Resident Evil

Never get elective surgery at a teaching hospital during the month of July.  This is the time that all the new interns and residents arrive on the scene.  Their MDs degrees shiny and new, these smart men and women are nonetheless inexperienced as doctors, never having executed independently those skills for which they have studied their entire lives.   Although they introduce themselves as “Dr.” they sincerely hope their lack of experience and sweaty palms do not give them away.

My husband trains residents, so it was with my eyes wide open that I scheduled wrist surgery during the second week of July.  I had just competed in my first amateur piano competition, a task made difficult by the large and ancient cluster of ganglion cysts asserting themselves several compartments deep into my thumb joint.  I had but two choices:  have the surgery and risk never playing again or skip the surgery and know for certain that I would never play again.  The choice was a no-brainer for me.  I asked for the earliest possible surgical date so I would have the maximum amount of time to recover before the next competition cycle.

Surgery is scary stuff even under the best of circumstances.  I am baffled, maybe even sickened, by those surgery addicts glorified on television shows who have had dozens of unnecessary procedures.  I once saw a feature on a man who had repeated surgeries in order to transform his face into that of a cat.  I regret conjuring that image in my mind even now.   It is one thing to have a medically indicated operation.   Elective surgery, however, feels a bit like tempting the fates.  As my husband likes to say, “Random things happen randomly.”  There are good reasons why patients must sign informed consent forms.

So there I was on a Monday morning in July preparing for my worst nightmare—cutting my hand.  I had heard stories about patients waking up to find the wrong leg amputated.  Struck by a sudden panic, I grabbed a Sharpie pen and wrote, “Fix this hand” on my right arm, adding an arrow pointing toward the offending appendage.   Realizing that this would not be effective, I quickly switched the pen to the other hand and added, “Don’t cut this hand” on the left.  Thus tattoed, we headed for the hospital.

Once banded and dressed in green pajamas, I was taken to the pre-surgical area where I waited nervously on a table draped on all sides by curtains.  I was told the anesthesiologist would be by to start the IV.  Finally, a guy young enough to be my own son arrived and introduced himself as Dr. Delgato.  When he took my arm to inspect my veins, I felt the clamminess in his hands.  I tried to engage him in conversation, to relax him a bit.  I asked him how long he had been an intern (10 days).  As he prepared the needle I asked, jokingly, if he had ever done this before.  He blushed a deep red and looked down at the floor, mumbling “Of course I have.”

I do not enjoy being stuck with needles, but I can endure the discomfort for a moment or two.  My trick is not to look as it is being inserted.  I looked at my husband, hoping his deep blue eyes would get me through the deed quickly.  He, however, was watching the resident work.  Suddenly, he closed his eyes and shook his head.  The resident apologized, flicking my hand with his middle finger as if to imply that it was my vein’s fault that he failed to insert the catheter properly.

Embarrassed, he ripped open a fresh catheter and tried again.  I joked with him that I had all day, that I was not really looking forward to my surgery.  I braced as he tried again; I looked at my husband as he watched, a bit more anxious this time.  He set his jaw and shook his head again, communicating to me that the second attempt had failed.  I looked at the poor resident who by this time was beside himself.  I told him that I understand; after all, he has to learn on someone.  “Take your time,” I encouraged him.  A third catheter and again my husband shook his head.

Somewhat disheartened, the resident said he was going to try a different vein.  “Rehearsal is over,” I said, trying to keep the mood light.  “This one is for keeps.”  He flicked at the vein, this one a little higher up.  I assumed the position once again, gazing at my husband’s patient countenance.  Right on cue, my husband shook his head, his anguish turning to disgust.

I looked at the resident and as patiently as possible said, “I understand that you have to learn somewhere, but I feel as if I have now given my share.  This is your last chance.  After this, I let my husband start the IV.”  I watched as the young doctor took a cleansing breath, hoping that I would not see that he was losing his cool.  Thankfully, this time he prevailed.  Fifth time’s the charm!

I am writing this in honor of my nephew, Josh, who graduates this week from medical school in Miami.  He is coming to Boston to do a surgical internship at the same hospital where this story took place.  I want him to know that I would gladly trust him to stick a needle in my arm, if necessary.  But he only gets one chance!

Tomorrow's blog:  Amendment Won; We Lose