4 | Life is beautiful

(Another memory from the student days, when every experience is seen through new eyes.)

* * *

She was nervous. I couldn't blame her.

Terse replies met my efforts at small talk: her face was taut, expressionless.

Those moments of waiting have tortured humanity since the invention of the first rudimentary surgical instrument. Mortality never looms so large as in the quiet before submitting one's body to the operating table, trusting another person's skill with a scalpel. The idea of having one's insides opened to the world has never been a pleasant one. 

"Okay then! I think we're ready." The OR nurse deposited an armful of IV bags & tubing into my waiting hands. "Make sure you keep the piggyback higher than the primary; I've got a sterile pump in the room," she said in my direction. 

We helped the woman to her feet and waited a moment while she smoothed back disheveled blonde hair. The OR nurse led the procession with routine briskness, winding her way through the hallways connecting to the operating room. The patient followed heavily and I took up the rear, holding the IV bags at shoulder height & keeping the train of tubing off the floor. 

Her urgent surgery had been docked for 08:00: a glance at the clock showed that we were 30 minutes behind schedule. Despite the delay, the mass of foreign tissue growing below her diaphragm would be removed, the incision neatly sutured, and the whole ordeal over before she knew it. But no reassurance can shorten the moments before the plunge.

Inside the operating room every surface glinted in sterile perfection. Scalpels were arrayed with mathematical precision, gauze neatly stacked, suction equipment hooked up & tested. Sterile blue drapes had been spread over the table, ready to receive the patient. We helped the woman into place. 

"And, the surgeon is here!" announced the circulating nurse. "Michelle, you want to get him ready?" The scrub nurse nodded & began unfolding a sterile gown as the surgeon strode into the room. Following in his wake was the woman's husband-- who looked just about ready to faint. While they scrubbed in, the anesthesiologist struck up small talk with the patient.

"So. How're you feeling?" he asked after a few moments. The woman laughed shakily.

"You know that part on a roller coaster, when you're going up and all you can hear is 'click...click...click...?' That's what this part feels like." 

"Alright!" announced the surgeon a few minutes later. "We're a go." The light glanced off the first scalpel as it went in. 

Blood. Blood trickling down a swollen abdomen. The smell of burnt flesh as cautery meets blood vessel. The surgeon opened the skin with a smooth draw & burned back the yellow fat beneath. I moved to get a better view.

There: I could see it. The abdominal muscles separated and the mass was bared to the world. It was smooth, taupe, tangled with a complex and beautiful pattern of blood vessels just beneath its surface. It was larger than I had imagined. The surgeon made a few more incisions, reached in deep, & pulled. As he lifted, a foreign body came free in his hands.

The surgeon held up 8 pounds, 3 ounces of tissue. And as he raised it towards the light, it kicked him.

The room launched into motion. Nurses closed in, transferring the now-wriggling mass to a table. The table disappeared from view as blue scrubs bent over to perform a well-practiced dance.

"Heart rate 150."

"BP 67 over 35."

"O2 sats?"

"68 and rising."

"Looking good!" announced the pediatrician, laying aside his tiny stethoscope. A nurse gathered up the bundle and brought it over to the woman & her husband-- who was furiously rubbing away tears of joy.

"Here you go," said the nurse with a smile. "Congratulations; she is beautiful."