Wednesday, September 17, 2008

sign

those of you who follow this blog will know that we had an interesting prof. some might say eccentric. others might say idio(t)syncratic. whichever, there were interesting stories associated with him.

the prof demanded total silence during any operation. the silence was so absolute that the prof himself would not speak, not even to ask for instruments. he had hand signs which he used to request the next tool of his trade. his eyes never left the operation field and the sister had to make sure she palmed the instrument to him correctly if she didn't want to fall foul of the prof's sharp tongue. one incident delivered an exception.

it was an auspicious occasion. the prof was going to demonstrate the correct way to do a haemorrhoidectomy. he insisted that the whole firm was there to see how it was supposed to be done. i had lived through this demonstration once before so i was not too enthused.

soon the patient was cleaned and draped. the prof, suitably scrubbed up, settled into his chair between the patient's legs, getting ready to start. i noticed that the sister was junior. she was chatting to the floor nurse as the prof settled down, a definite no no. i actually remember thinking that it was just a matter of time before the prof got stuck into her. but, fortunately for her, he was too focused on the target zone, deep in thought, obviously planning the procedure. the sister was preparing the scalpel, also deep in thought. but her thoughts were related to the conversation she was having. her mind was far from where we all were.

she attached the blade to the handle and turned towards the prof, blade exposed. the prof, at that moment, seemed to finally have decided what his first move would be. without looking and in total silence, he swung his hand back with the index finger extended briskly in the sign demanding the scalpel. how was he to know that the sister was holding that same scalpel, sharp point towards him, exactly where his hand went. to put it bluntly (ok, maybe not the right word) the prof threw his hand onto the scalpel's point. i imagined an old japanese warrior throwing himself on his sword.

to say the prof was not impressed is somewhat of an understatement. the cut bled profusely and it took some time to settle everything down once again before the operation could get underway. that is the one and only operation i ever remember the prof doing where he spoke throughout. he let the sister have it. once he had given her a run down of her manners he went onto her upbringing and her ancestry. but at no stage did he let up until the patient was awake again.

to be honest i was chuckling on the inside, but the prof had taught me to be silent during his operations so it did not show.

7 comments:

amanzimtoti said...

Funny story. Does anyone actually use those signs anymore? Do they still teach them to surgeons and scrub sisters?

rlbates said...

Good story! What happened to the poor sister? Did she "learn" from the prof. or did he exile her from the theater in future cases?

The MSILF said...

Hahaha, I never even heard of those signs.

Dr Skakhi said...

Total silence is creepy in theatre! There is usually a sister with the portfolio of "radio-switcher-offer" when there is an arrest or conflict. Therefore in my little mind, silence has bad connotations. Surgeons have an expansive repertoire of finger signals for the gas monkeys too ;)

make mine trauma said...

Bad, bad mistake on the sister's part. Not the talking, but the handing of the scalpel. I'm sure the prof went overboard with his tirade, but the point is(oh, a little pun!) she will never, ever make that same mistake again.
When I scrubbed a lot for the gyn/onc doc I knew those signs very well. A slightly different hand for scissors, clamps, clips, suture, etc.

Greg P said...

Funny yet sad.

I hope that some day we see the end of such people in medicine (the surgeon, not the sister). Where I went to medical school, the surgery department was much like this, and the end result was that some very bright medical students avoided surgery at all costs as a career, to some extent perpetuating this apparent specialty-specific behavior.
Since then I have found that at other schools the surgeon faculty were actually human, and understanding, and communicative. It doesn't have to be the other way.

Julie said...

I have worked with surgeons like this one, fortunately now they have mostly gone the way of the dodo.

The ability to interpret the hand signs though is still taught (us crusty old theatre nurses keep it going) and practiced to an extent - it must get very tedious to ask for a clamp every time you need one during an open bowel resection.

Amanzi, love your blog. It certainly makes this old 'first worlder at large metro hospital' appreciate what we had.