It is a splendor to behold. Hidden in the recessed bowels of the building. Down in the basement. Long halls with windowless rooms. Bright lights. Down here it is always daytime. The operating rooms of the University hospital live in the snaked caverns of the basement. The floors and walls tiled. Industrial cleaners creating a sterile space with a distinct smell that is somewhere between clean and pungent.
Instead of “operating rooms,” the British call them “operating theaters.” Some unseen people come out between shifts to keep this place orderly and clean. Between those shifts, the actors come on stage.
Entering as a medical student into the theater for the first time, I was filled with awe. One of the modern wonders of the world. In the operating theatre, huge lights hang from the ceiling on mechanical arms that adjust with ease and then hold their position like a strange mannequin. Steel trays hold instruments that might double as medieval torture devices.
The patient lays on the table at center stage under the bright spotlights.
The anesthesiologist puts the patient into an induced sleep. They are attached to a machine that breathes for them. Infusion pumps drip medicines into intravenous lines. Monitors track the heartbeat, blood pressure, and other vital stats. All these machines add to the background noise of steady hums and intermittent beeps.
Blue sterile cloth appears on the scene. They are a cross between cloth and paper — disposable, stiff, resists blood and fluids. The patient is draped with the blue cloth. Like set designers creating just the right backdrop for the theater… Draping is an art.
The anesthesiologist becomes the man behind the curtain.
If this is an operation on the abdomen, the drapes leave a square of only the part of the body that needs to be seen. The person is hidden away behind the drapes. Like the people who cannot see the face of the meat that they eat, the surgeons see only the part that they need to see.
Before we start there is something that you need to know. The first time that I saw a bedside procedure I nearly passed out. I had to sit down. This time, there was no place to sit. This was an operation that required a special room and a special team. Would I be able to survive my first surgery without ending up on the floor passed out? I didn’t say anything to anyone. I just prayed that this would be different. This would be ok. Will power!
And then it begins, someone starts the music. Yes, there’s music chosen by the head doctor.
Standing in our assigned places around the patient, the team of doctors includes the head surgeon, assistant surgeons, and then there was me, the medical student. All of us dressed in the garb of this place: blue hair and shoe covers, sterile blue gown, sterile gloves, face mask and visor. On the nursing team, the scrub nurse stands off to the side. Whenever the surgeon says “scalpel” and holds up his hand. One magically appears in his hand. This place has its own dance rules. Something that I would learn in time.
And then it really begins, the first incision is made.
Well, I didn’t pass out at the first incision. The body was opened, and for the first time, I could see the living insides of a human being. My science brain was fascinated by the details. My creative brain was shocked by the beauty inside this machine. I realized that the secret was the drapes. I saw only what I needed to see.
Surgeons fix things. They take an acute problem. In the best of cases, they perform an definitive operation. They help the patient recover. The patient can be cured by surgery. In the best of cases, surgeons are not left with chronic patients.
A strange thing happened to me as a medical student. While I did not think that I would like surgery, I loved it. Everyone said it would be hard. Yet, the technical skill that one must learn is like learning any art. The performance in that operating theater was a thing of beauty that I learned to appreciate.
I probably would have been a surgeon… if I had liked surgeons.
Stay tuned.