Mar 16, 2010

Slice n' Dice

I am lame.

On the first surgery of my first day in the OR, I got faint and had to sit down. I am so embarrassed even to write that here. And it was on a simple tumor excision- no big deal! This wooziness from a girl that was a phlebotomist in college, thinks emergencies are interesting, had a relationship with a cadaver (named Phyllis!), and enjoys nothing more than the gory display of childbirth. Granted, I had just recovered from a pneumonia, and have a propensity towards hypoglycemia if I don't eat every two hours, but I don't think that was it. I think it triggers something in me when I see a sign of life in the patient on the table. When they become a person, and not a body, it freaks me out.

Normally I am okay with surgery. I stand there, assist, do what I need to do, and have lunch afterwards. In fact, I'm usually hungry in the operating room. As far as I can tell, the only times I have gotten woozy is when I connect the parts to a whole. I was fine with c-sections, except one time when the patient began complaining of pain. The thought that she could feel the pain of my knife instantly made me anxious and dizzy. A hysterectomy is a removal of a part, akin to replacing the air filter in a car. That's the level of attachment that I have towards the body. But one time, I was assisting on an open hysterectomy and saw the iliac artery, pulsing just beneath my tools, and right away I was nauseated. Of course I know that the person on the table is alive, and this is normal anatomy. However, I think that a sign of life- pain, a pulsating artery, the woman today who was talking to me about western movies- these force the connection for me between patient and body, person and pain.

Surgery is a different mindset than medicine. As my attending said today: "In medicine, you help people live with their disease. In surgery, you either cure or kill." The more I thought about it, the more I thought he was right. There is something to be said for being a mechanic, for leaving everything you got on the table, and walking away. It's not for me though. Those signs of life that make me dizzy- I think that happens because I love patients, because I connect and empathize with them. I don't think I'd ever feel fulfilled having a practice where the patients were primarily unconscious. Plus, its hard on you physically- to stand that long, under those bright lights, with your bladder exploding and stomach grumbling. I'm kind of dreading the next month. And I'm hoping that I can breathe my way through those moments where I catch a glimpse of human pain, and maybe even learn something about being a good surgeon.

3 comments:

  1. When I was a student at Rancho Los Amigos Hospital on the cleft palate team, there was a resident plastic surgeon. Apparently she had a reputation for getting woozy and passing out in surgery. (I learned this when I got woozy watching a craniofacial surgery.) Everyone including the main surgeon was very supportive of her and said that this is not unusual for beginning surgeons. The resident's name was Dr. Janet Solomonson and I have seen her name emerge as a very specialized and well-respected craniofacial surgeon in Los Angeles.

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  2. Once again I am so taken with your writing, Annie. You have such a sense of compassion which leads me to believe you are going to be an incredible doctor. Your patients will be lucky that their doctor felt "woozy" at some point - I think it means that you have a heart.

    -Katy

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  3. Dude...I get woozy over a stitch.

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