Surgical Syncope

This week I got my first taste of surgery. After the whole debacle with my clinical skills, I’m sure there’s a little anxiety about the thought of me in the OR. Don’t worry though, I wasn’t the one wielding the scalpel. I wasn’t even standing close to the doctor wielding the scalpel.

As part of my first-year education, it has been mandated that I spend at least 12 hours doing something medically related. I don’t know about the specifics, that was a couple months and a much emptier brain ago. After thinking about the necessary hours and considering all my options, I decided that I would go right for the glamourous world of plastic surgery.

Before we get off on the wrong foot here, let me explain what I mean by plastic surgery. Plastic surgery comes from the Greek word “plastikos”, which means to mold. I’ve had to explain a few times, often to my horrified relatives, that plastic surgery does not only include cosmetic surgery. It also includes reconstruction of the face and hands to fix a congenital defect or after trauma and is a big part of treating burn victims. Did you know the first surgeon to win a Nobel Prize was a plastic surgeon (Dr. Murray), and he won it for pioneering the first kidney transplant? I certainly didn’t. I had all the same hang-ups about plastic surgery as my family had until a very talented surgeon spoke to me and my classmates about his profession.

A couple months later, and I was in the OR with that same surgeon. He was every bit as exciting to listen to there as he was in the lecture hall and while my view was a little worse, the experience was so much more fulfilling.

The first surgery I only saw the back of the resident’s head, and I felt like I was constantly in the way of the nurses. They seemed like they were used to it though, and the other 3 students crammed into that little theatre weren’t in much better position than I. Well, except maybe the fourth year. He was probably 6’6″ and was able to tower over the table without entering the mythical “sterile zone”.

The second surgery, two of the students had to go to classes and I was told to scrub in. Oh boy, it meant I could get closer to the action, and maybe even be useful! Every student dreams of the day where the surgeon barks at you to hold a body part or a tool.

The first time I scrubbed in, I was a little terrified. It feels like such a big deal to soap up outside the OR. Of course, when I got into the room the scrub nurse (the not-so-benevolent ruler of the sterile zone) told me I did it wrong, and to try again. So I did. And then again once more. This time I was finally allowed to put on the surgical gown and everything else.

The second surgery was fascinating. While I have to be sparse on the details, suffice to say I got to see my first abridement (removal of damaged/infected skin) and skin-graft. I was very excited to come in and watch as they used the cauterizing gun to burn through the subcutaneous fat holding the skin onto the arm. The smell was certainly something else, but it was somewhere between B.O. and rotting veggies on the scale of stank; far from the worst thing I’ve ever smelled.

About half way through the abridement, I noticed something weird. I was starting to break out in a cold sweat, my hands were shaking, and I was hyperventilating a little. This only made the smell seem worse. I must have looked off to the nurse because I was quickly rushed out of the OR, sat in a chair and given apple juice. After a good half an hour of trying to scrub in, I must have been in there for only 15 minutes! The big worry, the nurse explained to me, is that you’ll pass out and as she told me, “it’s easier to get you into a chair than to pick you up off the floor”. Luckily, I was spared the embarrassment of passing out in the theatre – one of my professors later told me that her classmate had actually fainted onto the patient while she was in school. Bullet dodged!

After a little while I was allowed to go back into the theatre, but I didn’t scrub in again. This time I hung back and watched as the new skin was stapled onto the freshly skinned flesh, and learned as much as I could from the surgeon as he spoke. Everyone worked together beautifully as a team, and the whole process seemed streamlined and efficient. Kind of how you hope an operating room looks.

As the graft sites were being bandaged, the surgeon took a moment to speak to me. As it turns out, he almost fainted his first time in the OR too! It’s good to know there’s still hope for me, and that if I so choose I may one day be a surgical superstar. Until then, I’ll just keep a juice box in my scrubs.