Pharmacy and surgery are often considered diametrically opposed fields. For many conditions, treatment options are surgery or drugs. There are clinical trials that directly compare, for example, surgery vs. chemotherapy for prostate cancer. In pharmacy school, we aren't taught anything about surgery. Sometimes it'll be noted as part of a treatment algorithm- try this drug, then this drug, then if that doesn't work do surgery.

So what is a clinical pharmacist doing on a surgery team? Because that's what my November rotation was. Pediatric surgery.

When I started on this rotation, I didn't know what to expect. What kind of drugs do they use on a surgery service?

Mostly, the answer to that question is pain medication and antibiotics (for wound and line infections). Pain medication was mostly Tylenol and morphine, since all of our patients were children, but there were a few more complicated drugs that pharmacists could help out with. Ketorolac, for example, should always be given with ranitidine (in children) and should only be used for 5 days at a time. More often, we were able to help with antibiotic dosing, especially since they often used vancomycin and gentamicin, which have to be monitored with drug levels. Soon, the medical residents were turning to us, the pharmacy students, for our opinions on interpreting drug levels and how we would change the dosing.

As for me, I learned a lot about surgery. It was a whole world of medicine I had never been exposed to- appendectomies, bowel resections, intusussception, and even surgery to remove something stuck in a child's throat.

So in the end, surgery and pharmacy can learn a lot from each other. Surgeons don't know much about drugs, though their patients often need them. And pharmacists often know nothing about surgery, even though patients on almost any service may need it.

In medicine, even polar opposites sometimes work best together.