February 5, 2015
Written by Vickie Nguyen (class of 2014-2015)
My first OREX day was an absolutely terrific and most magnificent experience I have yet to experience at Highland Hospital. Though the surgeries themselves were a great spectacle, I couldn’t help but note down a lot of things that may be trivial to all those who work in the OR, but to me they were really quite interesting. In comparison to 5E and SDU, the department I have been volunteering for the past couple of months, I couldn’t help but notice how CLEAN everything was. And I mean CLEAN. Hospitals are normally thought to be clean places, there are so many sick people entering and leaving, and I know that it’s very hard to maintain a sterile environment. The operating room however, is seriously no joke. Everything was pre-packaged, everything sterile was blue, everything was systematic, and everything was carefully and preemptively thought out. I admired the environment and the precautions taken to ensure prevention of contaminations and infections that could jeopardize not just the hospital’s reputation, but human lives! The thought process that goes into designing an OR and what goes in the OR is absolutely magical to me; it takes a lot of brilliant and practical minds to prepare an environment as such. To the say the least, I’m really happy to finally know what the inside of an OR looked like.
Upon entering my first surgery observation, I reminded myself to remain very calm. Standing in the middle at least five feet away from everything, I analyzed the room and carefully made my way to an area as far away from blue so that I could get a good view of the patient without contaminating anything. Dr. Lee introduced himself to me and told me the patient had large masses developing at the site of where he received dialysis, his left forearm. This is also called a renal fistula. Dr. Lee said the masses growing maybe due to an infection and that him and Dr. Harken would be able to figure out the source of growth with this surgery. I watched Dr. Lee as he felt the masses, slightly pushing on the masses and methodically moving his way up and down the arm, even in areas where there was no lump. He told me that the vein in which the patient received dialysis felt hard. Both Dr. Harken, Dr. Lee, and Nurse Ruthie made their way to the operating table. With just an arm exposed in a sea of blue sheets placed atop the patient, they began.
Dr. Harken drew lines such that the end product looked similar to that of standing waves. Dr. Lee then used a scalpel to cut the patients skin, carefully following the lines Dr. Harken’s lines. Next, Dr. Lee used a device to separate the skin surrounding the mass, revealing an enlarged vein. I now realize the device is called a cauterizer, I thought it was kind of cool and weird to see how easily it separated skin and let off smoke… In the middle of all this, another person joined us, he turned out to be a medical student, it was his first time seeing a vein removal too!
The first piece of the vein was removed, and Dr. Harken pointed out the graft that was placed INSIDE of the vein to prevent the clot. Unfortunately for the patient, the graft did not help with that, because when the medical student squeezed the second piece of vein, a large, squishy, dark, and thick clot of blood came out. AND THAT, my fellow Orexers, was the cause of the huge growths. Prior to the removal, I should note that there were four noticeable masses lined up on the patient’s inner forearm. The largest of the masses were the middle two, the size of the masses…imagine cutting a decent size boiled egg in half, hot dog style, then placing that half on your arm. That big.
In total, three pieces of the vein were removed from the mans arm, each end of the remaining ends of the vein were stitched closed by Dr. Lee. And for those of you wondering, what happens when you remove a vein? Don’t we need it? (At least those were the thoughts running through my mind) We actually don’t need it, there are other veins in our arms, and instead of the blood running through the severed vein, they’ll just find another vein to flow through!
I attended five other surgeries afterwards, all are definitely worth talking about, but there was one particular surgery that I felt was truly unforgettable.
I was on my way to the cafeteria to grab a quick bite before heading back to one last surgery, and Dr. Krosin actually stopped me and asked if I wanted to join him on his hip replacement surgery! Of course I said I would love to! I rushed back to the OR, and tried finding my way to OR #1. Instead I found myself walking into Dr. MacDonald’s nasal polyp removal surgery. He allowed me to watch him in two other surgeries that day, and I decided that I would stay because I thoroughly enjoyed the way he talked through the surgery and gave his resident pretty helpful tips. (It still would have been awesome to see the hip replacement surgery, hopefully I have a chance to watch another time.)
The patient had severe polyp growth in his nasal cavity, to the point where he had chronic headaches and could not breath out of his nose. Before the surgery took place, a resident, Dr. Zerhouni showed me an MRI of the patient’s head. She pointed out how the nasal cavity of the patient was grey in color, and it shouldn’t be. It should instead be black in color, which represents air. The grey color denoted liquid that filled up the patient’s nasal cavity, very abnormal and is the precise reason why he was in the OR that day.
Dr. MacDonald used an endoscope,a device with a camera and light on the end, so I got to enjoy most of the surgery on a big screen. First impression was that it would be a short surgery, because Dr. MacDonald’s previous surgeries were much shorter than the other ones I experienced. The surgery ended up being over two hours long. One by one, Dr. MacDonald began removing these milky colored polyps from the patient’s right nostril, and it seemed as if these polyps were just attached via mucus-like strings. Each polyp removed was taken by Nurse Nina, and she placed them in jars to be taken down to pathology. While performing the procedure, Dr. Macdonald carefully talked through it to Dr. Zerhouni, and eventually she took a turn at removing the polyps in the left nostril. This procedure was drastically different from the vein removal, it was very microscopic and it required a lot more technological instruments. It reminds me how blessed we are to live in an era where we have so much access and knowledge to such useful instruments that are used to save and/or better human lives.
Nearing the end of the surgery, I remembered both the assisting nurse, Wendy, as well as Dr. MacDonald acknowledging how much this surgery is going to change this young man’s life. Though this was not a typical life-saving surgery, it was a one to enhance this person’s quality of life. I felt that the first surgery I attended was a lot less humanistic in comparison to the polyp removal. I’m not saying that Dr. Lee and Dr. Harken are robots, but I think the way Dr. MacDonald kept mentioning how much better off this man is going to be after this surgery is what really opened my eyes to what surgery can do aside from saving a life. Certainly anyone or anything can live, but I think that the emphasis on the quality of life is sometimes forgotten.
Overall, I find that my first day of surgery was successful, inspiring, and it’s left me craving more time in the OR.