rashid elhawli

The Operative Matter

The familiar smell was difficult to describe. It didn’t sting the nose, but it was sharp. It was not wholly unpleasant, though my nose did automatically screw up in disgust. There was something metallic about it, sickly. But it was also a little sweet. And most definitely meaty.

Well, they weren’t wrong when they said the smell of burning flesh was unique.

I rocked on my heels, blinking furiously. It wasn’t my first rodeo, but fatigue had still managed to creep up on me three hours into my time in the operating theatre. The surgical lamps were bright, but spinal surgery incisions were small, and I had never been particularly partial to prolonged exposure to bright lights. To add to the optical assault, I was observing the majority of this particular surgery on a monitor, as the surgeons needed a camera to magnify the site. The assistant surgeon’s words echoed through my head: “Now Priscilla, if you feel faint at any time, just let us know and go sit down on the floor so you don’t fall on anything.”

You’re not faint, I told myself. Just a little sleepy.  The surgery will finish soon, just hold on.

I’m nothing if not stubborn.

Just as I mentally prepared myself for at least 45 minutes of pure concentration, it began.

Right there, on the centre of my forehead, sitting perfectly on my hairline, was a little niggle. As it came under my attention, the little niggle became a little tickle, and the little tickle became a little scratch, and before I knew it, there it was:

An itch.

I started to feel an unreasonable amount of panic. I was scrubbed in, completely sterilised in that tiny area from chest to belly button, including my hands, which were resting in that awkward position just below my chest that made me appear as if I was constantly timidly trying to ask a question. My head on the other hand, was definitely not sterile. I legitimately had an itch I could not scratch. Could I ask the nurse? Was that rude? Or should I just suck it up and practice some mental endurance?

I chose the latter, convincing myself I was actually being stoic. Besides, imagine the little story I’d be, going around the staff lounge: “We had a medical student once and she scrubbed in, but then had to contaminate herself because she had an itchy head.”

I had never been so concentrated on meditated breathing in my life.

Fortunately, I was saved by the completion of the surgery. The surgeon de-robed, and I was given the opportunity to stand at the table opposite the assistant surgeon, with the immeasurable privilege of snipping his stitches. I say this with some sarcasm; however I did feel much more useful than I had ever felt shadowing other surgeons. When the doctor you have been assigned to puts just that little bit of extra effort to include you in their work, you a) feel like you are part of the team and not a curtain on the wall, and b) learn something.

This is what I have found to really alter the attitude that a lot of medical students have towards their placement. It is a complex balance between the student’s determinations, their interest in the rotation specialties and very importantly, the attitude of the team they are attached to. I personally have flourished and been much more accomplished in the rotations where I had friendly, welcoming teams who made it their job to ensure I played a part.

That being said, it cannot always be expected that doctors will pay much attention to you. Medicine is a time-consuming profession, and in the end, it is probably more appropriate that a patient takes priority over the hapless (and frankly useless at times) medical student. Doctors are busy, and when that happens to be the case, it is up to us medical students to take just a tiny little more initiative to make the best of the situation.

Sometimes it is difficult. The challenge I have often experienced is the willingness to actually turn up to my timetabled clinics, or rounds or surgeries when I have little interest in the specialty. But what I have been learning is that it is not the specialty, but the people who practice within it that make it interesting. I enjoyed my hours in that operating theatre, and was genuinely disappointed when their morning list was over. And that was unexpected for me, as the previous day I had been in theatre under a different doctor and been completely bored out of my mind. It is definitely worth remembering, I think, that it’s not the work that makes the job, it’s the people.


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