My American Dream: 26. The Pain of Surgery

by Harijan

There was blood everywhere.

It was on the surgeon’s glasses.

On my gloves and gown.

On the surgery drapes.

On the floor.

In the abdomen.

There was even other people’s blood hanging from the pole which the anesthesiologist replenished in quarts.

You see, the human body need the liver to provide the clotting factors to stop bleeding. When the liver doesn’t work anymore, bleeding doesn’t stop. In medicine, we call this hepatic coagulopathy, clotting disorder arising from liver disease – or in the case of patient on the operating table, missing a liver.

I was in a liver transplant operation. This was the very first time I scrubbed into an operation.*

By taking out the bad shriveled up liver from hepatitis C, we took away what little ability the body had to clot. Unfortunately, the liver connects to some very large blood vessels.

This operation also happened to be at 2AM on a Saturday night. Despite the surreal view of human body in the deepest cavity and the blood, I was falling asleep with my eyes open.

The old senior surgeon and the junior resident surgeon did not seem as tired. They had focus and objective. Even at 2am in the morning, their hands moved faster than my eyes can follow.

Clamp, cut, tie, tie.

I just helped by retracting other organs from getting into the field of view and did my best to stay awake.

The liver went in. They connected all the pipes back together. Though all the blood vessels were tied, they still seem to continue to bleed. I couldn’t fathom how a body could live through that experience.

With the blood still oozing from the depth of the abdominal cavity, the two surgeons closed the surgical incision and sent the patient to the intensive care unit.

Driving home after that sublime experience, I thought it insane people stay up so late to do these kinds of surgery. It was definitely something that I did not think much about. I did not think I could do it myself if someone’s life depended on me.

I got home. I was exhausted. My feet ached. My back was destroyed. It was so nice to lay horizontal and make truce with gravity. My mind drifted into sleep despite the hallucination of anesthesia machine beeping to the rhythm of my own heart and my mind to the imagery of blood.

I saw the old surgeon a few days later.

“How’s Mr. Krietzki doing?”

The old surgeon said, “we had to take him back the next day to stop a bleeding vessel. I was hoping it would stop spontaneously. But… it didn’t.”

He gave a shrug, ‘what else can we really do?’

—-

That was four years ago. I was barely done with first year medical school then. Now I’m a surgical intern.

A week ago, a patients came into the hospital on a Friday night with severe abdominal pain. We had to go to the operating room urgently at 11am. He had a hernia in which a piece of omentum was stuck. The operation took 2 hours and I ended up driving home at 2 AM.

As I drove home, it was no longer a surreal experience anymore. It was a result of my desire to provide good care to that person. I was still just as tired, but I also had ownership of what I had done. Despite the bodily pain and mental exhaustion, it was what I wished to do. Despite all the sacrifices I had to make to be there, it pleased me to see the patient feel better when he finally woke up.

Again I fell asleep, hallucinating to the beating sound of the anesthesia machine. This time, it sang a lullaby as I drifted into sleep.

Beep, Beep, Beep…

*To scrub in means to wash one’s hands and arms meticulously then get into a sterile gown and glove without touching anything else.

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