I'm amazed by what doctors do -- in one day, their work can swing from tragedy to joy. Perhaps the joys make up for the tragedies? At least a little? That's how I have felt just being an observer in a hospital.
One morning when I was shadowing a gynecologic oncologist at a teaching hospital in Switzerland, the doctor was called to the OR because she had to preform a scheduled mastectomy. Even though the doctor had earlier clearly explained the steps of the operation to me, when the call came, I didn't have time to think about what I would be seeing. I am not sure whether that was a good or a bad thing.
We went downstairs, changed scrubs, and put on a mask and hairnet. I was scared. I knew I had had some difficulty at the start of the last surgery I had witnessed (my very first time in an OR) when the patient's skin was visible for what it was -- the patient was visibly a "person," and not just a surgical problem. What I worried about on this occasion was that I would have difficulty watching what was clearly a woman's breast being removed. Because of my fear, I decided to sit down at the beginning of the operation.
Once the patient's skin had been cut, though, the doctor I was shadowing asked me whether I wanted to look, so I went up to watch from the head of the patient. At this time the doctors were pulling/holding the skin up in the air while it was still attached to the fat and other tissue so that they could cut more easily.
I found myself getting hot in the face. I tried to breath deeply IN and OUT, but I kept watching. As I did so, my face kept on feeling very warm and my head... I'm not sure how to describe it: It was as if my eyes had become very focused, yet totally unfocused at the same time. I didn't feel nauseous or dizzy, just weird, different. I decided to tell the anesthesiologist that I was going to sit for another bit.
In my defense, I hadn't had a full night's sleep the night before and it was only my second surgery ever. But perhaps more than that, I was having problems because, well, because I am female. The doctor had told me that this operation is an especially mentally demanding surgery because breasts are considered to be such a fundamental part of a woman's body. Even to me at age 14, a mastectomy was something that I could almost feel. It seemed like a violation -- even if it was a necessary one.
For the rest of the operation, I wanted to watch, but I didn't want to stand up because I felt a little faint. So, from my position I tried to see as much as I could. I looked in the reflection of the plastic glasses that the surgical team has to wear, and every time someone moved I would compensate so that I would have a view. I got a clear shot of the chest muscles at one point, which I have to admit was a bit shocking, but really cool and interesting because I could see so clearly the striations and therefore could easily differentiate between them. Then the doctor removed the patient's lymph nodes and finally sewed the patient up from the middle of her armpit to the other side of her breast. I watched this from the beginning to the end without difficulty, and I don't know why.
After the surgery was over, I followed the doctor as she completed paperwork, took a meeting and visited some other patients. It was then that she got a call that there was to be a C-section that I could watch. I joined two other doctors and changed into new scrubs and put on protective goggles and a mask. As we went in, nurses were finishing prepping the mother for the first incision. I went to stand in front of the mother, where I had a clear view of her stomach. She was awake, but with the anesthetic she could only feel pressure, no pain. A nurse came and stood next to me and answered all my questions. I surprised myself by watching the entire operation, including the first cut. The blood spurted a bit, but the doctor cauterized it all immediately. My face felt slightly heated, but I kept talking to the nice nurse standing next to me, and so I was able to keep steady.
The surgeon cut through the fat and the wall of the uterus and lifted out a baby girl. The father was ecstatic, and kept telling his wife how beautiful the baby was. The nurse who was standing next to me then suggested that I go with the baby nurse and the father to examine the baby and check her weight and height, count her heart rate, and check her color, breathing, reflexes and muscle tone. The nurse was handed a timer to make sure the tests were done exactly on time. The baby girl was so adorable, and I was ecstatic when I was asked to help the nurse measure her! First we stretched the baby out to her full height, and the nurse documented it while I held the baby's head. The nurse then weighed her and wrapped her in blankets.
The nurse then brought the baby out to her very happy mother. As the mother held her newborn, I watched the doctors finish sewing her up and then wheel her out of the operating room. Throughout this process, the baby was screaming, and I honestly wanted to cry at the noise. It was so loud and shrill, but truly it was one of the most beautiful sounds that I have ever heard.
That day, I couldn't help but think how scary and how miraculous it is to be a woman -- and I also couldn't help but think how wonderful it would be to be a doctor who can take care of women at the moments of their worst fears and their greatest joys.