A country surgeon with kids: A day in the life

I have this life. It’s not a cubicle life — there’s a lot of everything in it, and I never really know what the next hour will hold. Whenever I talk to people about what I do, it’s surprising to me that almost no one has any real clue what my life is really about.

Here are the impressions that they tell me, when I ask other people what they think I do:

Chopping, slicing, hacking, dicing. (Eh, no.)
You’re like Peter Benton on ER, right?
Office hours from 9 to 4, except on Wednesday afternoons, when you play golf.
You never sleep. (Close, but no.)
Hip replacements.
You decide when people will get better — as in, the specific date and time — and when they will leave the hospital.
You always have a Swiss army knife in your pocket in case someone needs an emergency procedure of some kind. (Hell, no!)

So let’s dispel the mystery, shall we? Here’s a day in the life of a simple country surgeon. Today, in fact:

4:00 a.m. Page from the ER about a college kid with appendicitis. Discuss the case with the wonderful, organized, succinct and reliable ER doctor, and agree to admit him to my service (agree to be his doctor for this illness during this hospital stay). Look at his CT scan. Review his bloodwork. Online order entry for admission orders.
4:10 a.m. 7-year-old daughter had a nightmare (more like, probably heard mommy talking to the ER guy that woke her up) so she climbs into bed with me.
5:30 a.m. Get up, get a shower and get ready for work.
6:00 a.m. Wake up 12-year-old son.
6:03 a.m. Make a cup of hot chocolate (my breakfast, and also my daily vice) and start breakfast for 12-year-old kid.
6:10 a.m. Wake up 12-year-old kid again; kiss 14-year-old kid good morning as he gets his own stuff together without the need for parental supervision. (Thank God for him!)
6:15 a.m. Pack a lunch for 12-year-old kid
6:30 a.m. Wake up 12-year-old kid again with a stern voice and mild threats.
6:40 a.m. Cajole 12-year-old kid to eat the food in front of him because he is still half asleep at the breakfast table.
6:50 a.m. Kiss the boys on their way to the bus.
7:00 a.m. Wake up daughter.
7:10 a.m. Make breakfast for daughter.
7:15 a.m. Discuss clothing choice with daughter and send her back to change.
7:20 a.m. Pack lunch for daughter.
7:30 a.m. Encourage daughter to eat the food in front of her.
7:40 a.m. Sign school notes for daughter’s after school activity, and get her stuff together.
7:55 a.m. Walk daughter to school bus stop.
8:00 a.m. Daughter on bus; get in car to drive to work.

Car ride: Phone calls to surgery team to get the appendicitis patient ready for OR. (That’s not rushing him down the hallway on a runaway gurney, I mean paperwork.)

Also conversation with the nephrologist about dialysis orders for my patient in ICU.

Also, call with my mother about pick up planning for my daughter after school.

Also, call with the school because I forgot to stick the darned school note in her bag.

8:45 a.m. Arrive at hospital; see appendicitis patient. Interview and examine appendicitis patient, and explain laparoscopic appendectomy to the patient.
9:15 a.m. Pop into ICU to see my patient there, review overnight events with her nurse for any quick order needs
9:20 a.m. Back in the car to go to satellite office.
10:00 a.m. Office visit with patient who has an umbilical hernia that just doesn’t seem right. He has had it for years, but now wants it fixed. The patient has emphysema, severe heart disease, early dementia, and an abdominal aortic aneurysm (according to the medical record, not according to him), thus a high-risk patient. He really wants to have surgery. I send him to his cardiologist to assess his risk of cardiac complications should we decide to go forward with a surgery plan.
10:40 a.m. Back in the car to go back to the main hospital.
11:30 a.m. In OR, to do an appendectomy.
12:45 p.m. Appendectomy all done, talk with parents. (“So how many times have you previously done this procedure?”)
12:50 p.m. Dictate operative report
1:00 p.m. Office patients, main office. A lipoma (benign fatty tumor), a sigmoid diverticulitis, and a guy with jaundice. I spend the better part of 30 minutes setting up a same day visit to a gastroenterologist, the doctor he actually needs to see for his problem.
3:00 p.m. Paperwork, paperwork, paperwork.
3:30 p.m. Back to ICU to round on my ICU patient — go over everything with a fine-toothed comb — discuss with cardiologist, discuss with nephrologist (again), discuss with infection disease specialist, discuss with family. Write note. Only a page today. Yippee!
4:00 p.m. Sign out to my partner who is on call today. (Tonight he takes the calls for all our patients in the group.)
4:30 p.m.-Meeting with administration regarding hospital staffing issues and office business.
5:30 p.m. Drive home.
6:15 p.m. Arrive home. Dinner already prepared by the nanny. (Gotta love that!)
7:00 p.m. Watch TV with kids.
8:00 p.m. Bathe daughter.
8:30 p.m. Read with 12-year-old kid.
8:50 p.m. Read with 7-year-old kid.
9:15 p.m. Shower.
9:30 p.m. Blog.