The Sum of Four Years

I got the summary of my procedure logs from residency in the mail the other day. It"s kind of funny to think, "this is the sum of four years of victory and defeat, immense joy, and some of the most unimaginable pain you could ever think of", which all sounds melodramatic, but really is true. I can truthfully say that my residency was the best time of my life and the worst time of my life. I"m like Mowgli, but instead of being raised by the jungle creatures, I feel like I was raised by obstetricians, and my childhood can be summarized as follows:

Surgery on antenatal patients:
Appendectomy 1
Laparoscopy 17
Cerclage 9

Abdominal Hysterectomy:
Total/subtotal hysterectomy with/without removal of tubes/ovaries: 78
Radical hysterectomy (for cervical cancer) 2
Hysterectomy after Cesarean delivery 1
Other abdominal hysterectomy 13

Vaginal Hysterectomy:
Vaginal hysterectomy with or without removal of tubes/ovaries: 23
Laparoscopic assisted vaginal hysterectomy: 9

Laparotomy:
Removal of ovaries: 7
Laparotomy for ectopic pregnancy: 4
Removal of Mass: 16
Myomectomy: 10
Other laparotomy* 98

Incontinence and Pelvic floor:
Urethral suspension: 1
Paravaginal repair : 5
Anterior/post repair: 32
Other incontinence repair: 24

Spontaneous Vaginal Delivery: 437**

Forceps Deliveries
Low/outlet forceps: 27
Mid/rotational forceps: 1

Vacuum Deliveries: 49

Cesarean deliveries: 226

Breech presentation delivered vaginally: 12***

Multifetal deliveries:
Twins: 18
Triplets+: 2

Low birth weight:
500-1000: 18
1000-1500: 23
1500-2500: 34

Operative laparoscopy: 91

Hysteroscopy/operative: 32
Hysteroscopy/diagnostic: 47
Other hysteroscopy****: 38

Conization of the Cervix: 35

Induced abortion (Medical or surgical): 88

Surgical sterilization: 117

Vaginal Ultrasound: 118

Miscellaneous: 353^

Endocrine/Infertility Surgery: 118
Uro-gynecology: 49
Surgery for invasive cancer: 76

Outpatient/primary care visits:
hypertension: 353
Diabetes: 173
Thyroid disease: 82
Dermatologic: 38
Gastrointestinal: 156
Respiratory: 46
Breast probs: 89
Geriatrics^^: 147
Behavioral medicine:292
Immunization: 45
Peds/adolescent: 59
Preventative care: 329
Other ambulatory: 277

For a total of 2086 outpatient visits in 4 years.

Wow. It"s really weird to see the most formative years of my life summed up in numbers like that (some of which I suspect weren"t documented quite right, like the 98 "other" laparotomies). I remember every single forceps, every single breech presentation delivered vaginally, and every single surgery for invasive cancer I did (half to 3/4"s of the cancer patients I operated on as a resident have now died of their disease).






* I don"t remember what other laparotomy really means... maybe exploratory laparotomy/lysis of adhesions?

** Um... I probably did more like 600-700, but I stopped counting after 2 years of residency

*** My favorite!!

**** I can"t imagine a hysteroscopy that"s not either diagnostic or operative, those are the only kinds there are!

^ Um.. what 353 cases did I do that don"t belong into those catagories above?