Doesn’t it seem strange that there are a million boring mandatory training videos you have to watch in life – fire safety in the dorms, proper burger flipping, how to run a cashier, how to properly greet a customer or treat a patient with respect – but there’s no boring mandatory “how to scrub in for a surgery” training video? Because that one seems like it would be helpful. It sure would’ve prevented this:
Nurse: Okay, and what size gloves do you wear?
Everybody within earshot: *laughter*
Transplant Surgeon: Uh, an 8 for me, let’s try a 7 for her.
Me: (THERE ARE NUMBERS??)
Nurse: *hands me many small blue and fluffy things*
Me: … Hmm. Ah. Yes. *unsure whether I should pass some of these to the surgeon, or if they’re all for me*
Super chic transplant fellow: You set?
Actually, the problem wasn’t “scrubbing in” as much as it was “staying sterile”. I don’t know how the scrub nurse managed to actually do her job when so much of her time needed to be spent watching my arms to see what new way I was trying to break the field at any given moment. First I didn’t know that I needed to hold my arms above my waist (I guess I faintly remembered it from a TV show. It rang a bell when I was informed that was a rule.) and then when I finally got that down, I went too far in the other direction and had to be told that the area above my shoulders wasn’t sterile either. The scrub nurse helpfully mentioned that the blue cloth was sterile, so from then on I tried to just rest my hands there.
My biggest fear was fainting. No matter how many people tell me it’s just physiologic, I feel self-conscious about it every time it happens. I still can’t help but see fainting as a sign that I’m not “tough” enough to handle things, no matter how much I know about vasovagal reactions and the parasympathetic nervous system.
So after a few minutes of not screwing anything up, I started to feel pretty good about how things were going – it wasn’t too different from dissection in anatomy lab, at first: he was just cutting through fascial layers while the super chic transplant fellow held the fat back. There was some blood pooling in the thoracic cavity, sure – but no big deal. Although there was a lot of it, all of a sudden… And the room was pretty hot, actually – that long gown was feeling really oppressive, and I wasn’t sure if I was even getting enough air through the damned mask on my face. No air at all, actually. Couldn’t breathe.
I tried everything. I stood back a bit, pumped my legs to try to get the blood back to my heart, and took long deep breaths. Finally, I told the team I needed to sit, and headed for a chair. I must have looked absolutely terrible, because while the effect I was hoping to have on the nurses was “Okay, let us know when you’re ready to scrub back in” (all cool and nonchalant because it’s no big deal and I’m clearly on top of things, right?), what actually happened was that two of them followed me, grabbed me, the world went wavy, they tried to tell me to take off my mask and gown (but I couldn’t understand what they were saying), and…
I threw up. All over the floor.
On the bright side – I didn’t faint*. An amazing nurse helped me find some water and clean everything up (she wanted me to sit down and drink more water, but my self-confidence felt more broken than my blood pressure, so I didn’t really do that.) I took a minute to collect the scraps of my dignity, then scrubbed back in.
And it was fine. The transplant surgeon decided to not mention it, which I appreciated (I’m a huge fan of the stoic mentality. If you pretend it didn’t happen, it didn’t happen.*), and the super chic transplant fellow told me afterwards that she thought I handled it well and that she herself actually feels faint and dizzy at least once a week. That blew my mind.
In conclusion, surgery, nurses, and super chic transplant fellows are awesome. I am less awesome, but at least I’m capable of cleaning up vomit. That’s a marketable skill.
omg this post made me feel a great deal of solidarity with you (although i don’t know you) because it sounds like exactly what i might do in that situation. first year of med school is such a funny time. so far this year i’ve almost passed out for a much lesser situation and it was horribly embarrassing. i’m just glad its not only me 🙂
Thanks! I’m glad there’s somebody I can feel solidarity with. 🙂
I love your writing style. You’ve captured EXACTLY what it was like for me going into the OR for the first time! I was allowed to observe a CABG last month. All I remember thinking at the time (as I realized that I was in a cold sweat and not getting much air) was, “Damn it, body, why can’t you just mellow out and let me watch this?” Had to sit down, get water, the whole nine yards. Embarrassing!
I’m just really glad that someone else has had a similar experience! Ugh, why can’t our bodies just listen to us? 🙂 Thanks!
There’s nothing like awesome nurses! Reminds me of the time I stood in the ER, attempting to compress a pulsating artery without letting squirts of blood explode onto me, the patient, and the floor. Hadn’t eaten, drank water, or slept in many, many hours. Just as I was about to hit the floor, a nurse noticed that I had not a single drop of color left in my face and graciously offered to compress the artery for me while I ran into the supply closet to drink water and eat skittles. 🙂
Wow, that’s seriously awesome!
I did a call shift for general surgery last summer, and I had the…privilege…of being a second assist on a lap chole at 2 in the AM. As I’m standing there, listening to the scary as hell surgeon talk about her divorce, I don’t realize I’m starting to nod off. Without even thinking, my body snaps into action, and I jerk my head back just as I’m about to fall asleep onto the patient!
Of course, this action attracts the surgeon’s eye, but I managed to play it off like I had just felt a cool breeze (…in the sterile OR).
Enjoying your blog.
Too late for your surgery clerkship – perhaps you can link your colleagues (above link, see: for your surgery clerkship) or get a lift from http://onsurg.com/how-it-feels-to-be-a-surgeon
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