Previous Challenge Entry (Level 3 - Advanced)
Topic: Oops (01/14/10)
TITLE: We Have Big Trouble...
By Emily Gibson
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I was a very nervous third year medical student when I walked through the doors of the giant hospital high on a hill for the first day of my Surgical Rotation. I had never been in an operating room other than to have my own tonsils removed at age four, and that was not exactly my happiest memory. I worried I was not "cut out" for the OR, and wondered if I would faint watching patients being opened up, smelling the cautery burning bleeding vessels, or hearing the high pitched bone cutter saw.
The first lesson on my first day was to learn how to gown and glove up without contaminating anything or anyone. It took several hours for an extremely patient nurse to get me to the point of perfection. She taught me what to do if my nose itched (ask a circulating "non-sterile" nurse to scratch it over our mask), or if I thought I felt woozy (back away from the operating table so I don't fall on the patient!). I was ready to watch my first surgery by the afternoon.
It was fascinating! I wasn't lightheaded. I could handle the sight of blood, wounds and pus, and the sounds and smells didn't phase me. I went home elated, eager for the next six weeks of caring for patients in a wholly new way.
Each day I helped in three or four surgeries, being asked to do different tasks by the surgeon, from holding retractors so he could see what he was doing, to doing the suctioning of blood in the surgical field, cauterizing blood vessels, and putting staples and sutures in the skin at the end. The chief resident I worked with most frequently was a very high energy guy, talking non-stop during the surgeries, sometimes teaching ("what's this that I'm holding? what does this connect to? tell me the blood supply to this?"), all the while listening to Elvis Presley tapes blasting over the sound system. He'd dance in place sometimes, and sing along. To this day, I can't think of gall bladder surgery without hearing "You Ain't Nothin' But A Hound Dog" in my head.
So when the surgery got complicated, I could tell because all the surgeon's antics stopped. He got very quiet, and he focused on his hands, including getting more demanding of the staff around him. Shadow swept in, covering his normally sunny personality, and he'd bark orders, and sometimes grab my gloved hands and move them where he needed them.
One day, we were involved in a high risk surgery on a patient with late stage liver disease, who had recent near fatal bleed from dilated blood vessels in her esophagus, caused by back up of circulation that could not easily pass through her scarred liver. The blood vessel shunt procedure the surgeon was doing would allow the esophageal varices to deflate with less chance of breaking open again. The surgeon had been intently working, without singing or dancing that day, so when I heard him softly exclaim "oops!", I looked up at his face. His eyes were big and round, his forehead sweating. I looked down at the large blood vessel he had just nicked accidentally, and then the wound filling rapidly with blood.
"We have big trouble here!" he shouted. I was moved out of the way, and the surgical team launched into action. I was sent five floors down to the lab to retrieve as much blood for transfusion as I could hold in my arms, and spent the next hour running blood up those five flights of stairs. The patient didn't make it.
Sometimes in my dreams, I am still running those hospital stairs carrying bags of blood. I never do save the patient.
And “oops” will always mean big trouble…
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