Monday, April 24, 2006

He nicked The Ureter

In the realm of gyn surgery, The Ureter takes on almost mystical significance: Muscular tube just 3 millimeters in diameter! Propels urine from kidney to bladder! Runs precariously close to the uterus! The Ureter can easily be nicked by an overzealous surgeon during procedures such as hysterectomy.

I can't think of a single intraabdominally-approached gyn surgery in which an attending did not pointedly remark, "Look, [insert medical student's name], there's The Ureter".

Enter Dr. Austin Powers, International Man of Self-Aggrandisement. All pimped out in wool crepe trousers decked with sky blue pinstripes matching the precise hue of his Egyptian cotton shirt. Pimp Daddy. Pimpmeister. Pimp-o-rama-ain't-no-drama-wit'-yo'-mama. But I digress.

Long story short: he nicked The Ureter. No one said a word. If a resident or an intern had committed this folly, there would have been sharp reprimand and serious retribution. Instead, a SWAT team of urologists descended upon the OR and everyone donned lead-lined vests for the fluoroscopy-guided repair.

There was no further mention of the incident with The Ureter. His lecture on female pelvic anatomy was subsequently cancelled. Rather fortunate for me, as I would most likely have succumbed to my irrepressible urge to display this:

Friday, April 07, 2006

Contaminated

"You're contaminated!" says the OR nurse as my double-gloved fingertip accidentally wanders one centimeter south of the top surface of the operating table. She banishes me from the OR and I am relegated back to the scrub sink, destined to begin the elaborate scrub ritual once again. I start cackling inexplicably as I recall a streaming instructional video detailing the mysterious nuances involved in staving off contamination before surgery. You start with the requisite scrub brush, hermetically sealed in a little plastic package and permeated with the industrial cleaning solvent of your choice: povodine iodine, extra foamy soap, or the strange red stuff that resembles sweet & sour sauce. After scraping under each fingernail with the plastic stick, you scrub the tips of your fingers with the brush side (30 circular motions for each hand). Only then can you advance to the spongy side and start the serious scrubbing.

There is something uncommonly obsessive-compulsive about surgical scrubbing. Each finger has 4 planes, and each plane must be scrubbed 20 times. The palm of your hand has 3 planes, each of which must be scrubbed 10 times. Your forearm is divided into 3 parts, each of which is also scrubbed 10 times. Is the American Psychiatric Association aware that surgical scrubbing falls under the definition of compulsions as repetitive behaviors (e.g. handwashing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly?

I am tempted to make an anonymous phone call (handkerchief placed over my mouth in order to disguise my voice) to the Obsessive-Compulsive Disorder Police to turn these people in. For the sake of their mental health, of course.

"You're contaminated!" says the OR nurse as my double-gloved fingertip accidentally wanders close to the imaginary line extending from the sterile blue drape behind which the anesthesiologist is seated.

Bite me.