a) holiday shopping isn't one of my favorite activities

b) trying to find parking while avoiding the moving obstacle course of holiday shoppers in a busy lot is more stressful than scrubbing in on a surgery

c) crazed holiday shoppers and stressed out employees annoy me (although I'm not sure if a stressed out surgeon is a better alternative) and

d) holiday shopping was not included in my graduate student budget prepared by financial aid

However, I did care about having an extra day off. A day off during clinicals is like a breath of fresh air after working in a stuffy attic for 3 hours. My only consolation was that I got to report in at 7:30am rather than 6:00am. Now you may think to yourself that early is early is early but trust me, once you've been on early morning starts for a week or two, you will thank the gods for any extra bit of sleep you can get.

So I got in at 7:30 and changed into my surgical scrubs still wishing I were in my cozy bed dreaming away like some of my more lucky classmates who had the day off. My preceptor told me that we should be able to get out early today as long as the ED didn't have any emergent surgeries for us while we rounded on the patients. Here's to hoping. Our first stop was the ED and the two abdominal cases there weren't surgical candidates (yes!). After establishing that, we discovered a poor 30-40 year old man in the adjacent trauma bay who got side swiped in his car didn't make it. My thoughts immediately went to his poor family who didn't yet know of his passing. (The paramedics were calling him 'John Doe') I couldn't dwell on this tragedy too long because there were patients on the floors that needed my attention.

Not quite halfway through rounds, my preceptor received a page from an OB/GYN doctor. Our assistance was required in a C-section. Oh my. I hadn't reviewed surgical C-sections yet and just like a typical guy, my knowledge of internal female anatomy is...limited. I prayed the attending wouldn't PIMP the life out of me during the operation. This was my first C-section so I wasn't expecting to be able to scrub in but...the OR had my gloves and gown ready for me when we arrived. Yes!!! This Black Friday was started to look pretty awesome! My only comment about the procedure was that there was a fair amount of fluid involved and I'll leave it at that for those with a weak stomach. I couldn't really appreciate the actual birth of the newborn because as surgeons, our focus was the mother. Once the baby was taken out of the uterus it became the responsibility of the pediatrician waiting in the adjacent room. Thankfully there were no complications with this case.

As soon as we returned the mother to her room, we were paged again for another C-section. Sweet! I had a little time in-between though to review indications and complications of C-sections as well as uterine anatomy. Of course, as luck would have it, I didn't get asked any questions this time. Isn't that how these things always go?

All in all, it was a pretty great day. I did get to leave pretty early at 3:00pm, much better than my previous days' 7 or 8 pm check out times. Days like this always come along when you need them to re-energize your system and remind you why you're in the field of medicine.

--Ryan Narciso