oncology.

Deja vu. I was plucked from one hospital and dropped in another with the same attendings and even a few of the same patients. Upon arrival, I was informed that I would be taking floor calls, ICU calls, and consults for the 3 surgical oncology teams, the vascular surgery service, and the thoracic surgery service that day. Thus began my second month on pancreas surgery/surgical oncology. The acuity of the patients seemed higher at this hospital, and there was the added joy (also known as pain) of HIPECs. This is an odd, yet beneficial, procedure in which hot chemotherapy is run through the abdomen of a patient with carcinomatosis for 100 minutes. For 100 minutes, therefore, the lucky intern's job is to stand at the patient's side and literally rock the abdomen back and forth. In a large patient, one needs only to rock the belly. In a skinny patient, one must essentially rock the entire patient. Surprisingly, it is more tiring to rock a small patient than an obese one. The hospital also rolled out a new electronic discharge system that month, and I nearly blew an aneurysm the first day this went into effect. I learned on this rotation a clever way of shirking intern work restrictions. In this hospital, interns on the surgical services are allowed to take in-house overnight call alone while receiving "direct supervision" from the in-house ICU attending. Consults and floor issues continue to be precepted to the chiefs/fellows of each service, who are at home. Codes, I suppose, may be attended by the ICU attending. Thanks to my overnight call, however, resulting in fewer net hours for the last week, I did indeed manage to sneak just under the 80 hour mark (discounting discharge summaries that were done after leaving the hospital, of course). Having escaped several potential HIPECs also contributed greatly to that achievement.