I try to find humor in small things, like the confusion behind which type of nut the resident is referring to. I have to find the humor, because a lot of vet school has been spent finding the imperfections. One thing my entire veterinary school class has in common is this unrealistic goal of flawlessness. We all strive for perfection, knowing well enough that such a thing is not obtainable… but at the end of the day, we’re are still disappointed when we can’t obtain the unobtainable.
Yesterday, I can honestly say I wasn’t even striving for perfection. Simple demonstrations of the principles of surgery would have been nice. My first castration was a great hands-on learning experience, and also a great way to assess my weaknesses…areas I will work on and improve upon over the last 5 months of veterinary school.
Without harping on myself more (trust me, I did last night), the best thing I can do now is reflect on what I didn’t like, make a plan to change it, follow through and work-hard to be what I want to be.
Reflecting back on my part of the castration, there are several things I need to improve upon. Take away lessons for myself:
- Incise with confidence.Make fewer passes of the scalpel. I used a #10 scalpel blade but because I was so worried about applying too much pressure, I had to repeated incise. This means creating several fascial planes and a “jagged” layered look. Not life-threatening and also not ideal.
- Extend or work-out.There is some force required when pushing the testicle through the incision. My classmate helped “squeeze” the testicle out. There is no shame in extending the incision, which I should have done when I couldn’t get the testicle out. Either, I need to increase my muscle mass in my hands or extend the incision.
- Trust my instincts.Using 2 vicryl, I started to do a simple ligation around the spermatic cord. I had separated the cremaster muscle away from the cord, when my classmates stopped me and said to ligate the cremaster first. I started attend my suture to the cremaster muscle, but was subsequently corrected by the surgeon. Shame on me, I need to heed my own knowledge and instincts.
- When placing ligatures, place the ligature.Hands-down, the most embarrassing part of the whole procedure was the event that ensues. I placed my encircling ligature around the cord, did a surgeons throw and placed the second throw. The surgeons knot was lose. I removed the ligature and made attempt #2. This time realizing I could not get my first throw to sit. I tried again, no avail. This is basic 1st year principles of surgery stuff. Humiliating. Humiliating when I asked the resident to watch me and tell me what I’m doing wrong. He took the suture material and placed the surgeons knot. I performed the rest of the throws with defeat in the air.
Room for improvement: No doubt