Taking the scalpel...

As I near the end of my intern year, my attendings are much more comfortable allowing me to yield the scalpel.  At the beginning of the year, I was lucky to be allowed to cut suture.  At this point, it isn't uncommon for the attending to scrub out while I close with a medical student and get the patient to the PACU.

It's pretty scary, taking a piece of sharp steel to a person's skin.  Although I feel like I have a good understanding of anatomy, it's never enough to have just looked in Netter's before going to the operating room.  I'm not the most spatial person in the world, but boy is it important to learn human anatomy in layers.  A couple of days ago, I had a nightmare that I cut a patient's superficial peroneal nerve in an approach to a fibula fracture.  I can't imagine having to go and tell a patient's family that I messed up their loved one.  Hopefully, I won't ever have to figure out how it's done.

Getting permission to cut through a person's skin and mess around with their insides is a big deal.  I think that is not necessarily obvious until you are the one holding the knife...