I was so excited that particularly Tuesday morning. I was going to scrub in with my favorite consultant in obstetrics and gynecology. She was my favorite because of her friendly nature. She made being a consultant look so cool. Forget about those other old school-fellows who bark, bellow and blame the intern for literally everything that is going on in the patient, including a fly that just landed in the ward. Folks I haven’t intimated to you how medicine is a deeply hierarchical profession. You might convince yourself that you are working hard to save a patient’s life but in the real sense, you are working your ass off to please your mean consultant. One day I will write about vehemence in medicine. I will write about my most difficult moments in the hands of my fellow human beings.
We were doing a secondary closure of a wound that had been infected after a prior cesarean section. It was going to be my first time doing an obs/gyn procedure outside cesarean sections and salpingectomies. Salpingectomy is literally cutting out the fallopian tube. It is usually performed as a way of birth control or in cases of ruptured ectopic pregnancies.
I had got to the ward early and made sure the patient was ready. My best friend was doing a procedure on the other side of the theatre. We love working together and this was one of those opportunities. The consultant remained unscrubbed to oversee whatever we were doing. I had asked one of the beautiful medical students to be my assistant. Dear readers, the operation field is a deeply intimate space. Sometimes you can literally hear every beat of your assistant’s heart. I was going to open my heart over those forty or so minutes that I was going to be there. I chose my assistant. I see my seniors doing that all the time.
The wound we were going to repair was very clean. It was actually begging to be closed. We cleaned the patient and draped as per standard operating procedures. The wound was quite deep, almost getting to the peritoneum, the cover of the intestine, and other abdominal organs. I asked for the scalpel. That moment was humbling. I was actually asking for a scalpel. It was surreal. I was a little slow because it was my first time doing such an operation. We refreshed the edges of the wound till they started oozing scarlet red blood. My hand was steady and sterile. By this time, I had started a small talk to break the silence between me and the medical student assisting. She was breathing hard and smelling nice. She participated actively in my small talk as well as the operation at hand.
I got to the base of the wound in no time. That is when the plot thickened. Our conversation was getting deeper and deeper but the operation was going south. My scalpel had gone a few millimeters deep and a sudden gush of fluid-filled the operating field. My heart skipped a beat and adrenaline set in. I knew I was in trouble. The fluid was straw-colored; I had nicked the bladder. Luckily for me, my consultant was watching every step of the way.
“Doc, don’t panic, take the size 3-0 needle and let’s repair the bladder and remember to keep the catheter for at least 14 days” She quipped.
I got confident. I slowly followed her instructions and beautifully repaired the bladder. I was terrified. In my entire rotation, I had never had such a complication. We finally managed to close the wound. The conversation stopped suddenly. We could not get back to where we were, we just wanted to get done with the operation and grab some food. The opportunity had gone. Taken away by an injured bladder. I longed for another operation, I longed for another moment with that particular medical student that was breathing hard and smelling nice. Why was she breathing hard though?