Monday preop hibbyjibies!

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An inquisitive resident jokingly asked me how was preop conference during our time (which was not so long ago). I replied “I often get Monday jitters that starts on the Sunday prior to the preop.” He asked why. I said “We prepare our preop cases on Sundays- examine and reexamine patients, review diagnostics, bully radio techs to get elective radio graphs and then read journals. After that we prepare power point presentations while calling our service attending (on Sundays!-you know how bad its gonna be when he tells you ” get lost”) for referrals.”

Mondays are typically hell days. This is the time when we’re supposed to be best dressed (coat, tie, the works) yet somehow, we seem to be obviously more disheveled- unzipped fly, an OS belt or a sandal instead of a shoe!

And you cannot swallow any food out of sheer panic or something. Your adrenaline, which is in a “flight or fight” mode, is ten times above normal. You read again your presentation, study your radiographs, shop for more attending’s opinions and then retype your presentation. All these you do in between seeing patients- on a heavy Monday OPD day, an elective OR or worse a service conference. Lunch is a thing of the past.

During preop, your inside an aquarium, like a meat surrounded by sharks with the whole world is watching. When you get to be picked for grading, someone slowly bite you to bleed (and then the whole aquarium becomes a gory “resident” feeding of sort) with endless questions that cannot seem to be answered by a simple journal discourse. Worse, if you don’t have an RCT and there’s no attending backing your proposed surgery, you’re fried meat. And if you we’re fried from previous preop, be ready to get a hotter frying pan this time. In all these, you’re still expected to be less knowledgeable and will have to read more. That is the luckiest you can get. The worse is you cannot do any surgery at all because you showed a magnanimous display of stupidity. Sometimes a resident get axed from the program if he claims a study that never existed!

At the end of the day, when the BP’s are low and adrenaline rush goes back to normal, you feel like you’ve been sick for days. Physically drained.

Then my resident asked “Where’d you trained sir?” Afghanistan? I said “No. But we sure feel like we’ve been there and back!”

Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is Chief of Clinics at General Santos Medical Center and Medical Specialist II Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (