Friday, July 17, 2009

The Fainting Intern Award

When I took off my scrubs today, it was still soaked in sweat. Today was a perfect example how humbling it is to be reminded that one's strength is finite. You see, I'm the kind of person who usually thinks he can take it all, and more often than not, I do prove in the end that I can do more than your average person. But maybe that was the problem- I'm not a person who excels because he's born gifted, but rather an ordinary chap who tries so hard to be better.

When I looked at the board, I tried to review the things in my head. Primary Classical C-section- indicated when the baby or mother's health is at risk and NSVD (normal spontaneous vaginal delivery) is not possible. A breech position of the baby, active herpes blisters on the mother's vagina, cephalic-pelvic disproportion- these are just a few of the reasons. Blood loss at around 800mL.

I imagined the instruments and materials we would be using: needle holders, sutures, clamps, retractors, Metz, bandage scissors, ovum, cautery machine, os, lap pads. Anticipate the needs of the surgeon, be snappy when serving the instruments, pay attention!

After scrubbing and gowning, I served the gown to the surgeon, then gloves after. So far, so good. The draping went well, and when I gave the first knife, cutting time had begun. First the skin, then superficial fascia, then deep fascia and muscle.

Bleeders were cauterized. I was to the left of the First Assist and was even allowed to sponge the surgical site when there was too much blood and the surgeon and first assist were busy with free ties. The room started to smell faintly like burnt flesh. I ignored it.

Secretly, I have a phobia with the sight of blood- although during NSVD and other cases I am still able stand it. During after the delivery of the baby, however there was a lot of it. The uterus looked like a small basketball with a vertical slice where the baby was delivered from.

As I served sutures, I was beginning to feel faint. Blood flowed generously from the side of the incision. The scrub nurse suctioned the blood while the first assist used one lap pad after another to absorb the blood. As the layers of the uterus were sutured, the surgeon started asking us questions- pretty basic actually: what are the layers of the uterus? which layer are we suturing now? The questions did not bother me, the blood did.

I began to feel extremely thirsty (and at this point according to those who were watching me, I looked pale as a ghost) so I begged for water. Blood was still oozing. There was blood on the instruments (which I mechanically began to wipe off with a wet os), blood on my gloves, pieces of flesh and clotted blood on my gown. My nostrils were assailed by the sickly sweet, coppery odor of blood.

Breathe. I willed myself. My heart pounded and I was afraid people could hear it.

My mates gave me water to drink. I drank a few drops with my parched mouth, and tried to control my fear. But it was too late, and my confidence was shaken. I wish I was like the first assist coolly assisting the surgeon. She looked so composed and skilled.

With both shame and trepidation, I stepped back a little. When the operation was finally over, I wiped the sweat off my brows. I decided not to be too hard on myself, I mean, if I'll feel bad just because I made one or two mistakes in a quiz, or beat myself up because I didn't do things perfectly- or that I got overwhelmed, I'd probably go crazy. There is a learning curve to this, and as far as conquering fears is concerned, the first time you face it is always bad. But like the past diving incident in Coron, the best way to conquer fear is to get right back to it.

So tomorrow, I go first on deck.


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