Writings: Surgical Training

There is a heaviness I cannot shake. It's like a bowling ball in my lungs, pulling things down with each breath, which is probably how my patient feels when his breathing machine pumps his chest full of air. He is unable to move his diaphragm or say any words or open his eyes at this point. But prior to the surgery we performed to fix his expanding aorta and dying leg, it was his habit to greet me during my 4:30am pre-round visits with a welcoming, "Now what? Oh you again? Can't you ever let me sleep?" But like most cantankerousness octogenarians his grumblings were more expressions of wit/endearment rather than true annoyance, and when I visited him in the early mornings he would always tell a long story to get me to stay a little longer.

"Oh Mr. H, I'm late and I've got to run," I'd always be thinking in my mind, but he was such a funny man; it was nice to laugh. He couldn't see or hear very well anymore but his sense of humor was as sharp as ever.

During his surgery my attending let me throw two stitches in his femoral artery. The fellow and attending joked that if anything happened to the leg it would be my fault. It was one of the most amazing moments of my surgery rotation. I nearly threw up with nervousness and my hands shook holding the tiny needles. I got so close to the artery, I contaminated my attending's forceps with my face mask. I've been awestruck by what these vascular surgeons do for a living, by the power they literally hold in their hands during these high-risk surgeries, and for a small moment I felt like they had allowed me to step in the glow of their glory. Thank you, thank you!  

But when the OR lamps are dimmed and the patient is rolled to the ICU, the lines and drains go in with their incessant beeping sounds, and the magnificence is somehow lost. And when the patient goes into multi-organ failure with myocardial infarction and I read my attending's notes saying that the prognosis is grim and the family understands, I get this sense of heaviness that just sits on the chest and weighs down my hands, legs, and maybe even spirit too - if the latter does indeed exist after all.  

I am not important enough to be responsible for this current state of affairs, but I feel guilty all the same for being so happy to practice/ play pretend surgeon when a person's life was at stake. Tomorrow I will go in at 4:30am and pray he is still there. I will translate our visit into vitals measurements and medical jargon during my presentation. It will be impersonal and good practice, and maybe if I'm lucky I will impress someone and honors in this rotation. I would be both delighted and thoroughly disgusted with myself for the accomplishment. 

Everyone is plagued by their own personal despairs, and I suppose when our grievances intersect it's called empathy. My favorite fellow told me not to feel bad for patients, not because he was being mean, but because we can't go on doing our jobs if we do. It is self-absorbed to despair and wallow, I know. It's nobody's fault and we must go on all the same.