Surgery: Trauma Team, and Code White, Part 1
January 5, 1999
Wednesday
Hello all and happy 1999! This is quite a belated greeting as I spent New Year’s Eve on duty and New Year’s Day trying to get enough ZZZZs to pay my sleep debt. But I’m getting ahead of my story.
For the week of December 25 to 31, I was with the Department of Surgery’s Division of Trauma. The residents and interns of the Trauma Team take turns at being on-call for trauma referrals. Trauma referrals are those phoned in by the surgeon-on-duty at the emergency room: these are vehicular accidents, gunshot wounds, stab wounds, falls, and the like. The nice thing with this division is there are no elective surgeries – therefore there are no scheduled operations unlike, say, cholecystectomies (removal of the gall bladder) or mastectomies (breast removal). Basically, we are free the whole day unless a stab wound victim (or two) comes to the emergency room and is immediately brought up to the operating room. Being on-call meant we could go bowling (bowling alley was a few blocks away), malling (the Robinson’s Place mall is right next to the hospital, very accessible) and eat breakfast leisurely (usually at the nearby McDonald’s). Of course, we should be ready to drop everything and return to the hospital once paged. There is only one intern on duty every night, whose tasks for the night are to sleep in the hospital and be ready to assist in any trauma operation if needed. Not bad, as long as the operation isn’t a 5-hour exploratory laparotomy (an “EL” starts with a long midline abdominal incision, through which the surgeon can visualize all the abdominal contents: liver, stomach, intestines. etc. – and possibly repair any damage to the organs).
December 30, Rizal Day – holiday! All residents and interns not on duty for that day went home at 12 noon, and I was stuck in the hospital. Boring. Didn’t do much until 2 am (December 31 early morning), for which we did an EL on a… well… OK, fat woman. She had a fight with her husband, who stabbed her twice just below the rib cage. The surgeons feared damage to the liver or stomach. They opened her up and what do you know! The fat saved her One of the stab wounds didn’t even reach the abdominal cavity, and the other one just nicked the liver, a superficial cut. Good for her. And good for us too (the operation only lasted 2 hours, thus we could sleep a bit more). What we found, though, was intestinal parasitism – several worms could be felt within her bowel walls – yuck) No surgical intervention for that was needed, just medicine to kill the worms and facilitate their exit from the bowels.
The next day (December 31, New Year’s Eve) the Departments of Surgery, Orthopedics and Anesthesia were on Code White. Code White at the Philippine General Hospital means that everyone in the departments affected would be on 24-hour duty. So post-duty people (like me) have to stay another 24 hours or so; pre-duty people go on an extra 24-duty before their real 24-hour duty. Luckiest are those on duty (for Dec. 31), since they don’t lose any of their non-duty time.
OK. This is getting long. I’m writing about New Year’s Eve duty in the next issue. Watch out for Part 2.
JOINT is the Journal of INTernship, a series of email messages to family and friends (“journal subscribers”) written during my yearlong medical internship from May 1, 1998 to April 30, 1999. Internship is one of the requirements before taking the Philippine Physician Licensure Examination (also known as the Medical Boards). Journal entries were edited for clarity in January, 2020. Read more about it in the first blog post, Introducing JOINT.
