Feeling better today. Not one hundred percent but better. Got up and head to ward round for 8am no problems, was immediately plucked out of ward round by a consultant and followed him to theatre for a treat. Today was an interesting case, a ‘pioneering’ surgery. Basically they did a dynamic face lift with a twist. A patient with a facial hemiparesis can have a few things done- a static facelift, where the paralysed half of the face is lifted up so that it doesn’t look droopy, or a dynamic facelift with a view to restoring a bit of movement, also known as ‘facial reanimation’, which just made me think of zombies. In this particular case the temporalis muscle was mobilised and attached distally to the nasolabial fold (which in itself is pretty cool- with physiotherapy the patient can re-learn ‘chew’ as ‘smile’) with the added modification of a periosteal flap from the cranium to cover the whole thing to minimise the cavity defect of moving temporalis. It’s going to be written up as a paper by the consultants who invented it. Immensely cool. The un-cool part about it was that I got to see approximately zip. I was really hoping for a good opportunity to illustrate but what with the entire Maxfacs and Plastics departments along with the university film crew being there I was sort of confined to the edges. But still. Was very cool.
Things I have learnt: the scalp is ridiculously vascular. You can bleed out from a scalp wound and heard tale of a patient who died of hypovolaemia from as much. While the Reg was closing the scalp he popped the suture through, caught a vessel (of which there are many) and a puddle quickly formed by his feet. This is why, before any scalp incision, they infiltrate with a special mixture of saline, adrenaline, hydrocortisone and magic.
In my cunning schemey way I plan over the next day or two to try and turn the op into a series of technical illustrations. I know it’s hoping against hope (since there was a lot of photography) but if I present these to the consultant he may want to use them. But even if he doesn’t, it’ll still make for some cool illustrations. Sadly, in amongst all my being schemey and wiley, I have managed to leave my sketch book somewhere. If it’s in theatre I’m ok - I came in today, having not been in theatre for nearly a week, to find a library book I had borrowed, on the side exactly where I’d left it. I hadn’t even noticed it was missing. I need to start hanging on to things a bit better.
I abandoned ship after this op, at lunchtime, due to a combination of headache and needing milk. So I nipped to the supermarket, milk, bread and fruit, then home. Painted a bit, napped a bit, painted a bit. Then was invited out for a pint by some fellow flatmates. Trying not to nurture my antisocial tendencies I accepted and have just come back from a couple of pints at the local. It was really nice to spend a bit of time with other human beings. There are two guys and a girl from Austria and they are all really friendly. The girl’s English is fantastic (I was lamenting over our drink my inability to speak another language and admiring the fact that they are working in A&E in a second language). All in all a really nice bunch. I also met another MaxFacs elective student today. He seems really nice and also expressed a penchant for scheming and projects. I think there’s a secret bunch of MaxFacs aficionados around the country who need a central organisation through which to scheme together- but that’s a scheme for another day.
Interestingly this evening’s portrait was done before I went out but looks strangely like me after two pints- sort of a bit sleepy. I must be drawing the future again.
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