by Debbie Eisenberg Merion
Photos by Lin Jones
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| Adams checks in on a patient she operated on earlier in the day. |
It’s 5:30 a.m. on a cool, late-spring day and Meredith Adams, a third-year
house officer in the U-M Department of Otolaryngology-Head and Neck Surgery,
sits at the kitchen table in her condominium sporting her “uniform”
of hospital-issue sea green scrubs.
She forks at a dinner-like breakfast of chicken, vegetables and rice in an attempt
to eat her best meal at the beginning of the day, “so I can have more
energy and not get hungry in the OR,” she says. Soon, she will make the
short trek up the hill to University Hospital for a full day of presentations,
rounds, surgeries and consultations.
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| Adams and attending physician Theodoros Teknos, M.D., associate professor of otolaryngology, consult on her first surgery of the day. They discuss details such as on which side of the patient’s mouth the ventilator tube will rest. While Teknos goes over specifics with the patient, Adams scribbles on a series of forms, including “Postop Discharge Instructions” and “Path Sheet” — the latter will accompany the removed lesion to the pathologist. “My goal is to get as much of the paperwork done as possible before we start,” she says. |
Before presenting a pair of cases at Grand Rounds — educational conferences
where attending physicians and residents discuss cases — Adams, along
with her fellow team members, evaluate all inpatients and discuss their findings
with the attending physicians, and together they make a plan for treatment.
By mid-morning, Adams is in the OR and well into her usual full agenda, which
on this day includes surgery to remove a suspected cancerous lesion from a man’s
upper lip.
Adams spends an average of three days a week in the OR, and is a vital member
of a team of physicians, nurses and staff that has made the Department of Otolaryngology
the fifth-ranked unit nationally in the U.S. News & World Report annual
rankings of best hospitals and specialties. The morning routine is one of the
most important and busiest times of a surgical resident’s day. “One
of the things I love is that we accomplish so much so early in the day,”
she says.
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| Adams scrubs in for her first surgery of the day. She thoroughly cleans her fingernails and fingers and washes her hands and arms up to the elbows. During this time, she and the attending physician often discuss the case and the approach the OR team will take. If she is alone, Adams says she uses the time to think about the case — important anatomy and the steps of the procedure — one more time before going in. |
Before entering the operating room, Meredith meets with each patient to discuss
their surgery and answer any questions. “I introduce myself and give the
patient the option of introducing who is with them to draw everyone into the
conversation,” she says. “I enjoy getting to know my patients. This
is one of my favorite parts of the day.”
Two lengthy surgeries await — a neck dissection to remove cancer in a
male patient, and the repair of a mandible, or jawbone, in a woman injured in
a car accident. These operations take several hours, and in-between, Adams tends
to several inpatients and participates in a new consultation.
More than nine hours into her day, Adams makes a hasty sprint, not to a waiting
OR, but to the cafeteria. She picks up a pre-wrapped package of chicken and
noodles sitting on a shelf and gulps it down in 15 minutes before she is paged
to the OR.
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| Taking a brief break between surgeries, Adams searches for information on a patient’s X-ray and makes a few phone calls. She often checks labs or responds to a page in the fleeting moments when she can let down her guard, or in this case her surgical mask. |
Between mouthfuls, she talks about her attraction to medicine and ear, nose
and throat, or ENT: “I love this specialty because it’s a great
mix of things — oncology, rhinology, otology, pediatrics, laryngology and
plastics. We have great patient interactions, and we have the satisfaction of
operating on patients and then seeing them afterwards in our clinic.”
Adams earned her Bachelor of Science in biology from the U-M. Part of Inteflex
— a now-defunct Medical School program that allowed students to pursue
bachelor’s and medical degrees in a combined program — the Ann Arbor
native always has had medicine in her family and future.
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| Adams shares a light moment during evening rounds with fourth-year medical student Manoj Dalmia (left) and fellow resident Bradford Bader, M.D. |
“I have two brothers I’m close to who are physicians — they’re
11 and 13 years older,” she says. “I also wanted to have an active
role in serving other people.”
Closing in on 9 p.m. on the hospital clock, Adams makes her final rounds and
begins to wind down. After charting a plan for the next day, she reads up on
her cases. At home, she tries to read something non-medical before falling asleep.
If she is afforded the luxury of more time, Adams runs on a treadmill. “But
on a day like this, all I want to do is go to sleep,” she says.
She is under the covers by 11 p.m.
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| Adams uses a “Bovie” — an electrical instrument that cuts and seals blood vessels with heat and an electric current — during the neck dissection, which causes small wisps of smoke to rise above her head. | Nearing the end of her day, Adams reviews patient charts. She reflects on the surgeries, from the neck dissection for a young patient battling cancer — “I feel sad about the situation; I don’t try to take away that feeling, but I focus on the job I have to do” — to the successful mandible repair — “It’s satisfying because you fix something that’s broken and in the end it works. She’s going to love her new mandible,” she says with a smile. |
