Saturday, April 16, 2011

surgeon superhero

this is a post i wrote as a guest post for another blog a few years ago. since then that blog has been retired, so i decided to import the post back here.


yes i have an alter ego. yes, i dress in funny clothes with a cap covering my head and a mask covering my face. and yes, dressed as such i try to fight the powers of evil (mainly sepsis and bleeding and cancer and the like). i am ... a superhero. but there is often little understanding for what goes on under the paper thin masks and baggy gowns we wear. certain …um…occurrences, well, occur with us just as much as with other people.

a common cold behind a theatre mask is no small thing. remember you can’t blow your nose. sniffing loudly only works for a while and attracts all sorts of strange stares. just leaving it is really the only option. the positive side of this is you suffer less from the mild dehydration that accompanies massive loss of …mucus. there is, after all, fluid replacement (it is a very short trip from your nostrils to your mouth over your upper lip). ‘nuf sed. somehow this never appealed to me though. so, for all you budding surgeons out there, when you have a cold, plug your nostrils with tissue before scrubbing up. once you’re scrubbed, it is too late. The side effects are only a slight change in voice which is a small price to pay to avoid the constant lip licking and salty taste throughout the operation.

then there is a running stomach. this may be one reason to excuse yourself, handle the situation and rescrub. however, there is the real problem of dehydration, confounded by long hours of standing and concentration. here may i suggest a drip. the gas monkey (anaesthetist) can quite easily give a quick bolus or change the vaculiter when needed. (quick note, i’m not pulling this out of my thumb. i have actually seen this). stay at home, i hear you say? somehow that just doesn’t work with us doctors. i’m not sure why, but it is very rare that a doctor will stay at home merely because he is sick. what sort of a superhero would that be.

the last problem that can be encountered is best explained by thinking back to my registrarship. i was assisting the prof with some or other laparotomy. my stomach had been giving me trouble for some time. up until just before scrubbing up with the prof i had found it necessary to quietly leave polite conversation to allow the release of colonic gas quite a number of times. but once scrubbed up, this avenue was no longer open to me. what could i do? i simply puckered up and held it all in. this worked well, but became progressively difficult. we were approaching the end of the operation, but i could pucker no more. finally i reached a point where i had no choice. i needed release. i decided to quietly let one slip as to not attract too much attention with loud noises. so, as the professor started to close the sheath, i did just that. i was just inwardly congratulating myself for the stealth with which the…um…operation had been executed when the professor stopped closing and dived back into the abdomen. in a dry voice he quietly says, “someone cut the colon.” as he started carefully moving bowel out of the way to better examine the colon. now imagine my embarrassment when i was forced to say’...

“colon? yes. cut? no”

6 comments:

  1. The last line makes it all worthwhile. I remember my surgical chief, a woman who was about eleven months pregnant: I swear, she was HUGE and no way in hell was she going to stop working no less than thirty seconds before that baby dropped. We were on the liver service and doing a lot of whipples. These are long-ish cases, and the chief was supposed to do them all. The attending was famously picky about not allowing a single red blood cell of blood loss. My chief did not want to suffer the loss of face -- or loss of the case -- that would result if she had to scrub out during a operation. So, recognizing the reduced size of her bladder, she would simply insert a foley catheter and wear a leg bag during the course of the operation, then remove it afterwards.

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  2. I have recently found your blog and am enjoying it immensely. An interest in medicine and all things African-your blog was a shoe-in the moment I saw the link on another medical blog whose name escapes me right now. Thanks for sharing your life with us.

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  3. Another such example, applicable only to women surgeons, is having the monthly period, and a particularly heavy flow during a case. One can get unscrubbed and, well, need to back out of the roomo and go change. See, at least you don't have to worry about that one!

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  4. Silent but violent............the quiet fart can be deadly! Thanks for a good laugh!

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  5. I love your human side bongi!

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  6. I nearly collapsed laughing! Funny how such a natural body function can scare the begeezzzus out of us!
    Salagatle!

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