get the official report reading

"Gross: Appears to be part of a once implanted total hip prosthesis."

As a fellow, one of the PACU nurses asked if I'll be the one putting in post op orders...

The look I got from my attending when I suggested we call the BIG rongeurs the 'Ron-Jeur-emys'...

(I'm not explaining who ron jeremy is.)

When I'm grabbing a quick bite between cases, and see the anesthesiologist in charge of our room sit down for lunch...

Watching a med student throw a stitch with my attending...

My attending asked me a question during lecture about company specific cup-cage constructs...

We still have to handle patient phone calls as fellows, which is mostly for

When I'm trying to eat healthy, but my attending brings in deliciously greasy food...

I had an attending ask if I had heard of orthopedicresidency.blogspot.com...

When surgeries going well, and all of the sudden you forget the next step...

How I feel about whoever decided to make the national board exam 3 days after July 4th this year...

We operate with plastics every now and then for flaps. How I feel before closing a wound with a plastics attending...

As someone who's trying to study for boards, get ready to move for fellowship, graduate residency and look for jobs...

When I mistakenly ask an attending in a bad mood if I can do anything to help...

When peds OR desk says they're bringing in the call team so we can do our type 3 supracondylar...

We had an attending send out an email bemoaning typos in the notes... except there were typos in the email...

Whenever someone I don't know from the hospital says they like my blog...

When the trauma surgery resident says "Hey, have you seen the patient with the bimal fracture yet? The one with the big breast implants?"

The usual reaction to this conversation

Me: "So sir, I have to have you sign a consent for surgery because theres an increased risk. Your urine came back positive for meth."
Patient: