Don't Touch Anything

This is Nicole again. On day one of observing surgeries, I was able to see a laparoscopic cholecystectomy, or removal of the gallbladder because of painful stones, and an open small bowel resection to remove a tumor. On the second day I saw two open hernia treatments, a fistula removal near the anus, surgery on a foot ulcer, and an emergency appendectomy.

My first surgery I’ve ever seen in real life was mostly seen by my eyes glued to a screen. In a laparoscopic cholecystectomy, everyone hovered over the patient and knew exactly where to place the two holes for the instrument entrances and the one hole where the camera went in. It was like I was watching two doctors play a video game. I’m not comparing surgery to a game, as if a patient’s life is ever a game, but it was like watching, for instance, someone playing League of Legends in a help video on the internet. I’m excited with every single intricate detail of the game, but I at the same time I just imagine myself doing everything the gamer is doing and I want to play it with my own hands so badly. My only job was to never touch anything and back up as fast as I can when I sense the doctors want to switch places so they don’t accidentally bump into my non-sterile self. Carbon dioxide was pumped into the visceral cavity to make it easier to access and see the gallbladder to be removed.

The second surgery of my first day was even better. A doctor told me they were removing half the intestine, but I think that was supposed to be translated to part of because there was still plenty of intestine left after the tumor was removed. First, an incision was made right down the middle of his body and everything was exposed. The tumor was bigger than I expected. For some reason I was really intrigued this tool that looks like it electrifies tissue to seal it, and was also used to cut with some sparks and smoke escaping. I first thought it was heat but then I noticed that the surgeon touched it against another metal tool sometimes and it transferred the electricity to the end of the tool without hurting the surgeon’s hands. I will research this more. For the hernias, a synthetic mesh material was put around the muscle. The doctor pointed to a vein and asked me to identify. I didn’t know quite how to say it in Portuguese but I think he was trying to joke because he said it would be very bad to cut that because it connects to the testes. He was so hilarious between surgeries as well and loves North Carolina already! He told me during one of the surgeries “Maybe next year you do this”. I’m not sure if he knows how many years it will be before I can do what he does every day. All in all, everything went smoothly for both patients who each received the treatment on different sides.

I enjoyed the fistula surgery a lot more than any normal, respectful person should. There is nothing uncomfortable about it because the giant blue sterile sheets with holes cut out cover up everything except the area to be worked on. I like especially that the patient is under general anesthesia so they won’t feel something that otherwise would be extremely painful! Another doctor is also there to cut and sometimes someone else there to blot the area. Once, the doctor inserted a metal blue marker right through it to see if it ended up in the anus, signified by blue mark on the finger after inserted inside. It looked like it was never there after the surgeon did the final suture.

The emergency appendectomy was a little chaotic. One nurse found it necessary to regularly physically position me where she wanted me to stand so I could get a good view but also not be in the way. I preferred this because I could tell she really wanted me to see but didn’t want me to be in the way of the work. What was more chaotic was that a small hole to remove the appendix was getting bigger and bigger. I was a little confused. Since when did they have to feel all of the intestines after removing the appendix? And why did they suck up some yellowish liquid into a syringe and put it on the table? Pretty soon they were using the huge metal plates to hold the membranes back and look inside. When another doctor was called in and talked to the others, the nurse finally told me that they found a sign of infection and what they thought was the problem, wasn’t the problem. I saw another piece of an organ placed on the table. In my dissections of pigs in class, this is normal. This was a human though, you can’t just pull things out like that, can you? Then the new doctor told me they found a tumor in the fallopian tubes. It did not look like a fallopian tube, so something might have been lost in translation, but I kept watching anyway. Most of the nurses start to leave when the last sutures are being completed, but I love that part because then I am able to see the scar the patient will have to live with, but now amazing that in one moment they are so exposed to the outside world, but in the next few hours they are going to be perfectly fine and in a few days can digest food again. Surgery is intense and exhausting, but I’m so grateful that I could watch such brilliant surgeons in action.