Posts Tagged ‘OR’

The other side of the OR door

May 31, 2010

I’ve often written of how surgery day is excruciatingly long. They may tell you that it will take four hours, but that is rarely true. And every minute seems to drag as you wait for news of your loved one. You just want this to be over – but nothing good comes of a short operation. The longer, the better – the doctors are still working, still fighting for you. A short operation could mean that the fight is over and the good guys lost.

It’s the same on the other side of the Operating Room door. When you are waiting, just standing there twiddling your thumbs, time drags. When surgery begins and everyone has a job to do, time flies. “Five people working as one unit,” Gene Hackman said in the movie Hoosiers, and a Surgical Unit is a team in every sense of the word. Everyone has a job to do, and when you work together long enough, you even begin to think together. In this article appearing on, Dr. Bruce Campbell explains that time distorts in operating rooms, too. But it seems to act in reverse:

I look up at the clock. ItĀ seems like only a few minutes have passed since I had anxiously waited to begin the case. Five hours have disappearedĀ like an instant.

Go and read Dr. Campbell’s work.

Two Clocks

November 12, 2008

“How long has he been gone?”

“Five and a half hours… maybe a little longer.”

“I’m getting worried, they said it would take about four hours.”

“I was just thinking the same thing.”

Heart Moms and Heart Dads, have you ever had that conversation? Who hasn’t? Whenever your child is taken from you for surgery, time seems to slow down. The first hour may actually be the hardest: the more time that passes, the more sure you can be that something didn’t go wrong at the outset. To quote Tom Petty, “The waiting is the hardest part.” Then as the operation goes on longer than we expect, the tension level moves to an incredible high. It’s taking too long. There’s a problem. We would have heard something by now.

For our loved ones, the goodbyes come to a climax when we reach the door with the large WARNING! sign. Where they can go no further with us, because beyond is a sterile area that only hospital staff and patients can enter. Where they turn us over to the surgeon and his team with no guarantee of what may happen next. They tell us that they love us, and everything will be OK, and they’ll see us later, and hope all they’ve said will be true. And then it’s really time, and I’m sorry but we have to go now. And when that door closes behind us with a loud click, real time stops and waiting time begins.

Start the Clock.

But while Mom and Dad are being shown to the Surgical Waiting Room and being told that someone in the OR will call with updates, there’s a whole lot of…. nothing going on. More than likely we’re just on the other side of the WARNING! door, waiting. A surgeon who is worth his salt – and he wouldn’t even be here if he were a slacker – is not going to be rushed; he’ll take just as much time as he needs, thank you. And besides, “the operation” is the entire process, not just the act of cutting and stitching. Records are being checked, double checked, and even triple checked to make sure that the patient and the scheduled procedure match. We’ve probably been lightly sedated (no one wants to chase you down the hall if you change your mind at the last minute) but we are still awake. The Anesthesiologist may stop by for a few words and to reassure us, one of the surgical assistants may lean over our gurney to say hi, and he may even ask us who is our surgeon and what are they going to do to you today? You mean you don’t know? you think, suddenly worried, but don’t fret. It’s just another safety check.

We’re still conscious when we are wheeled into the operating room. First they aren’t sure what they have planned and now we’re going into the OR awake? That’s normal. The Anesthesiologist can put you under at any time, and they would rather wait as long as possible. The less time you’re knocked out, the better.

Finally you are unconscious, the surgical team is ready, we’re certain that this is the right patient, all the equipment is functioning, and we have a backup available in case anything malfunctions. Scalpel, please.

Start the (real) Clock.

You don’t rush a surgical procedure, especially heart surgery. Surgeon Sid Schwab has written of how at a critical moment, he stops and double checks everything. Extra blood, more clamps, IV fluids ready. Music off, and everybody make sure your brain is online and functioning. There are also various safety rules that are followed, such as the “two sponge” rule. You count your sponges before you start and you always place two sponges in the body – even when you only need one. By using two, anytime you count sponges and get an odd number, STOP! One’s missing, and it could still be in the patient’s body.

Operation finished, you’re stitched up. Someone is on the phone to Recovery, making sure there is a bed open and alerting the people there another surgical patient is coming down. Another call goes to Surgical Waiting, where they tell your family that everything went well and the surgeon will speak with you soon.

“Good to see you,” your family says, leaning over your bed. You can’t speak because of the breathing tube pushed down your throat. “You had us a bit worried, it took longer than we thought it would. But everything went great.”