Monday, July 18, 2011

Getting into and surviving the operating room

I've known that I wanted to attend medical school for 4 years now. But seeing as I didn't have the required coursework, I've spent 3 years of that getting said required coursework. As such, I've talked with a lot of pre-meds. One thing that always boggles them is how I have witnessed so many surgeries and procedures as a pre-medical student.

Looking back, I guess I have seen a fair bit. I've seen robotic heart surgery, a tracheotomy, burr holes drilled, brain surgery, defibrillation, extreme limb trauma, a baby being born, spinal trauma, a split scalp and have even been present when a doctor informed the family of a loved ones imminent death. So how did I do all of this?

The answer is so deceivingly simple many people haven't thought of it: I asked. After setting my sights on medicine, I decided that I really wanted to see one of the Da Vinci robots in action. So I found the one practicing physician in my city trained in robotic heart surgeries and called him to ask. He checked with the hospital, checked with the patient and approved it. Simple as that, I was in.

Of course, the next challenge was that I had never actually been in an operating room before. Oh sure, I'd seen them on Grey's Anatomy and I'd even been a patient in them a few times, but I'd never been a witness. I'd never seen a living, breathing person being opened up; how would I handle this? I'll admit, I was a little scared. Whether I was more scared of embarrassing myself by fainting, or of totally screwing up something important, I couldn't say.

Here's my advice to all the pre-meds and/or medical students about to step into the operating room for the first time:
  1. Make friends with the scrub nurse. She or he will be able to give you pointers on where to stand, and cues about when to stay quiet and when to ask questions. They will probably be the ones to revive you if you faint. Be respectful, otherwise they may draw on your face with black sharpie while you are passed out.
  2. Don't touch that! No, but really, most likely you won't be touching anything in the operating room. Especially avoid touching things that are blue. Blue means sterile. Your hands are not sterile, no matter how many times you antibacterialized them today. No touchy. 
  3. Don't even touch the blue LEGOs
  4. Don't tick off the surgeon. I learned this lesson from an awesome nurse anesthetist: try to know your surgeon before going into the operating room. Does he mind if you ask him questions? Does she like teaching students? The surgeon is busy and focused, try to be mindful of that even when you have a question you want to ask so badly you think you might explode. Take a deep breath and wait until the surgeon isn't in the middle of sawing through a major blood vessel.
  5. You passed out; your life is now over. False. I've been told by many a nurse and doctor that many medical students or pre-meds faint their first time in the operating room. It is nothing to be ashamed of. Not everyone is meant to be a brain surgeon. (I get grossed out by dentists, ick!) If you think you are going to faint, get a chair, or better yet, leave the operating room for a little bit to get some air. Let the nurse know you are nervous. Make sure you're not going to fall on the life support equipment. Also, a common mistake I'm told is to lock your knees. As a med student or pre-med, you know what happens. You cut off the blood supply to your brain and wind up horizontal. Shift your weight back and forth slowly to keep the blood flowing.
After about 30 minutes watching the robotic heart surgery, I was just fine. I had forgotten about my nervousness because the surgery that was being performed in front of me was breathtaking. This was the first time I've ever seen the lungs rising and falling in a chest cavity. The first time I'd seen an artery taken out of the body. It didn't look anything like I thought it would. It was grey, and tiny! No bigger in circumference than a cocktail straw. Amazing how something so small could hold the key to life or death.

From then on, it just got easier to get approval to shadow doctors. I cannot overemphasize the importance of volunteering in a hospital setting. I learned HIPAA guidelines (essential for shadowing) and got references I could give to the doctors. In fact, some of the doctors I shadowed were people I met while volunteering. I'd notice the hospital department logo emblazoned on their shirt and straight up ask if I could shadow them. That's how I got my next shadow gig with a neurosurgeon.

Shadowing surgeons takes a lot of patience though. They are busy, busy, busy. Their schedules change erratically. I can't tell you how many times I showed up to attend a surgery that was cancelled. But finally seeing a lot of procedures I did made it all worth it. I now have another basis for saying why I think medicine is the right place for me. The excitement I felt during this shadowing was unlike anything I've ever felt doing engineering. I can't wait until I'm doing the procedures myself.

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