Once Upon a Time I was a Nursing Student

BEHOLD. An old journal entry from my semester in nursing school:

~~~~~

I’ve discovered two things about myself:

  1. Gore doesn’t bother me in the slightest.
  2. Ritz crackers and peanut butter do not constitute a filling lunch.

I stood at the anesthesiologist’s side, watching with interest as the doctor went at the leg with something that looked a heck of a lot like a soldering iron, a part of me still waiting for him to pull out a saw and start cleaving away. Logically I knew this to be a ridiculous assumption, but I’m still expecting something out of a revolutionary war movie, with bullet-biting soldiers waiting to have their gangrenous limbs taken off, no blue in site and doctors that have never heard of a sterile field.

Another moment of watching follows and I’m struck, inexplicably, by the thought that Ritz crackers are NOT enough for lunch. In the back of my head I start to visualize dinner, and I am only slightly horrified in a vague “I really shouldn’t be thinking this” sort of way at how easily I disassociate one from the other. I shouldn’t be hungry right now. But I can’t stop thinking that I am.

“So,” Dr. Stein says cheerfully, soldering off flesh as easily as though he were cutting through butter, “what is this here?” He points at the bone that I can see freely unattached to anything else in the leg. My answer is quick (“trochanter”) and wrong.

“Nope,” he says. The other surgeon clamps a suddenly spurting artery, already demanding a needle with thread attached to sew it off. “The trochanter is already gone. I removed it myself. This is actually the middle of the femur—it moved up with the removal of the head.”

I raise my eyebrows in surprise. I had no idea.

He goes on to question me on pressure ulcers, and I mostly fail to embarrass myself, though I’m struck dumb more times than I like. “I actually have no idea,” escapes my lips more times than I’m happy about.

Dr. Stein just smiles. “That’s fine.  That’s an honest answer.”  He goes on to explain, and even when he is not teaching the anesthesiologist – cheerful, short, and popping in a CD into the boom box in the background – explains what his job is. He and the nurse are my first experiences with the OR, and they’re both happy and willing to tell me things-that-I-do-not-know, which turns out to be a lot. Everyone in this room is incredibly helpful—I think they’re happy to have new blood around, and as equally happy about being able to teach. I didn’t expect them to talk to me, with this vague idea that I would be shoved into a corner and told not to touch anything. The nurse even tells me I can move around the room for a better angle, sets up a stool for me over the doctor’s shoulder, urges me twice to watch the sterile field (and I vow to myself, after the two close shaves, that she will not have to tell me a third time), and sets me up with the best spots. I tell them I’m a trained monkey, and with a few smirks in my direction, I’m told exactly what I can and cannot do.

There are a lot of people in this room—three surround the patient: the doctor (who says with a certain amount of groaning that he prefers cosmetic surgery to hacking off someone’s leg), another surgeon, and a third, younger man who spends most of his time handing the two surgeons clamps and supplies from the sterile supply table. Following this there are two nurses to make sure they have everything they need at all times, an anesthesiologist (whose job I have never truly realized is as life-and-death as the doctor’s until these four hours), and one nursing student who can’t believe she’s really seeing this.

I have seen the Operating Room innumerable times on shows and in movies, and the thought comes to me then that it is so much freaking cooler than on TV.

It’s more interesting, and it makes more sense. The doctor leaning over the patient, talking to the nurse over in the corner about her family, while the anesthesiologist watches the vitals, taking occasional notes and seeing how high he can turn up the volume on his iphone because who the hell brought this CD? There’s also less of the yelling and dramatic exclamations that TV doctors are prone to, with more joking and larger messes. I never thought about the fact that they don’t care about a mess of blood and flesh as long as it came from within the sterile field, and I can’t help but think it’s cool that arteries really do spurt suddenly. But the doctor’s only jerk out of reflex action when it occasionally hits their face mask, then calmly demand a clamp, ASAP please, and take care of it.

But it doesn’t really hit me that they’re amputating a man’s leg until the doctor’s got his hand on the bone, lifting it clear from the table as he passes it to the surgical assistant at the end, who in turn places it in a bin, and suddenly I’m struck by the thought that NO WAY THAT’S SOMEONE’S LEG AND HOLY CRAP THEY TOOK IT OFF.

“How’s the nursing student?” he calls over in my direction. “Still with us?”

“Oh yeah,” the anesthesiologist answers for me, looking at my face as I stare with eyes absolutely sparking with interest. “She’s just fine.”

I think they stop waiting for me to faint at that point.

In all, the surgery took four hours. I watched, stalking around the room, skirting the sterile field, as he separated the skin from the muscle he had left, first folding up the back thigh muscles then taking the front thigh muscles and flapping them up and sewing them into place. The skin was a puzzle piece, a little too large, and he took his time fitting it to the proper spot, cutting it down to size. It didn’t really strike me that stapling meant literal staples either, though I should have known better, until they were using the staple gun to keep it together (along with stitching as well). It made a sound remarkably like the sound my own stapler makes—a twanging ker-chunk, ker-chunk, ker-chunk.

It was essentially over then. I watched as they cleaned up, the primary surgeon stepping out as the rest took care of bandaging, cleaning the stump, taking him off anesthetics, and moving him to another bed.  I followed to after-surgery, only leaving as he started to wake up. I stayed long enough to have the nurse point me to the locker rooms, afraid that I would get lost within the bowels of the OR.

I had to step into the bathroom before I undressed. Because I had to know what I looked like. An OR nurse, maybe, or someone with more experience than me. In a surgical mask and gown, with blue scrubs and eyes that said she had seen something more interesting than you.

I laughed at the face in the mirror. Attack of the Lunch Lady, hair covered and mouth hidden, laughed back.

By 9 pm I was beat, ready to go to bed, and yammering at my parents into the phone. “Mom, mom! I got to watch the gnarliest surgery ever! An amputation.  And guess what?” I didn’t wait for her guess. “I’m not bothered by gore at all!

“Oh, honey,” she said. I could hear the wry smile in her voice. “I’m not surprised at all.”

And somehow, I like what that says about me.

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