Further Foibles in the Operating Room
Surgeons can be curious folks - at least, they're reputed to be rather intense. One common description one would hear bandied about the hospital floors is that some individual exhibits "the classic surgeon's personality." Never used as a compliment. In reality, I think surgeons are pretty much like any other group of people - a mixture of cool, laid-back, intense, and, yes, some classic surgeon's personalities. I was warned of one such individual before I started Orthopaedics, "Dr. Jayne."
Dr. Jayne, I was told, would not even lower himself to speak to a medical student. You could offer him your hand when you introduce yourself, but he'd ignore it and walk right by you. The first time I see Dr. Jayne is during morning rounds when the Orthopaedics residents present the most recent cases to the surgeons. Dr. Jayne sits in the front facing the X-ray films, with his back to everyone else. He never turns to face the other people in the room. He rarely says a word. Once the presentations are over, he gets up and walks out of the room never making eye contact with anyone. Yeah, I'll try to introduce myself and shake his hand, all right. In Hell.
Naturally, I'm scheduled to be in the OR with Dr. Jayne. He sets up his OR with meticulous detail, instrument tables, portable X-ray, and people all centered efficiently around the patient. He is able to communicate even without moving his eyes. He says all of two words to me directly during the four-hour procedure ("Watch out"), and that was to get out of the way of the X-ray machine that was coming in to check the alignment of the patient's bones. Other than that, Dr. Jayne uses silent communication to instruct me. At the two hour mark Dr. Jayne breaks scrub and takes a half hour break. When he scrubs back in, he just walks up to me, still not making eye contact, and hands me the tag from his operating gown so he can tie himself back up. Aha! At least he knows that I'm standing in the room. I consider this an enormous success and plan to reward myself with an extra 15 minutes of sleep that night.
Dr. Jayne is in absolute total control when in the OR. Nobody moves without his permission, and he essentially performs the entire operation. Even the senior resident has a minimal role in the procedure. I do manage to get my hands dirty, though, when Dr. Jayne speaks (without looking up, of course): "And [muffled] would hold the retractor down here..." I'm so impressed with myself - OR time is approaching 4 hours, my presence has been all but ignored, and I'm still paying enough attention so he doesn't have to repeat himself.
In contrast, I assist the Chief of Orthopaedic Surgery in the repair of a hip fracture. Dr. Emery isn't even in the room when the operation starts - he allows the Chief Resident to set up the room and begin the dissection. The Chief Resident, Anthony, allows me to do so much more, like cutting the skin and the underlying fascia, feeling the fractured ends of the femur, cauterizing any bleeding arteries, using any number of doohickeys for retraction, and another doodad to guide cables around the bone to hold the reduction in place. Luckily, I don't have to know the names of all the other whozeewhatsits and thingamabobs and whatchamacallits on the instrument table. That's like surgical resident knowledge.
Dr. Emery steps in for the most important part of the procedure, fixing the bone in place, then breaks scrub. He places total trust in Anthony. I expect to be pimped, and Dr. Emery fixes his gaze upon me:
Dr. Emery: Where are you from, Mike?
Mikey: Pittsburgh. (yippee! First question right. I so rock.)
Dr. Emery: Ah, Pittsburgh - do you know Dr. Fu?
Mikey: Yes, um, I know of him.
Dr. Emery: Do you watch 'Big Love'?
Mikey: No, but I've watched Six Feet Under...
Dr. Emery: Ahhhh....Six Feet Under. Great show. Big Love is probably just a little bit better.
Mikey: I'll keep an eye out.
Okay, so that wasn't really being pimped by any measure.
Anyway, Anthony lets me help him stitch up the patient. Hilarity ensues. Even the anesthesiologist is giving me pointers. I need to practice. I think, however, for my first time stitching up a real live person, it was a success in that I didn't sew my own fingers to this lady's leg.
Coming soon: Mikey practices his surgical knot tying, successfully saving the lives of an orange and frozen pig feet. Or not.
Dr. Jayne, I was told, would not even lower himself to speak to a medical student. You could offer him your hand when you introduce yourself, but he'd ignore it and walk right by you. The first time I see Dr. Jayne is during morning rounds when the Orthopaedics residents present the most recent cases to the surgeons. Dr. Jayne sits in the front facing the X-ray films, with his back to everyone else. He never turns to face the other people in the room. He rarely says a word. Once the presentations are over, he gets up and walks out of the room never making eye contact with anyone. Yeah, I'll try to introduce myself and shake his hand, all right. In Hell.
Naturally, I'm scheduled to be in the OR with Dr. Jayne. He sets up his OR with meticulous detail, instrument tables, portable X-ray, and people all centered efficiently around the patient. He is able to communicate even without moving his eyes. He says all of two words to me directly during the four-hour procedure ("Watch out"), and that was to get out of the way of the X-ray machine that was coming in to check the alignment of the patient's bones. Other than that, Dr. Jayne uses silent communication to instruct me. At the two hour mark Dr. Jayne breaks scrub and takes a half hour break. When he scrubs back in, he just walks up to me, still not making eye contact, and hands me the tag from his operating gown so he can tie himself back up. Aha! At least he knows that I'm standing in the room. I consider this an enormous success and plan to reward myself with an extra 15 minutes of sleep that night.
Dr. Jayne is in absolute total control when in the OR. Nobody moves without his permission, and he essentially performs the entire operation. Even the senior resident has a minimal role in the procedure. I do manage to get my hands dirty, though, when Dr. Jayne speaks (without looking up, of course): "And [muffled] would hold the retractor down here..." I'm so impressed with myself - OR time is approaching 4 hours, my presence has been all but ignored, and I'm still paying enough attention so he doesn't have to repeat himself.
In contrast, I assist the Chief of Orthopaedic Surgery in the repair of a hip fracture. Dr. Emery isn't even in the room when the operation starts - he allows the Chief Resident to set up the room and begin the dissection. The Chief Resident, Anthony, allows me to do so much more, like cutting the skin and the underlying fascia, feeling the fractured ends of the femur, cauterizing any bleeding arteries, using any number of doohickeys for retraction, and another doodad to guide cables around the bone to hold the reduction in place. Luckily, I don't have to know the names of all the other whozeewhatsits and thingamabobs and whatchamacallits on the instrument table. That's like surgical resident knowledge.
Dr. Emery steps in for the most important part of the procedure, fixing the bone in place, then breaks scrub. He places total trust in Anthony. I expect to be pimped, and Dr. Emery fixes his gaze upon me:
Dr. Emery: Where are you from, Mike?
Mikey: Pittsburgh. (yippee! First question right. I so rock.)
Dr. Emery: Ah, Pittsburgh - do you know Dr. Fu?
Mikey: Yes, um, I know of him.
Dr. Emery: Do you watch 'Big Love'?
Mikey: No, but I've watched Six Feet Under...
Dr. Emery: Ahhhh....Six Feet Under. Great show. Big Love is probably just a little bit better.
Mikey: I'll keep an eye out.
Okay, so that wasn't really being pimped by any measure.
Anyway, Anthony lets me help him stitch up the patient. Hilarity ensues. Even the anesthesiologist is giving me pointers. I need to practice. I think, however, for my first time stitching up a real live person, it was a success in that I didn't sew my own fingers to this lady's leg.
Coming soon: Mikey practices his surgical knot tying, successfully saving the lives of an orange and frozen pig feet. Or not.
posted by Mikey at 10:42 AM
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