BREAKING MORE THAN BONES

I’m on my way down another hospital hallway to see another postop complication. 

This particular lady’s large belly is split open large enough to fit a human head into.  The open space is covered in a black plastic lining with a tube connected to a vacuum next to the bed.  It helps her infected abdomen heal by creating negative pressure.  I think.  It’s a surgery thing, not my field.  I’m just here to follow the cultures, and make sure she’s on the right antibiotics, has a bowel movement, keeps peeing, doesn’t go comatose from pain med overdose, doesn’t have a heart attack, or pneumonia, or blood clots, et cetera.

Anyways, my beeper goes off.  It’s Amy paging me.  Hmm.  The last time she paged me at work before noon, she called to say she was … pregnant. 

“Hey what’s up?”

“We just saw the ortho surgeon for Sun Su.  He said he knows you by phone,” Amy answers.

“Yeah, I thought he sounded familiar.”

Our medical group gets consulted by dozens of surgeons at some point or another here.  Even so, I can barely name more than a couple by face.  Most of the time the surgeons are in the OR.  They tend to see patients either at 7 in the morning or 7 at night (by special request usually). 

“Anyways, he said Sun Su needs surgery,” she says.

“Like with anesthesia?” I ask an awfully dumb question.  My stomach drops.

“… Yeah,” Amy pauses with the same concern I do, “This Wednesday. He said it’s too bent. He said that’s what he’d do if it were his kid.”

“Yeah. Okay. What time?”

“Noon (at the hospital I work at).  I’ll page you so you can see him before.  I know he’s not going to like getting the IV.”

“Yeah.”

“See you tonight.”

“Bye.”

I’m a little worried now.  Not so much about the surgery but it’s the anesthesia that concerns me. What if it’s too much for Sun Su?  Or he has a reaction to it?  Or doesn’t wake up?  Or aspirates his stomach contents into his teeny lungs? 

Fool’s thoughts, I tell myself. The anesthesiologist has done this thousands of times. Just not on my kid.

Not on my kid.

So I have lots of scary thoughts of possibilities, not just imagined, but what I’ve seen. I only see the 1 in a 1000 worst cases but still. If you’ve seen what I’ve seen….

I see the next patient. The lady with her abdomen gaping open like a giant maw of infected bowel stew and that bizarre black vacuum pump coiling out of it. She hasn’t been out of bed for weeks because of it. 

She must have been somebody’s baby at some point too.

 

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1. First, do no harm.
2. If what you are doing works, keep doing it.
3. If what you are doing doesn't work, quit doing it.
4. Above all, never let a surgeon take your patient.