Tag: surgery

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Cut and Splice

Daily writing prompt
Have you ever had surgery? What for?
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Surgery is one of my favorite topics. I spent years in operating rooms passing instruments and sutures, holding retractors, and eventually doing some assisting. To me, it’s a bit more than a necessary intervention of a bloody nature.

I guess it’s because of the enthusiasm that many of the surgeons I worked with had for the art and science. Trust me; you don’t want someone bored with the job standing over you in the operating theatre. You want a surgeon who lost count of how many of these he’s done, finds each one fascinating, and is interested in educating the team and the patient.

Another thing you don’t want is someone who grows incensed with inquiries. They may be skilled, but a knowledgeable surgical team and a patient with an understanding of what’s coming make for better outcomes. And that’s what it’s all about.

Over the past twenty years, I’ve had several operations caused by the inevitable wear and tear the body accumulates with age. The surgeons who care for me were first amused that they had a patient who had a grasp of the anatomy and procedures. But they soon slipped into teacher mode when they found I hadn’t scrubbed since 1980. The pre-surgical visits turned into teaching sessions on how my procedure would differ from the ones I had scrubbed on in prehistoric days—smaller incisions, less blood loss, and utilizing better surgical materials and implants. It was encouraging and a bit daunting.

 I admit my enthusiasm for technique may be a way of distancing myself from the fact that it would be my body going under the knife. But I can’t help myself. I left the OR to have a career in anthropology, but I never lost my affection for what we achieved in the OR.

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A Trip to the Vets

Mother took father to the vet today. When he came home, we walked with a big thingee and limped. The dog and I actually had a conference about it. Sometimes he isn’t as stupid as he looks. Max said that he stunk of shots. He hoped that they hadn’t “fixed” him. I heard Mother say something about his sleeping downstairs.

The gall! How am I going to nurse him back to health with licks, kisses, and fur therapy? Loud purrs are clinically proven to be a valuable tool in promoting healing.

The dog and I worry that Mother took him to a vet for humans rather than our doctor; Dr. Balderelli is the best. I hope that where he went is OK.

But they must be foolish. They forgot to put the Collar of Shame on him: incompetence, just plain stupid incompetence.

What if he attempts to bite his stitches?

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First Time

We all remember our “first time.”
Get your mind out of the gutter, please. That’s not the first time to which I refer. However much, it has outsize importance to some people. But, no.

I remember one night at a boat show. We were out having dinner- our little clique of builders, boaters, riggers, and me- the carver. The topic of memorable first times came up. We had a pretty impressive group of far travelers, so many recollections of sunrise or moonset at exotic locations got related. Then there were the boating-related stories: European canal trips and the fine wines and eateries visited. Finally, one or two of the group chimed in with hilarious anecdotes from boat shows past.

Through this, I made the rare comment, laughed or grinned with amazement and amusement but did not share any of my own experiences. I couldn’t think of anything. I had traveled in the Navy, but being very young – and under the influence of fellow reprobates, I was more familiar with the interior of barrooms in port cities than with their cultural glories.

At last, I recalled something that I was sure the others had never experienced. So I told this tale:

” I belong to an exclusive club open to only a small segment of the population in any country. If you are not a member of this club, but have participated in this, you are probably a member of one of the outlaw sects still practicing human sacrifice.” Now I had everyone’s attention. “As a young man, I served as a scrub technician in surgery. My typical duties included preparing surgical instruments, passing them to surgeons, holding retractors, etc. But not all surgery is routine, and sometimes I’d play a more active role. Near the end of one procedure, deep into the thoracic cavity, the surgeon looked up at me and said, ‘Lou, have you ever touched a beating human heart?’
He then took my right hand and gently instructed me to touch the heart. For just seconds, I held the heart under my hand. It will always be one of my cherished memories.”

It was hard to gauge the group’s reaction because it was so varied. Some looked squeamish, others tried to process what I had said but had nothing to add, and a few looked at me as though they were reevaluating what they had previously known about me.

At last, one of my friends smiled and said, “it’s time for another drink!” The next safer topic was interesting boats we had seen at the show.

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Operate

Part of the joy of being a long-term member of an operating room crew is knowing who has you back in any situation. The OR does not work well when significant trust issues exist within the team. Starting in OR’s in the 1960s and departing in 1980 for professional anthropology work, I saw a wide selection of OR’s. My favorite was the last Boston area, OR I worked in from late 1978 -until early 1980. It had affiliations with major hospitals and medical schools. Among the things that patients and surgeons never saw was the intense internal accountability level in the OR. Everyone participated in preparing instruments, surgical drape packs, and sterile goods for procedures in my day. Items for sterilization got sealed with a special tape that had marking bars on it. These turned dark when the article had been through a complete sterilization cycle in an autoclave ( a steam sterilizer). On each tape were the initials of the person who prepared it and the date sterilized.
The fight against bacterial contamination was constant. We did not have a separate team for cleaning. We cleaned our own assigned rooms between cases and prepped for the next day after the OR schedule ended for the day. Idle moments were spent in idle conversation – while we checked crash carts, sterile supplies, and equipment. There was an extraordinary amount of checks and counter checks to ensure that our surgical outcomes were good.
It’s not mawkish to state that while we had each other’s backs, we also had the surgeons and the patients. think about that next time you are wheeled into an OR for a surgical procedure.

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Cutter

It had been a lengthy procedure. I was still new to the trade of Surgical Technician, so the circulating nurse kept a close eye on me. She made sure that I didn’t contaminate the sterile fields, properly handled my suture material, and prompted me if I couldn’t remember the correct instrument to hand to Dr. Max.
Dr. Max and his resident appeared to be finishing. He looked up at the circulating nurse and me. ” Hey, Clair, it looks like we’re doing fine here. I’ll start closing as soon as I finish up these last bleeders.”
Looking towards the anesthetist, he said, ” Harry, how is she doing?” While that conversation was going on, I was getting my wound closure sutures lined up on my mayo stand. Soon Clair and I would start needle, instrument, and sponge counts before the surgeons began closing the incision.
Then Dr. Max looked up and said, ” Hey Lou, give me your hand. Now gently. Just place your hand on this.” Dr. Max gently guided my hand, just above the beating heart of the patient. “Now you know why our job is essential.”
All I could say was a rather inane, “WOW!”

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Dr. Max

Dr. Max was one of the first surgeons I ever scrubbed for in the operating room. As a total green hand, I was prone to confusing instruments. Dr. Max took my errors in stride- no screaming, no grabbing instruments from my Mayo stand. Just calm advice: “no, Lou, I want that retractor there.” After an incredibly long hard case, I asked him how he kept so focused and unperturbed. Here is his answer:

“I was a machine gunner in the First World War. The machine gun was one of the game-changing weapons of that war, like tanks. When the war ended, I had all the violence I ever wanted to see. So I trained as a surgeon. But history had other plans for me. I had just finished my Residency when World War II broke out. I enlisted and eventually found myself in a mobile army surgical hospital – what you would call a M.A.S.H.

We worked under awful conditions, saved countless lives, and learned to handle whatever was handed to us with little or no preparation.

By comparison, almost all my civilian work is leisurely. I have to prepare and think in advance. But the experience of the operating room in wartime makes you ready for the unexpected. The keys are experience, preparation, and not being afraid of the unexpected.”

His advice to us was the same as General Eisenhower’s – “Plans are worthless, but planning is everything.“ In his private life, Dr. Max started to learn the piano at age sixty and was an agile hiker into his seventies. He was one of the people who convinced me that lifelong learning was not just important but essential.

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