Tuesday, November 16, 2010


one of the all time legends in medical blogging has to be suture for a living. she doesn't only patch people up but she sutures other stuff to make amazing works of art. i suppose this is not too surprising. in the end plastic surgeons are so much more artistic than us mere general surgeons. but i like to think that when the chips are down and the pressure is on, we can focus and place stitches almost as well as most plastic suturers.

it was one of those days. i was on call and all hell was breaking loose (again). i didn't seem to be able to get ahead of the deluge of work. too many people were trying to bleed all over the place at the same time and there were too many people in casualties demanding attention. suffice to say when the internist stopped me in the passage to discuss a patient with him, i was a bit irritable. internists have a way of drawing a story out. they are just not like us. they don't have our sense of urgency and when they stop you in the passage to discuss a patient, it shows.

i quickly realised the internist was going to string the discussion out as long as possible. it was frustrating, but it was also important to maintain a good relationship with our long winded colleagues, so i decided to accept it and be patient. in an attempt to settle down i even lifted myself onto the windowsill and consciously relaxed. i allowed him finally, after some meandering, to get to the point. i was actually amazed that i could bring my basal metabolic rate down to his for the duration of his drawn out discussion. finally he concluded his communication with me and readied himself to leave. even this took time. i jumped down from the windowsill in a smooth motion that i hoped looked emphatic. unfortunately my trousers hooked on something and i tore a massive hole in them.

great, i thought. now i had an unsightly tear in a somewhat unflattering position on my trousers, pretty much displaying my underwear for all to see and i had no time to rush home to change them. as the internist slowly sauntered off to continue his day in slow motion i even had a thought of wrestling him to the ground and stealing his trousers. however i quickly realised that would do nothing to the already strained relationship between our relevant departments and gave up on the idea. i would have to come up with a better plan. then i realised, i'm a surgeon. if i can close an abdomen then surely i can close a mere hole in my pants. the solution was obvious.

i rushed off to theater at a speed that would probably have given my internistic colleague whiplash and asked the sister there for some vicryl ( a type of suturing material). after all it was a thread i was familiar with. i then went to the surgery tea room which was adjacent to the female surgical ward. fortunately the tea room was empty so i got to work.

now vicryl (and pretty much all surgical suturing material) is made already attached to a semicircular needle. to use it properly one needs a surgical instrument. i had a leatherman which would have to suffice. unfortunately, a laceration on the nether regions of the trousers, even in the hands of a very skilled surgeon, can not be addressed while the trousers are still on. there was only one thing to do.

i sat on the bed in the tea room and dropped my trousers to around my knees. this presented to me the laceration pretty much between my knees, an easy place to work. then i started the repair job.

the sisters knew that i spent my spare time in the tea room and would therefore often first look for me there before paging for me if there was a problem in the ward. as luck would have it, one of the sisters came looking for me as i laboured over the laceration of my trousers, dropped to knee level. she walked in and addressed me. only once she was halfway through her question did she look up to see me sitting there, trousers down, working furiously with needle and thread between my legs. she doubled over in laughter before running out. i looked around to see what was so funny. not seeing anything from my point of view, i dropped my head again and continued my operation, totally focused.

moments later, pretty much every sister from the female surgical ward was crowded at the door to get a glimpse of the surgeon caught with his pants down. i watched them as their bodies shook and almost convulsed as the waves of laughter engulfed them. most of them then threw themselves into each other's arms and held each other until tears ran down their faces. i was focused. even the noise wouldn't distract me from the operation i was required to perform. the sisters then disappeared.

soon afterwards the sisters from the male surgical ward were also huddled in a tight group at the door, writhing in mirth and wiping each other's tears. again i smiled at them and returned my attention to where it was needed. finally i finished the procedure. i stood up, pulled my pants up and closed the things that needed to be closed. by then i was alone again, but the loud laughter stilled echoed through the corridors for some time afterwards.

yes i doubt my job was as neat as the work of my friend and fellow blogger, doctor bates, the plastic surgeon, but then i wonder if she has to contend with the amount of laughter i was requited to deal with while working.


Anonymous said...

Glad to see you're back! Dankie!

rlbates said...

Thanks you my friend! You have left me laughing at the image of you caught with your pants down laboring over the "laceration."

BTW, if there are any of the old straight needles around that had to be threaded, use them and silk. Would work wonderfully.

Vijay said...

Once again you prove that you're a better man than me, Bongi.

Anonymous said...

Surely one of those sisters had a camera phone?

PS said...

Makes me think of a crazy night I decided to cut out a nevus on my own left knee in between cases (surgery call; community service year); sutures, check; blade, check; Leatherman, check; neat incision, check (not bad for an aspiring pathologist I thought; not quite as good as your plastic surgeon buddy though); no gauze, dammit. Socks make good gauze substitutes. Having to work the rest of the night without socks ... not good

anne said...

'moments later, pretty much every sister from the female surgical ward was crowded at the door to get a glimpse of the surgeon caught with his pants down. i watched them as their bodies shook and almost convulsed as the waves of laughter engulfed them.'

This begs the question: were your underpants in good condition? I keep thinking to myself, 'he must have been wearing some sort of exotic/colorful boxers'. Though the story did make me laugh.

By the way, a button on my lab coat is currently sewn on with 1-0 silk. It is much better than sewing thread for buttons, even if it is black...and my lab coat is white