Work!

So I am all settled in to my new place, and Elizabeth Tatoulis, who has graciously and quite effectively taken on the role as my Australian Mom, has insured that I have settled in quite comfortably and with no shortage of food.

I began working yesterday and got the opportunity to watch a mitral valve replacement and a nuss procedure. A mitral valve replacement is where they replace the valve in between the left atrium and the left ventricle. After I asked him how long the replacement valve would last the surgeon also told us jokingly "all valves come with a lifetime grantee" (the patients lifetime if you dont get it)

A nuss procedure is where they put a huge stainless steel bar underneath the sternum and bend it up as to push out a pectus excatvatum, or concave dented chest.



The first operation was incredibly delicate full of finesse when compared to the less subtle cracking of the rib cage. Truthfully the tools on the bench looked like they were borrowed from the Spanish inquisition.

I also got to watch a triple bypass on a completely beating heart, which I didnt even think was possible.

The surgery was really incredible. What has been so great is that this is a teaching hospital, and ive been viewing surgeries with residents of the hospital. As such the surgeons have been amazingly informative. The duration of the surgery (hopefully not to the patients expense) was full of quizes and lessons of sort. From "What from physics do you now about the type of electricity used in diathermy so that it does not effect the patients heart?" to "What drug will we use to reverse the effects of heparin?"
Obviously I was behind the residence in most areas (especially in those pertaining to anatomy) but was still able to keep up quite well.

This morning I went on rounds with the residents which was also a bit taxing on the old bean, as I was not totally exempt from questioning about subjects I have no idea about. Right off the bat I got:
"Christopher, judging by this chest X-ray do you think he has any pleral effusion?"

I didnt know, so I said "I dont know"

"Well what can you tell from the costophrenic angle?"

..uh

.....

........

..........?

All the residents looked at me and I could feel crickets chirping. I was a little embarrassed cause I didnt know the answer, but also I was very gratified that they would even ask the question which sort of implied they thought I might know the answer.

"I actually haven't been to medical school"and I thought that would clear up the mix up, and solve my little issue, but the Dr. said she knew that and continued to look at me for an answer. A few bars of staggering later she bailed me out. In case youre wondering he had no pleral effusion (fluid in the lungs, duh), and the costophrenic angle (allegedly) made that quite obvious.

Being in the care of Dr. Tatoulis is great because nobody questions him. Hes one of the most senior members in the hospital and everyone knows him. Im not sure if its just the nature of Australians, or their fear of "the prof", as they call him, but either way everyone is incredibly nice and accommodating to me at the hospital.

People here are very keen on American politics, and I mean every aspect of American politics. I expected some questions about Obama, and the Iraq war but yesterday someone seriously asked my opinion on the Kennedy assassination conspiracy! How does an Australian even know about that? They (if I may make a sweeping generalization based on limited experiences) may not know that much about their own government, but they are extremely welI informed (and critical) about ours. I cant speak with out people instantly recognizing where im from (the accent), which naturally stems countless jokes about Americas death penalty, our horrible coffee, and what seems to be everyones favorite topic; our gun control laws (or lack there of).

Australian word of the day: If you called a small child a toddler, people may think youre saying hes drunk. An "ankle biter" is apparently a better term for a small child.