Monday, October 29, 2007

Monday thoughts

1. Everything in surgery seems to come in threes. As a resident, you never just did one whipple while on the hepatobiliary rotation; a third one always seemed to show up on the schedule before you switched services. Same with Appendectomies. Sometimes I'll go a couple weeks without doing one and then I'll have a weekend where I just line 'em up. I had two back to back early Sunday morning, but then it was quiet the rest of the day. I couldn't relax though; you just know it's eventually going to come. Bedtime rolled around and still nothing. Maybe this would be an exception to the rule. And then the inevitable page at 4AM. Trifecta. Start some Zosyn and I'll be in after I shower. One of the cases was a classic argument for laparoscopic appendectomy. The kid was 17 and he'd been languishing for 4 days at home with abdominal pain. His parents were out of the country and his older brother was ostensibly "watching" him. He showed up tachycardic with a white count of 24,000. A CT scan suggested some fluid around the liver, in addition to peri-appendiceal inflammatory changes. The appendectomy went fine, but then with the scope I was able to look around. He had pure pus above and below his liver. I spent twice as much time irrigating and aspirating as I did taking out the appendix. I don't think the open approach affords you the ability to do that.

2. My liver transplant bowel obstruction guy is now on the regular floor. The Clinic had a bed available today but I cancelled the transfer. He's mine now. Hell, I operated on him; doesn't seem fair to dump a post-op on the BFH.

3. There's a professional tennis player named Nikolay Davydenko. Apparently, he's pretty good, the top ranked Russian male player and ranked fourth in the world overall. A couple of months ago he was involved in a peculiar situation at a tournament in Poland. Somebody named Martin Vassallo Arguello defeated him when Davydenko "retired" due to injury in the third set. I guess that kind of thing occasionally happens. The peculiar aspect was that a British online bookkeeper suspended payouts on the match because of "betting irregularities". Ten times the average amount had been placed on the match, most of it for Arguello. Suspicious, no? And now last week, at a tournament in St Petersburg, Davydenko was fined $2000 for "lack of effort" during the third set of a match against another nobody that he ultimately ended up losing. Lack of effort? Are you kidding me? Please let this be the final dagger that kills off tennis as a major sport. I hate tennis. Especially this post-modern mash and maul variety with the titanium oversized rackets and the three hit rallies and the women with their orgasmic grunts after every shot and Roger Federer winning everything and Rafael Nadal wearing clamdiggers for some godawful reason. What if Dwyane Wade had been fined for "not trying"? Could you take basketball seriously as a sport? Please go away tennis.


rlbates said...

I'm glad you "kept" the transplant patient and that he is doing well.

Thanks for the "three" stories in one.

Anonymous said...

Good points on the tennis situation. I played mediocre highschool tennis in the 70's with a Jimmy Connors T-2000,then quit in college. A few yrs ago I started playing again, bought a $12
racket at walmart. Just for fun I got my old T-2000 out to compare. Even a total klutz can do pretty well with the big rackets, that pros get to use them is insane.

Bongi said...

must say here i actually would agree with a lap app.