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Slack Tide: Emergency surgery

Posted: September 8, 2012 - 11:00pm

Nurse, send in the next patient.

Ah, come in. Please, sit down.

Well, I have your test results right here and, frankly, they could be better. Now, relax. Nothing major. Just a slight — slight — irregularity in your heart, lungs, pancreas, liver, gall bladder, kidney, thyroid and large intestine.

And small intestine.

And large intestine.

Did I already say large intestine? Hm. Let me check my notes… Yeah, it’s really bad in the large intestine.

But not to worry. I scheduled you for emergency surgery first thing tomorrow morning. In fact, I will be performing it myself. Now, if you could sign these consent forms… Here and here.

Something wrong?

What’s that stuff on my face? You mean this stuff? Oh, just a little tissue paper. Now, if you could sign these consent forms… Here and here.

Look, if you must know, I cut myself shaving, okay? It’s nothing. Actually, it’s usually a lot worse. I don’t know, I never quite got the hang of shaving. I sort of just go in there and hack away for a while. Funny you should suggest that — I do use an electric razor.

You look worried.

Tell you what, why don’t you sit back down and let me explain the procedure. You’ll see there’s really nothing to fear. Sound good? Excellent.

Okay, once you’re in the operating room — also known as the “surgical theatre” — we’ll put you under anesthesia, very standard. Then, I’ll shave the area. Ahem. My assistant will shave the area. After marking the site, I will then make a small incision right above the…

Damn! That is so annoying. This button keeps falling off my lab coat. I keep sewing it back on and it keeps coming right off — it’s like my stitches won’t hold or something.

What?

Oh, I get it. My stitches won’t hold. And I’m a surgeon. Ha-ha. Droll, very droll. But seriously, that’s not even a concern, my friend, because in your case we’ll be using surgical staples.

Which reminds me, I’d better put your file together right now so the nurses can start prepping the surgical theatre — see how nice that sounds, with that slight British inflection? Prestigious.

What the?! Man, this stapler always jams. No, I’ll get it. I just need to slam it a little harder. Grrrrr. Maybe if I stomp on it with my foot! Ah! I hate this thing!

Yeah, it’s definitely broken now. I hope I don’t have the same problem with the surgical stapler. I can’t afford to replace another one. They cost a lot more than your run of the mill desk stapler. I didn’t know that.

Wait, where are you going? We’re just getting started.

Please. I know you’re concerned, but rest assured, I’ve been practicing medicine for a long, long, long time. I bet you didn’t think I was that old, right? Seriously, my family wants to put me in assisted living, but I don’t want to go; I think I’ll miss yelling at the all the neighborhood kids to stop rollerblading on the damn sidewalk.

Why are you laughing? That wasn’t a joke. They really do want to put me in assisted living and I really do think I’ll miss the neighborhood kids, even though they keep rollerblading on the damn sidewalk.

Okay, now, where was I? After the incisions, we loosen the abdominal fascia so we can spread your ribs with a, uh… what’s that instrument called again? You put it in the ribs and then you use it to spread them…. It’s on the tip of my tongue… No, not a rib-spreader… Whatever, I’ll think of it later.

Second opinion? Nonsense! Now, look, for a patient to feel anxious right before undergoing major, complicated, very risky emergency surgery, why, that’s perfectly par for the course.

What golf pun? I don’t follow.

Frequently, I find my patients feel better if they spend the time leading up to the procedure engaged in a relaxing activity, something they really enjoy. That can really help clear your mind.

Take me for, instance. I like to cook. It really calms me down and helps me concentrate. And believe me, you want full concentration when you’re two knuckles deep inside some guy’s duodenum. Although, I really shouldn’t discuss details of my private life at the office.

Excuse me, is there any way you could stop nervously drumming your fingers like that? It’s making me awfully anxious. In fact, you don’t mind if I cook a little right now, do you? I could definitely stand the stress relief.

Also, the radiology unit is having a potluck dinner tomorrow night and I promised to bring my famous meatballs. The key is vigorously kneading the raw ingredients together by hand. Thanks for letting me get a jump on it. Just pretend the giant mixing bowl of ground beef isn’t here. Or the tubes of sausage.

Right. So, after we’ve opened your chest cavity, we suction the excess blood and burn closed any spurting vessels. Then, we retract the organs before we reach in and pull out the… Oh, man. I just love the feel of meat. Putting my hands in it, gushing it around. I love the sensation, all warm and slimy and bloody, squeezing through my fingers. It’s so primal, know what I mean? It’s so…

No, wait, I think you’re right. It was a rib spreader.

Wow, these meatballs really are helping me think. But the best part is mixing in the breadcrumbs. Oh, no! The breadcrumbs! I completely forgot. I’ll have to pick some up tomorrow afternoon. Let me just make a note of that here — better not wash that hand. I’ll just note that on my other hand — better not wash that one now, either.

What? What’s the big deal? If you ask me, Americans are way too obsessed with hygiene.

Oh, hey, please don’t cry. I know what you must be going through. Everything’s going to be fine, I promise. Here, let me get you a tissue. It’s no problem — I’ll just peel one off my face.

No?

In that case, if you’re feeling better, I guess I’ll see you bright and early tomorrow morning. That’s assuming my hysterical blindness clears up. It tends to act up in stressful situations. Truth be told, the lights went out for me right after I said “Nurse, send in the next patient.” But I should be perfectly fine by tomorrow morning. And if not, I have a service animal. A helper monkey, actually. I call him “Nibbler.”

What’s that? You’d like someone else to perform the surgery? Well, I suppose we could have Dr. Reed scrub in. You know, Dr. Reed? Top surgeon, Harvard Medical School, residency at Johns Hopkins — 20-20 vision, 100% of the time?

You do realize, of course, that Dr. Reed is out-of-network. You’d have to pay the balance yourself.

I thought so. See you tomorrow.

• “Slack Tide” runs every other week in Neighbors. Read more of Geoff Kirsch’s work at www.geoffkirsch.com.

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