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12/12(火)

◆今日の気持ち
(外科 2ヶ月3週)
・以前、薬疹を報告したときのことを思い出す。経験ないのに薬疹と報告したら、みっちりと、病気を当てようとするなと怒られた。でも結局その人は薬疹だったけれど。外科にいる間は、考察する、ということはしてはいけないのかな…。診る、ではなくてただ、見る、ということだけをしていないと、怒られるのかな…。そのとき怒られたように、外科の範囲では不確実なことは、わからない、と放棄する姿勢が大切…。肌に合わないけれど…。
・手術が終って麻酔を自発的に落とさなかったら、記録係じゃないんだぞと指導医に怒られた…。けれど、すぐ上の先生に、以前から数回釘をさされていたのだけれどな。麻酔は指示を出すから自分でいじるな、と。すぐ上の先生の言うことは右から左に聞き流して自分の中にとどめることはしないようにしないと、いけなかったのだな…。それももう遅すぎるけれど…。
・先生によって「標準」が違うのがすごく困る。どれでもいい、であればいいのだけれど、その先生なりの標準とずれていると怒る先生もいるし…。
・気づけばステイプラーすらほとんどいじっていないな…。縫合で合格点取れていないからだろうけれど。でも、ひとのからだの感触と、上でやる感触はぜんぜん違うからいざとなるとよくわからない。やらせてもらう機会もほとんどなかったしな。…上の先生の場所を奪ってでもやらせてもらわないといけなかったのか。緩ませるところときつくするところの差がよくわからないから次の機会にはきかないとな。目に障害が自分はあるのだし、自分のやり方でやらせてもらいつつ…

●目指す医師像
総合内科医  問診を極めたい
西洋医学的には1〜2剤のみつかう医師
症状には漢方を使用する医師

●今日の新患・診断
・胃潰瘍出血
・総胆管結石?
・心不全
・胆石症
・ドレーン孔からの大網脱出

●今日の病院滞在時間
8時〜19時

●今日行ったこと・見たこと・知ったこと
・CPR
・慢性虫垂炎切除
・胃潰瘍出血 止血
・大網脱出ope
・恐怖症のある患者の麻酔 …麻酔から醒めるとき、シバリングみたいに…
 →意識回復待たずに抜管

●今日うまくいかなかったこと・失敗
・回診のとき、今日の回診リーダー独特の方法があって、何でそれをするのかな、と考え込んでいたら他の上の先生が、それにあった行動をぱっぱとしていた…。その先生がリーダーなら違う方法するはずなのに…。手をすぐに動かさないからできないやつとされるのだろうな…。手技の科学や患者の予後に気持ちを飛ばす以上に、まずチームがその場でスムーズに動く行動をするのが、外科では大切。その枠組みが体に染み付いてから、知識や手技を深めていくのが外科、なのだろう。今更気づいても遅いけれど…。

●今後学びたいこと

●明日の予定
・外科カンファ

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