Operation, Deconstructed

This is from part one of Sid Schwab’s nine-part series in Surgeonsblog:

TheoperatingroomWith as much detail as is useful, and as descriptively as I can manage, I’d like to relate what it’s like to do an operation, from before laying knife on skin to after placing the bandage. I’m a general surgeon, so I choose sigmoid colectomy as my prototype; it’s always been one of my favorites, although the particular operation isn’t the point. The idea is to let the reader into the operating room as much as possible. I figure it’ll be several parts. Let’s see how it goes.

First stop: the pre-op holding area, where my patient — and most often family — and I exchange greetings minutes before the operation. If I’ve done my office-job well, the patient is likely to be relatively calm and optimistic. I touch a hand, a knee, a belly, say something like “Seems like a great day for a colon resection.” To the oft-said “Hope you’re not hung over, Doc,” I respond with a raised hand, deliberately shaking, saying “Steady as a rock.” Laughs all around. Then more seriously, “Any questions since we talked, anything you want to go over again?” And a reminder of the plan: “You’ll meet the anesthesia person any minute. You’ll be sound asleep for the operation; we’ll be making the incision right here. I’ll numb it up with local before we’re done so when you wake up there should be little or no pain. It does wear off, though, in a few hours, and we’ll hook you up to a little push-button device so you can give yourself pain medicine whenever you want it. I expect you’ll be up walking in the halls tonight. (“Tonight?! Really??” “Yep! It’s the best thing there is for you. Gets the circulation going, gets those lungs working.”) [To the family:] OK, I figure the operation will be give or take an hour, little screwing around before and after, I’ll come out and talk to you soon as we’re done — probably an hour and a half. Don’t get worried if it’s a little longer. [To the patient:] See you in the OR.” Exit, stage left.

More here. The next eight parts can be found here.  [Thanks to Beajerry.]