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Friday, March 2, 2012

Take Your Daughter to Work Day

Every day for the pregnant lady is Take Your Daughter to Work Day, but today is particularly special for Baby Girl, because she gets to see her first surgery! And so does mama! Today we get to observe a total laryngectomy. Rumor has it the operating room smells like burning flesh, the process takes 4+hours, I have to stand the whole time, and the ENT will hand me the larynx once it's removed! I'm thinking maybe this early exposure in the womb will predetermine Baby's career as a surgeon. Then if things don't work out with Cirque du Soleil, she has something to fall back on. I will be observing Dr. Cohen, an ENT who wrote the book on laryngectomies. No really, he just came out with a new book, Atlas of Head & Neck Surgery. He's supposed to be fabulous, both as a surgeon and as an individual. For example, I hear he wears bow-ties. How can you go wrong? I would fully entrust my head and neck to a man wearing a bow-tie. As long as it was decontaminated appropriately for the OR.

***

One of my supervisors escorted me (and Francie) to the OR, where I then entered the cluttered Women’s locker room to dress down into size L scrubs. I put my hair up in a cap and booties over my shoes.


Someone new escorted me to my patient’s actual operating room. The lights were bright and there were about 6 people bustling about getting the room set-up with the proper surgical bed, anesthesia equipment, surgical tools, and every type of sanitation precaution you can imagine. I seated myself on a stool in the corner, awaiting the patient’s arrival. For the sake of his privacy but my ability to call him by a name, I’ll refer to him as Buck. It’s a name that wouldn’t surprise me if it were his.


The doctors were just like I imagined they might be. There was one resident and one attending (so Grey’s Anatomy, I know). They were both tall, athletically built men, more or less attractive, with nice shoes and rings on their wedding fingers. The attending, who I learned lives in the Goose Hollow/NW Portland area, was discussing the money he was to shell out at his kindergartner’s school auction that evening. The resident later inquired about the attending’s upcoming absence. Apparently his family was taking a non-Spring Break trip to Hawaii. The two docs talked Maui for the next 20-something minutes. Condo this. Sushi that. SNUBA here. Resort beach there.


They were nice enough, of course, but I had to laugh in spite of myself for this being such a cliché. OF COURSE the ENT docs vacation with their families in Maui. OF COURSE they stay in 5-star resorts. And OF COURSE they are going to compare vacation destinations and places to dine out.


Back to the patient. Buck was wheeled in sometime later when everything was all set up. The nurse anesthetist was so kind and talked Buck through the whole “going under” process. But I could tell this was not his first rodeo. He has scars aplenty on his chest, and I remember from his chart review that he’d had some sort of cardiac surgery. Once the IV drugs were administered and he counted backwards a few numbers, he was out, and they intubated him.


Strangely, I had a sort of emotional reaction to this part of the procedure. My eyes actually began to tear, and I wondered if I had the spine to stay and watch a surgery. I couldn’t stop thinking about how scared I would be if I were in his shoes. What if he stroked during the surgery? What if he could never tell his wife again how much he loved her? What if …?


So I am either the most empathetic person or the most self-centered.


Turns out, I have a strong stomach and the smell of burning flesh doesn’t bother me one bit. Or Francie for that matter. The blood spilling onto the attending’s shoe didn’t bother me. The hours of cauterization of the neck didn’t bother me. The lymph nodes didn’t bother me. The entire larynx, on the OR equivalent of a paper towel, didn’t bother me. The cancer, visible within the larynx, didn’t bother me. And the trachea – in all its glory as it was re-positioned through a stoma in Buck’s neck – didn’t bother me. In fact, I thought that was the coolest part of the whole procedure.


However, I did not leave the surgery thinking, “Oh my god, I should have been a surgeon.” In fact, I’m embarrassed to admit, I actually got pretty darned bored during the procedure. The first bits of cutting and cauterizing were cool. And that clean, pristine trachea – just like something you’d find in the plumbing section at Home Depot – that was cool. But after about an hour, it was sort of the equivalent of watching someone fix a BMW motor. Or hanging out with Alex while he builds a TV cabinet.


Francie kicked throughout the entire procedure. All 6 hours I was in the OR. I was beginning to worry she liked ENT too much. How on earth am I going to pay for my kid to go to college, let alone medical school!!


After work, I was ravenous. I made Alex come pick me up from the hospital, and take me straight to get a burger and fries at the Old Market Pub. Francie and I were tired after a long day of surgery, after all.



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