Letting it all hang out

This week finds me in la cirugía -- surgery -- so this morning I go to the supplies window in the operating room suite to be issued my scrubs for the morning’s cases. The students here get disposable scrubs made of papery fiber and so that’s what I get, along with my ration of mask and shoe covers. I change clothes and head on into the OR with my usual enthusiastic how-can-I-help-you smile where, after being introduced to everyone, I grab the patient’s chart to read about the upcoming case. What a dedicated medical student! Looking down at the chart under the bright lights of the OR, however, it occurs to me that I can see my socks awfully clearly through the legs of my scrub pants. Horrified, I realize that my thin papery scrubs are practically see-through! At first I’m hopeful that the worst of it is just being able to see my socks, but a discreet and increasingly mortified inspection reveals that I am basically standing there in a room full of anaesthesiologists, surgical residents, and nurses in my underwear. What can I do? I opt for a lengthy examination of the patient’s chart, but with the chart held a bit lower than usual.

Fortunately I manage to communicate to the friendly and helpful Dr. Gomez the fact that I would like to change my scrubs. Like most operating rooms this one is kept a bit on the cool side, so he asks if I want to change because I’m cold. (Can this possibly get any more humiliating?) I’m happy to let him run with that theory, however, because if I tried to explain any more in my limited Spanish I’d probably be arrested. Or sent to the Psych floor. I’m beginning to realize why so many people here seem to either bring their own scrubs or wear long coats.

At this point it’s all I can do to just keep looking straight ahead, repeating over and over to myself “it’s not what you wear, it’s how you wear it.” I reluctantly give up my modesty-preserving chart and Dr. Gomez escorts me down the hall back to the formidable woman guarding the supplies window. Dr. G asks the gatekeeper if I could get a robe or coat, but that is absolutely out of the question—“they’re only for doctors, not for students!” Finally he manages to talk her out of a set of real cloth scrubs. The pants legs only come down to mid-calf on me, and the shirt only just barely reaches the top of the pants, but at least they’re opaque. Now I can return to the OR without living the nightmare where you walk onstage for your trombone recital and realize that you’re stark naked.

And so, clinging to my last shreds of dignity, I scrub in for the surgery. As things turn out I get to do a lot of suturing and Dr. Gomez teaches me a stitch I’ve never used before, earning me a “¡muchacho!” from the junior resident.

At least, I hope the comment was for my suturing….

Back out

Yesterday I spent almost twelve hours in surgical cases, culminating in an excruciating forty-five minutes holding a 100-pound leg at an intervertebral disc-popping angle. Then on the way out of the O.R. suite I was reminded by the posters and screen savers appearing around the hospital lately that September is Pain Awareness Month. Didn't have to tell me that twice. Maybe I can befriend an orthopaedic surgeon on this rotation who can fix me up after it's done.

Mallet, please.

I'm really digging the orthopaedics surgeries I've been scrubbing into. (That is, apart from getting to wear the super-cool space suit headgear.) A typical case involves power drills, reciprocating saws, various sizes and types of mallets, and mixing cement. In other surgical fields you manipulate tiny, delicate structures with subtle instrumentation. In ortho you saw off the end of a bone and hammer a long metal rod into it. Gotta admit that it's really fun. Hey, I'm a boy; what can I say?

Open the pod bay doors, HAL.

Haven't been much of a blogger lately, have I? The feeble excuse is my current run of back-to-back surgical clerkships but, as noted, that's pretty feeble.

These days pre-dawn rounds find me on Orthopaedics--which, charmingly, is still spelled with the "ae." Yesterday I wore the ortho "space suit" in the O.R. for the first time. It's a tall helmet with a frame, over which is draped a sterile head covering with a fully-enclosed faceplate. When assembled it looks sort of like the space helmets in 2001: A Space Odyssey. (I seem to be fixated on exotic medical headgear these days, don't I?) What with the surgical gown, a warm O.R., and possibly even a lead vest and skirt under there if the procedure includes radiography, it can get pretty hot inside, so the headpiece has a small fan for ventilation, powered by a battery pack that clips to your scrubs.

After I suited up in this contraption for the first time, I noticed that it began getting really, really warm in there. Really fast. Worse, the faceplate fogged over, blinding me. After a couple of minutes it was getting hard to breathe, and I started to feel faint. Of course, at this point I've already scrubbed and gowned for sterile conditions, so it's a big deal to "break scrub," or take anything off. Fortunately one of the techs noticed my distress and realized that my fan wasn't working. He ran to the storeroom, came back with a new battery pack, and got it hooked up. As the fan started blowing fresh, cool air into my oxygen-deprived microenvironment I regained consciousness and my faceplate quickly defrosted. I'm just glad I didn't go have to leave, or even go down on the floor (which does happen to people from time to time in the O.R.)--not the impression you want to make on your first day. Many thanks, attentive tech guy!