Heard In and Around the OR

From Behind the Mask: The Mystique of Surgery and the Surgeons Who Perform Them written by Dr Gelber

Chapter 23

Muffled lives explode in understatements. —Paul Gray

In Pre-op:

The pre-op nurse will ask, “What surgery are you having today?”

“Repair of my hi-anal hernia.” (Hiatal Hernia.)

“Doctor is going to remove the fireballs from my eucha- rist.” (Fibroids of the Uterus.)

“Fix my piles.” (Hemorrhoids.)

“Suck out my gallbag.” (Laparoscopic Cholecystectomy.)

“Fix my erotic aneurysm.” (Aortic Aneurysm.)

When asked, “What’s your surgeon’s name?”

“I don’t know, he’s the one with red hair and glasses.”

screenshot723Before starting surgery:

When a general surgeon says, “This will only take thirty minutes,” it means, “It will take me thirty minutes assuming this tumor is in the sigmoid colon where the GI doc said it’s supposed to be. However, it could be in the stomach instead of the colon, so call Dr. Smith, who’s following my case, and tell him he’ll have plenty of time for lunch.”

When an Orthopedic surgeon says, “This will only take thirty minutes,” it means, “We’ll fix this and then get an x-ray and then do it again until I figure out which bone is connected to what; it will be at least three hours.”

When a plastic surgeon says, “This will only take thirty minutes,” it means, “It will take me thirty minutes to set up my camera. The surgery will probably four or five hours.”

Things heard during surgery and what they really mean.

Anesthesiologist to surgeon: “Is everything OK down there?”

Translation: “The EKG is flat, there’s no blood pressure, and you’d better start CPR.”

Surgeon to anesthesiologist: “We’re having a little blood loss.”

Translation: “I just cut the vena cava and you’d better call the blood bank, get the cell saver and a priest.”

Surgeon to no one in particular: “That’s not supposed to be there.”

Translation: “Call my lawyer, malpractice carrier and my mother, I just cut the Common Bile Duct.”

Surgeon to anesthesiologist: “He’s waking up.”

Translation: “Put down the Wall Street Journal and turn up the gas before the patient walks off the table.”

Surgeon to OR crew: “This is a new procedure; it may take a bit longer than usual.”

Translation: “I’ve only seen this done once before and I was hung over at the time.”

Surgeon to assistant: “This is a particularly difficult case.”

Translation: I haven’t the foggiest notion of how to proceed. Take over, I’m going to the bathroom.”

Circulating nurse to surgeon: “We’re out.”

Translation: “You don’t need that, you old fool, and even if you do, I’m not walking all the way to Room 12 to get it.”

Surgeon to anesthesiologist: “Put another quarter in your machine.”

Translation: “I’ve got at least another hour to work and the patient is awake enough to assist me.”

Anesthesiologist to surgeon: “This patient’s very high risk, but I think we can manage.”

Translation: “I’ve got vacation coming up and business has been slow.”

Soft “whoosh” . . . (Silence).

Translation: I’ve just cut the (choose one or all) aorta, inferior vena cava, and portal vein.” The “whoosh” is the sound of bleeding; the silence is the sense of doom. It is permissible to replace the silence with “Oh Shit!” Or any other similar epithet.

Such utterances are, fortunately, extremely rare. When something unexpected happens the greatest effort is made to maintain a calm, workmanlike atmosphere which explains the tendency to seemingly understate the gravity of the situation. As long as channels of communication are maintained between the members of the OR crew, the patient will receive the utmost attention.

Feel free to add to the list.

OnSurg thanks Dr Gelber, Heard in the OR author for permission to re-post from his blog. Dr Gelber has published two books “Behind the Mask: The Mystique of Surgery and the Surgeons Who perform Them” and “Under the Drapes: More Mystique of Surgery”.

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