09 May 2013

Non-standard operating procedure

It is my surgery rotation. My team consists of a number of surgery residents and myself. Until today, I had been spending the rotation observing my team's residents in clinic, on the wards, and in the operating room.

At our academic hospital, when a surgeon (an attending physician) operates, they are expected to have an assistant (typically a surgery resident). My team made a last-minute request to have a procedure added to the day's operating room schedule. By the time the operating room coordinators granted the request, everyone on my team was tied up, except me. Who would assist? The surgeon asked me to change into scrubs and meet her at the operating room.

I was beaming as I raced to the cafeteria to cram in some food (one should not operate on an empty stomach) and then scampered up the stairs to the operating suites.

Few medical students ever have the chance to serve as "first assist." This procedure was a good one for me because it was relatively brief and low-risk. I threaded catheters and stents through the patient's body, tasks that involved a fair amount of dexterity. I also inserted tubing that drained the patient's bladder, and mixed and injected medications. The surgeon and I had to communicate well, because our tasks involved complicated steps and movements that we needed to perform simultaneously. She also had to trust me, because my hands often were out of her field of view.

The procedure ended, and the patient was moved off the operating table. I thanked the surgeon for letting me join her and she congratulated me on a job well done. She said that the next time we did the procedure, I would be the primary surgeon and she would assist. I don't think she was joking.