First case as an attending

[ldsrmdude]

I just had the patient I did my first surgery on as an attending come in to the office for a new problem, and it made me curious. To those of you who are in practice, what was your first case as an attending? Maybe even what were your first elective and non-elective cases?

My first case was a partial 5th ray resection plus a single-lobe flap closure. I did the partial ray resection first and left it open, then came back a few days later and closed the wound and did the single-lobed flap for a separate wound.

My first elective case was BL 5th hammertoes.

Yes, I know, very exciting What were your firsts?

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[NatCh]

My first was a neuroma, back in 2000. I can even remember the patient's name and the (good) outcome. The case took me no more than 10 minutes skin-to-skin and I recall wondering if I had done a good enough job. After that the rest of the cases are pretty much all a blur except for the really bad complications -- I don't know if you can ever forget those.

 

[streetsweeper]

My first elective case was a hammertoe .. had this lil old lady punted to me by another podiatrist across town. She had been told by multiple podiatrists over the decades that she should live with it, that she's too old or circulation isn't great. I thought her pulses were fine and remembered being quite overzealous with my risks and benefits review with her. Long story short, she's very happy with the results -- a year later I've ended up treating her husband, middle aged kids, and recently did a foreign body removal on her grand daughter.

First non-elective case was an add-on I&D of an abscess on the foot while on call - young guy, not diabetic - started out as a puncture wound while at a lake and festered to a balloon sized abscess. Made an 8 cm linear incision across the dorsal lateral aspect of his foot to drain the abscess...skin tension and huge areas of necrotic skin prevented any primary closure. Had to place him on a wound vac for a time but he healed uneventfully 3 months later without any need for a graft.. He's pretty happy. I ended up treating members of his family a year later as well.

Successes like these makes me enjoy my job.

I definitely remember my complications as well but all have resolved so far...*knock on wood*... they were few but sure do cause me to lose sleep especially the first few months in practice. But you learn from it and become better. I'm glad I work with seasoned colleagues that I can review cases and share ideas with to keep me in check.

 

[Creflo]

Brostrom.

 

[ldsrmdude]

Brostrom.

That's a pretty solid first case.