The Surgical Reg

As a surgical trainee, there is always a constant, nagging pressure for numbers, numbers, numbers! Looming ever-present in our subconsciousness is the next stony-faced ARCP panel member peering over the top of their glasses and demanding an explanation for exactly why our numbers are so disappointing. Unfortunately, this pressure can on occasion lead to the rather undignified business of sharking - ie getting involved in an operation that another surgeon feels should be 'theirs' by virtue of the rota, groundwork with the patient or relationship with the consultant. Yesterday I found myself at somewhat of a loose end (not counting my overflowing in-tray of admin paperwork). Thankfully, just as I was about to grudgingly settle in for a session with the dictaphone, I got a call from one of the consultant to say that a cholecystitis patient on the ward was getting a little septic, and he needed someone to book her onto the emergency list for a cholecystectomy. I dropped my paperwo

I have been on-call this weekend. For the most part, it has been a dreary affair, with the ward round of the 40-odd surgical patients interspersed only with popping an abscess or two, and trudging to A&E to see the next non-specific abdominal pain that they're not sure what to do with. Fortunately however, the next phone call was a referral for a  74 year old gentleman presenting with abdominal pain, distention and vomiting. The CT demonstrated a closed loop small bowel obstruction, with venous congestion of the affected loop. I got on the phone to the anaesthetist and theatre co-ordinator to give them the good news. As it was Sunday, and my consultant had only popped in to be briefly acquainted with the new admissions so as not to fall foul of Trust Policy, I let him know what I was up to when the ODP was on their way to retrieve the patient from A&E. Once the anaesthetist had done their bit, I carefully examined the relaxed virgin belly, attempting to palpate anything tha