At the surgical department

AT THE SURGICAL DEPARTMENT

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            Most of medical students dream of becoming surgeons after graduating from the Institute. That was why my fellow students and I were greatly excited when our classes in Surgery began at the surgical department of the city Hospital.

            We were eager to attend the reception ward of the surgical department. We washed our hands and put on our white gowns. Our duty was to help the doctor and the nurse: we had to undress patients, give them a general rubdown and put on them hospital gowns. The first rule we had to follow here was not to cause the patients any additional pain, not to harm them, that’s why we had to be very careful in handling patients.

           At a quarter to nine an ambulance brought to the hospital a boy who had complained of a severe pain in the right lower part of his abdomen. The doctor asked the boy to lie down on the couch and began his examination by palpating the patient’s abdomen. He made the diagnosis of acute appendicitis. The surgeon directed the boy to the in-patient department for being operated on at once. It was necessary to remove the appendix immediately in order to prevent its rupture, which might cause peritonitis with a fatal outcome.

          The patient was wheeled on a stretcher cart to the operating-room. We were allowed to be present at the operation. We went to the scrub-up room together with the surgeons. There we watched the surgeons get ready for the operation. First they scrubbed their hands and forearms with soap and brush under hot running water then rinsed them twice in the solution of ammonium chloride. After rinsing the hands were sponged with alcohol and the nails painted with iodine. Then the doctors put on sterile caps and masks and sterile gowns and rubber gloves.

          By that time the patient had been prepared for the operation: premeditation had over and the patient was lying on the operating-table. The anesthetist gave him intratracheal anesthesia the patient fell asleep and the surgeon could begin the operation. Having removed the appendix, the surgeon closed the wound in layers. The operation was performed successfully and the patient survived the operation well.

          After the operation my fellow students and I started out on the round of the wards. The assistant doctor took us to some of the wards of the traumatological department where we could see the patients with fractures. Under the doctor’s guidance we acquainted ourselves with the methods of immobilization of extremities. We also examined the convalescents who had fractures of lower extremities and the patient who had the fracture of the hip and was lying under traction.

          Then my fellow students and I were on duty in the dressing-room. We had to assist in putting dressings. In the dressing-room the surgeon took out the stitches which had been put in after the operation. The suture was about 10 cm long and the patient didn’t complain of any tenderness on being explored the operative area. Then the patient, who had been operated on for acute suppurative appendicitis was wheeled on a stretcher cart to the dressing-room. The surgeon began to dress the patient’s wound.  

          We helped the doctor to take off the outer bandage. Then the surgeon examined the wound in the patient’s abdomen and carefully took out the gauze drain soaked with pus.  He introduced a solution of antibiotics into the wound and put a fresh outer bandage.

            The students understood that the work of a surgeon is difficult and very responsible.