Finishing up my evening in the operating room usually consists of walking around and pickup up everyone’s trash they left behind from the day and putting it up properly. Inside my mind making voodoo dolls for every staff member who utilizes their room like a toddler, waiting on their mother to come behind them and clean up after them. Desperate to make changes and accountability for this waste of time I am spending and knowing that in administrations eyes it’s “not really a problem”. Continuing to reinforce bad behaviors, and no change to be had. When I get a text from charge, “We have a add on”.
Walking to the board hoping it is a general case, even neuro at this particular facility, when I see it is GYN. I am immediately filled with dread, knowing the GYN group that comes to this facility are a nightmare to work with. I’m pretty sure GYN’s residency consists of delivering thousands of babies and doing maybe six or seven surgeries. As the minute they step foot in the operating room we are all holding our breath in hopes nothing bad happens.
It’s an ovarian torsion, not too complicated I said to myself. The ovary has become twisted and cut off blood supply to ovary and causes the patient intense pain. I begin reading the chart, very young girl, early twenties, labs look okay, waiting on the PA(physician assistant) on call to arrive to begin. I have a male scrub tech Matt with me, who is also a traveler, equally dreading the case as well. We are set up, and ready to go.
Arriving to preop, and seeing this young woman in immense pain, holding hands with her husband, giving each other hugs and kisses before we roll her off to the operating room. Him promising her everything will be okay, and I pray to myself, hoping he is right. Getting into the room and we go to sleep, position, and in walks the surgeon. Dr. X is cheerful, greeting everyone in the room. I verify a harmonic is all she will need to complete this procedure; she validates that and scrubs in.
Arriving to the field to meet the PA Steve, then asking Steve, “Well, how does a general surgeon usually access the abdomen?” I look at Matt, we lock eyes, filled with dread, and desperation to get through this case. Dr. X attempts to access the stomach with trocar, struggling, and every poke I’m praying we aren’t going to enter the bowel. She continues to prod Steve for help, Steve takes the trocar and accesses the abdomen for her. Steve places all three trocars, and the banter exchange appears to let Dr. X believe she is still in charge, when clearly Steve has taken control of the case.
Finally in the abdomen, and belly insufflated, I breathe a small sigh of relief. This is usually one of the riskier parts of the case. Camera in and Dr. X is looking down and identifying landmarks. Running into small adhesions, Dr. X is looking stressed. Steve guiding himself, with endoscopic scissors, showing her how general cuts them down as he completes it for her. Finally arriving at the uterus and ovaries.
Dr. X begins to assess the ovaries, looking at them, and picking them up one at a time. Steve letting her take the helm as we are at her specialty organs, this is her department. She asks for the harmonic and picks up a fallopian tube, Dr. X asks Steve “Does this look right?”. My heart picking up beats, looking at Matt who is scrubbed in, both feeling like this could be the lawsuit that we both get called into court for. Steve responds “That is not the correct side and moves her harmonic over to the other ovary.” Guiding her through cutting and burning off the strangulated ovary.
Dr. X is now complete, thanks everyone and leaves the suite. I walked up to the field, and told Steve great job on his surgery, and he smirked. I told him that if he wasn’t here, I don’t know what would have happened. Some places don’t have on call PA’s overnight, and he basically saved this woman’s reproductive life. I wonder how many of these situations are happening all over the place, and patients have no idea. To place your precious life in the hands of who you hope is a skilled surgeon is always a roll of the dice. Are you going to get a surgeon who will get you safely through your time of need and leave you intact to live a happy fulfilled life, or get one who asks the room “Does this look right?”.