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t m c » p u l s e | s e p t e m b e r 2 0 1 6 6 Anatomy of a Workday Sixteen hours with a first-year resident B y A l e x a n d r a B e c k e r We're very lucky to get to do what we do, and sometimes we forget that when we work really long hours. We get to help people and be an important part of their lives. — BRENNAN ROPER, M.D. First-year Orthopedic Surgery Resident at McGovern Medical School Medical School to attend a lecture led by Kyle Woerner, M.D., an assistant professor in the department of orthope- dic surgery. Woerner, who specializes in the upper extremities, begins his PowerPoint with a close-up photo of a bloody, mangled hand. "Can anyone tell if the flexor ten- dons were cut here?" he asks. "Definitely," a student calls out. Woerner smiles. "Look carefully," he says. "Do you see the cascade? All the fingers are still slightly flexed." What follows is an animated overview of surface anatomy (bones, tendons, nerves), common pain points (distal radius metaphysis, anatom- ical snuffbox, hamate hook, dorsal J ust shy of 5:30 a.m. on a recent Wednesday, Brennan Roper, M.D., arrives at Memorial Hermann-Texas Medical Center. The first-year resi- dent in the department of Orthopedic Surgery at McGovern Medical School at UTHealth lives less than five minutes from the hospital. He set his alarm for 4 a.m. so he would have time to shower, review anatomy books, and make his daily breakfast: an egg and turkey sand- wich on a toasted English muffin. On this particular day, he will not touch food for another 12 hours. By 5:40 a.m. Roper is bedside, speak- ing with a patient from his previous day's rounds. Twenty minutes later, the team convenes for their morning meeting. Residents, nurses and physi- cian assistants are always joined by the on-call attending physicians to review the day's case list and to discuss diag- noses, doses and expected outcomes. The human body contains a mighty 206 bones, but there are infinitely more ways to break them. Roper ticks off a list of likely sources: monkey bars, excited dogs, contact sports, slippery tile, upturned rugs, rollerblades, ATVs, cars, baseball bats, and guns. People fall, trip and crash. And the orthopedic trauma team at the nation's busiest Level I trauma center puts them back together. A Bloody, Mangled Hand At 7 a.m. Roper hurries to McGovern Brennan Roper, M.D., a first-year orthopedic surgery resident.