Resident Physician, Virginia Tech Carilion School of Medicine

My name is Matthew Joy. I'm currently a resident physician in training at the Virginia Tech Carilion School of Medicine in Roanoke, Virginia. I'm training in plastic and reconstructive surgery. At our hospital, we do mostly reconstructive surgery. Probably 75, 80 percent of our practice. So that could be anything from a skin cancer that needs to be removed and reconstructed to a congenital defect like a cleft lip or cleft palate that needs to be reconstructed. We do a lot of breast cancer reconstruction with our group. But then we also have a cosmetic surgery center where our staff works throughout the week. A couple of days a week, sometimes we'll have cases there doing cosmetic surgery. And then we see our patients in clinic both for consult and follow up. And then we take consults from the emergency room. For stuff that's coming in throughout the day and sometimes at night as well. We will see the patient generally in the clinic once they've had their diagnosis and they've usually already met with the cancer surgeon. At that point and they've decided that they're interested in getting reconstruction. We talk with the patient about those options, the different surgeries that we can offer them to reconstruct the breast after they've had either a mastectomy or a lumpectomy for their cancer. And then we usually coordinate that surgery with the breast surgeon. And usually the first surgery happens at the same time the patient has either the mastectomy or the lumpectomy and then we do the reconstruction, or at least the first part of it immediately at that same time during the same operation. So they have a mastectomy, and we usually will do a breast implant is the most common version of breast reconstruction. And we use a temporary implant first to reconstruct the breast. And to allow the skin to heal. And we can actually expand the skin to recreate a more normal breast shape after the patient has had a mastectomy. That process takes several weeks, maybe even a couple months. And after they've healed up from that, and the expansion is complete, then we take the patient back to the operating room for another smaller procedure where we remove the expander device and place a permanent implant. And then we can do ancillary procedures after that. So on a busy day, usually means I'm waking up around probably five o'clock, 4:30, five o'clock in the morning to get to the hospital by 5:30, six o'clock in the morning to round on my patients. I usually see anywhere from a couple to a half dozen patients in the morning. These are patients that have had operations recently that are still in the hospital. See how they're doing, write notes and orders for them in the morning and then head to the operating room to work with one of my attendings for the day. Anywhere from two to five or six operations for the day, depending on the length of those. And usually finishing up operating some time around five or six o'clock at night. Sometimes earlier, sometimes later. And then maybe checking on a couple of those patients afterwards. And then headed home for the evening.