Tuesday, October 16, 2012

An Ascended Day in the O.R.

Today was a different day. I could see a difference in my place of work. And the collaboration and collegiality were off the charts.

Walking in: everyone said 'hello' with a smile. Sometimes that is the only one I get!

First case start: surgeon was not chomping at bit.
I was on time. Patient had to pee. We still got in the room on time (we get dinged for late starts)

Case 1: Cantankerous surgeon is in uncharacteristically good mood. Shares stories about their personal life. We still can't play the radio, because this surgeon won't tolerate anything but silence. But not being yelled at is good.

Cases 2-4: Again, remarkable change in attitude in 'the old coot'. Patients do well, and we are in 'flow'. I even get to eat a snack when I am hungry between cases!

Case 5:  Surgeon who is the sweetest, kindest, gentlest general surgeon that ever lived (who is also a lifetime vegetarian) has case go well.

Case 6: Same surgeon, technically challenging case. He apologizes to the room at the end, and everyone says, 'that was tough' and 'no worries--we'd be here in the O.R. anyway, and it might as well be with you'. Everyone leaves the case with a feeling of teamwork and having had a good day.

Case 7: Shhhh! The one I didn't want to get got moved to a Different Room! Without my asking!

Case 8: The scary one. As in, the one I came 'this close' to cancelling due to multiple serious comorbidities.  But the surgeons 'wanted cardiac anesthesiologist' and the boss picked me.  You know, this was the nicest surgeon! A new one, Vietnamese. Calm. Collaborative. Caring. We got everything done without him once throwing a fit. Trained with a famous surgeon who still operates today. And it is NOT Hillel Laks! A heart case is a lot more to take care of than a regular one. And although this one was a patient who NEEDED heart surgery, we worked on something else in the chest.

Case 9: After dropping off Case 8 in the unit, I was asked to place a central line. This patient had no venous access, and there was nobody in house but me that could do it. I stayed. It was in a patient who was as dry as a potato chip. A colleague from OB came up. And was so kind and gentle! 'This one is really hard to do--the patient is dry, and dialysis is going, and the patient is moving. This would be hard for anyone.' We got the ultrasound, and got something in. But it may have been clot in there making the wire difficult. After permacaths, large vessels can clot up.

The Magic of Case 8: Angry spouse has been waiting every since the surgery started. 'I hate this hospital!' and I apologized. I said I was on my way to see here when Case 9 came up, and it was tough.
Guess what I learned? There were even MORE comorbidities in that patient. What I did was amazing, anesthesia-wise. The spouse said, 'You need a hug? I need a hug. Let's hug.' And it was the highlight of my day.

Case 10: Colleague in trouble in PACU. I help hold for  him to place an arterial line. He misses and asks me. I get it and it slides right in.

I felt like a cardiac anesthesiologist today. And like, I was not from this planet! Everyone was kind and thoughtful, caring and considerate. I could get used to it!


Reiki Doc