Allies in Care
sted by jdtaylor on September 11, 2013
As a citizen born and raised in the South, I’ve learned that as long as I’m in a foreign land of the North West, I should, more so than not, keep my mouth shut. This is especially true when discussing politics, religion, same sex marriage, or practically anything that is of a family oriented, or conservative nature. So when a fellow (conservative) countryman steps up to help me out, it’s a pleasant surprise.
Today I was working with the general surgery team. We started out with a simple laparoscopic removal of a gall bladder. Once we got to the meat of the case, the surgeon found several small abnormal nodules. We took a biopsy of one of nodules on the abdominal wall and sent it to pathology. On further inspection, we found the nodules on the liver and pancreas. While we were waiting for pathology, the surgeon told me to call the oncologist on call “to come by and take a look.” It didn’t take a crystal ball to see what was coming next. I asked the surgeon what were we planning to do, based on the findings from the path lab? In the OR, the circulators job is to anticipate what is about to happen next, and get the needed instruments before the they are actually needed. At an operating room budget of forty-seven dollars a minute, the circulator has to do whatever it takes to keep the room working smoothly. I didn’t think that we were going to do some sort of liver, or pancreatic resection in an outpatient setting, but if we were headed in that direction, I needed to be ready. I needed to obtain a bunch of different instruments, call the family, give them an update and amend the surgical consent. All this was needed to be done before beginning anything that was even the slightest deviation from the simple gallbladder surgery we had originally planned. I thought to myself, “this is just great, it’s an hour from going home time and we are actually considering converting this laparoscopic case to an open for some serious tumor resection.”
The person behind the curtain, providing anesthesia is usually quiet. That is, he practically never attempts to influence the surgery or make even a suggestion to the surgeon. This guy was different. He just happened to be one of the two anesthesiologists from the South now presiding in Oregon. This guy saw my hustle and leaned over the curtain and addressed the attending surgeon. He leaned over the curtain and said with a slow drawl, “Hey, you guys look pretty serious down there. You know, my mamma use to say, if you see a bucket of shit just sitting there in the middle of the road, you had better walk way around it and whatever you do, don’t kick it.” The surgeon looked puzzled as the old guy continued, “If you are particularly butt-headed and you have an overwhelming compulsion to kick that bucket anyway, you had better be ready to smell like shit for a long time.”
The general surgeon looked a little stunned. The room was dead quiet for, what seems like an eternity. I could tell that the surgeon was angry, but I couldn’t help to laugh. I tried to not let anyone on the surgical team seem my face. The attending surgeon begrudgingly said, “OK, I guess I’ll call it a day. Lets close up here and get a referral to oncology for this poor guy. We really can’t do any more here.”
Yep, it’s fifteen minutes to going home time, and thanks to my friend from Mississippi, we’re going to end on time… and we’re doing what’s really best and safest for the patient to boot… life is good