Saturday, January 12, 2008

Maiden Voyage

“Hey, you wanna see an operation?”

“Uh, sure.”

“Look, when we go in, just tell ‘em you’re a ‘fourth year.’ They’ll think you’re a fourth year medical student, rather than a senior in college.”

“Really? You sure that’s okay?”

“Hey, these guys are cool and they’re doing a really amazing case today. Some guy needs a repair of a huge descending aortic aneurism.”

“Cool,” I said, not really knowing what a descending aortic aneurism was at the time.

“Alright, follow me.” We walked through a labyrinthine series of halls and institutional doors. A few buttons were pushed on a door lock, and the heavy door was pushed aside to reveal the inner sanctum of a men’s locker room. It didn’t look too different from the locker room of my high school: lots of vertical lockers with little padlocks securing the handles and the artificial fluorescent lights that gave a pale green glow to your face.

One particular shelf had his interest as he sorted through some pale blue garments.

“Here, these look like they’ll work. Try these.”

“Can I wear my t-shirt?”

“No! You can take that off and hang it over here with your pants,” as he pointed to a series of hanger hooks perched above a large plastic bin marked “Soiled Linens.”

So I took off my clothes and put on the pale blue pants and shirt. The pants where held in place by a flimsy red draw string, the shirt was large, but felt comfortable with a deep v-neck exposing my upper chest.

‘What shoes should I wear?”

“Oh, those’ll do fine. Just put these over them,” He handed me this ridiculously small shriveled ball of paper with an elastic band attached and said: “One size fits all.”

So I sat on the bench in the locker room, put back on my tennis shoes and stretched the ridiculous elfin shoe cover over each shoe.

“You gotta put on these, too.” And I looked at his hands which held another pale blue paper ball with elastic attached and a surgical mask. It seemed the next elastic paper item was to be stretched over your hair, and the surgical mask had all of these strings attached.

“This is perfect!” he whispered. “Here, let me help you tie that mask.” And he proceeded to tie one pair of ties behind my neck and the second pair over the crown of my head. “There! Check it out,” as he pointed to the mirror.

I looked and saw myself looking every much the part of a surgeon. Regal. Mysterious. Or maybe like a bandito about to rob a train. I smiled as the thought came to me, but he couldn’t see.

“You ready?”


So off we went, out of the locker room through another door that opened into a long hall of the hospital. Like classrooms attached to a main hall, I could see through windows revealing other rooms packed with equipment, but most were empty. It was a Saturday after all. He waved me on in excitement.


And he opened to door.

I was completely unprepared for what I saw. Worse still, what I heard and what I smelled.

It was an electric kind of smell. Pungent, unfamiliar, like someone burning wood blended with steak and torched with an arc welder. It’s hard to describe. Except that it was unpleasant. No, that’s too kind. It reeked.

The light over the blue-draped table was incredibly bright – and cast a white-orange tint to the drape over the object on the work surface. Several surgeons stood on stools to get a better look wearing funny black-rimmed nerd glasses. A trail of smoke rose from the table each time a high-pitched musical tone could be heard. One of the surgeons held a thin garden hose full of (Holy sh--!) foamy blood. The hose was attached to a large container with a second clear tube attached to the wall. I could hear slurping. Again and again. Sschlluuurrrrrpppppp. Sscchhllluuurrrppppp. Then the tone and smoke and scccchhhuurrrrrppp again.

“Why don’t you stand over here?” he said to me, pointing to the area where the anesthesiologist was standing. “You can get a really good view from there.”

So I hesitantly walked over as he introduced me to the anesthesiologist. “Hi, Joe, this is my brother, he’s a ‘fourth year’ from Duke.”

“Nice to meet you. Wanna stand up here to see?” as he pointed to a small black stool barely 4 inches high. Next to him was a daunting array of machinery with some sort of bellows rising and falling with manometers and electronic gadgetry attached to this thing beneath the drapes. I looked down and saw hair for the first time. There was a body beneath the drape, lying on its side, with a white tube in its mouth and eyes taped shut. I peered over the wall-like drape separating the anesthesiologist from the surgeons and noticed what was happening for the first time. There, to my amazement, was the chest cavity, held open by a large rib-spreader, and a balloon like purplish-red organ rising and falling to the soft sounds of the machine: Shhhhhhhh. Gaaaaaaaa. Shhhhhh. Gaaaaaa. With each “Shhhhhh,” the balloon rose. With each “Gaaaaaaaa,” the balloon fell. It was his lung. Cool.

But there was bleeding. Lots of it. Seems the aneurism was leaking.

Shhhhhllluuurrrrrp. Tone. Smoke. Shhhhhlllluuuuurrrrrrrrrrpppppp. Tone. Smoke. Electronic smells pierced my olfactory bulb. I looked around. Everyone so focused.

“Mets.” I heard the surgeon say as he held out his hand and a scrub nurse slapped a pair of scissors in hid hand. “Hold here. Bovie.” He glanced up at me. “So you’re at Duke?”


“Know Dr. So-and-So?”

“No, can’t say I’ve met him.”

“Good guy. Head of Cardiothoracic Surgery. We trained together. Hey, don’t hold that like that, hold it this way. Suck!”

Our conversation was over, thank God. He returned to the operation.

Shhhlluuurrrrpppp. Really long tone. Lots of smoke.

I’d been standing of the stepstool for a while and noticed a sudden wave of nausea hit me. I felt cool. Clammy.

Schhhllluuuurrrp. Sccchhhhhhllluuuuuuup. Gurgle, gurgle. More smoke: like the smell of napalm in the morning. Shhhhhhhhhh. Stink. More smoke. Sccchhhlluuurrrrrp. Bleeps. Gaaaaaaa.

By now, I was feeling really nauseous. The thought of blowing chunks all over the operative field entered by mind. Maybe this is why I was wearing the mask over my face – to prevent such a moment. I noticed the medicinal smell of the mask and noted the little fibers tickling my nose as if to coax me into projectile vomiting.

“Uh, is there a bathroom nearby?”

My brother looked at me. My face was as white as a sheet. Maybe green is a better description. He’d seen that color before, I think, on someone dead.

“It’s just out the door to your left,” pointing me the way. I managed to make it back to the bathroom and just felt like hell. I sat on the toilet, unsure of what would happen next. I wanted to puke, but couldn’t. I put my head down, panting. I just wanted to die I felt so bad. So nauseaus. Oh, pleaaaasssse, just puke and get it over with! But it was not to be.

A few minutes later, my brother came back to the bathroom.

“You okay?”

Never wanting to sound like a wimp to my brother, I proclaimed, “No, I’m okay, I just need a few minutes” from the bathroom stall. My nausea finally seemed to be improving a bit. Slowly, gradually, I was coming back from the dead. Finally, I emerged from the stall, smiling.

My brother looked on in horror as he saw his brother emerge from the bathroom still looking like hell warmed over. He was nice enough to not say anything.

“So what ‘d ya think?”


-Dr. Wes

Image credit.


rlbates said...

Would love for you to submit this to SurgeXperiences ( It's a great post!

Margaret Polaneczky, MD (aka TBTAM) said...

I almost fainted the first time I saw surgery - a minor mole removal in the office! Had to run to the bathroom as well. And the ting was, I didn;t even know it was happening, I was so interested in watching what was being done.

All autonomic, I suppose, and uncontrollable.

Great post.

Anonymous said...

Is it ethical for a non-medical person to sneak into an OR without authorization, just for a lark? This is slumming at its worst.

DrWes said...

patient x-

Your concern is justified. But this was not a lark nor slumming. There actually was authorization granted by the operating surgeon. Trust me, I never would have been allowed to view the operation otherwise. I was pre-med, a senior in college, and already accepted to medical school. Was this unethical? Personally, I do not think so.

Anonymous said...

You misconstrue the question. Can an operating surgeon authorize an individual with no reason--and no connection to the patient--to observe? Given the intimacy (and violation) surgery involves--let alone risk on allowing someone in with no training, I would say the behavior was completely unethical. I hope you rot in hell for it.

Anonymous said...

You hope he rots in hell? Jeez, get a grip.

Anonymous said...

Reminds me of the time that they took my high school biology class to see an autopsy. While classmates were looking green the smell of it didn't bother me at all and I was pushing in for a close view.

So how did I end up in Info Science? Who the hell knows.

Charles said...

Anonymous 9:18 and Patient X
As a senior in high school, I had the incredible opportunity to observe dozens of operations in my local hospital. With absolutely no medical training, I was allowed to observe everything from routine appy's to organ recovery operations. In every case, the surgeon, anesthesiologist, and patient (except in organ recovery) gave permission, and I learned more from my experiences in the OR than from any anatomy class I've taken.