A few Mondays ago, I got to watch a man have his chest sawed open.
How’s that for a hook? Let me explain. As you may or may not know, I want to be a doctor when I grow up. I plan to begin the official studies towards that goal when I return to the States (of this I am 65-99% sure, depending on the day and hour), but I have been itching to have some kind of doctor experience in the meantime to see what it’s really all about. This is all a part of Figuring Out What to Do with My Life, and during moments of reflection, I ask myself, of course, Arianna, can you handle it?
A close friend here was helpful in putting me in touch with a cardiothoracic surgeon, Pierre, who invited me to observe a real, live surgery. I arrived at the Hospital San Bernardo that morning at 9 o’clock sharp, knowing only that the procedure I’d be watching would be centered somewhere in the patient’s cardiothoracic region. San Bernardo is a major public hospital here. A line of tired-looking people snaked from the lobby down a long hall in one direction, and all of the plastic lawn chairs that had been set up as a kind of waiting area were occupied. There weren’t any mangy dogs wandering around as in another public hospital I visited (on a quest for a yellow fever vaccine), but this place certainly looked like it could at least use a paint job. Pierre’s secretary met me at the entrance and led me to a doctor’s lounge, where I met one of the cardiologists, changed into scrubs, and waited.
When I got to the OR, two nurses (the only other women I saw in the OR all day) were busy prepping the patient, who was already unconscious. He was 52 and had had his aortic valve replaced in June of 2007, but unfortunately his new valve had some leaks that had to be fixed. I learned that valve problems are common in northwestern Argentina as a complication of rheumatic fever.
So, for the cast of characters: two cardiothoracic surgeons (Pierre and another guy), anesthesiologist (dude), cardiologist (man), two nurses (both female), and me. I don’t think anyone in that room quite new what to make of this American girl who was working as a teacher and had no background in medicine, yet wanted to become a doctor. Huh? That kind of story doesn’t really make sense given the Argentine system of choosing a career, which, like lots of other places in the world, takes place when a person is about 18. I’m 25 and haven’t even taken organic chemistry yet. And, I’m a GIRL. The anesthesiologist, who seemed to enjoy making me feel uncomfortable at first, told me I should just continue working as a teacher and not even mess with the whole medicine thing. He also asked me persistently how much money I’m making at my current job.
Pierre was put me on a step ladder so that I could see over his shoulder. I was about a foot away from the action. He asked me, just before the sawing began, whether I’d ever seen the movie Martes 13. I had no idea what he was talking about, then realized he meant Friday the 13th (here, it’s Tuesday instead of Friday). If I’d seen all the gore in that movie, open-heart surgery would be a breeze.
In the end, I neither fainted nor puked. I was determined to maintain my cool, partially for my own dignity, and partially to prove to these macho men that I could handle it. The surgery took a riveting, intense, and exhausting five hours. I’m not sure I’d ever want to be a heart surgeon, but I was amazed at the physicality and precision of the whole procedure. There’s the sawing through bones and the cranking open of the ribcage and the massaging the heart, and there’s the gentle separating of tissues and the stitching-up of miniscule tears. It was fascinating and intimate.
I can’t give a blow-by-blow because I’ll sound like a total novice, but here are some highlights and observations:
There are smells and sounds that happen during surgery that I hadn’t even thought of. Flesh was being cauterized at every step of the way, which made for a nasty burning-person smell. The sawing, obviously, made for lots of buzzing. There were also a lot of sucking noises, as one of the nurses was constantly vacuuming blood and other fluids out of the chest cavity (using a what seemed like a bigger version of what they use to suck excess spit out of your mouth at the dentist).
The patient went into cardiac arrest right after they finished opening his chest, which meant they had to use the defibrillators directly on his heart. He also went into some sort of anaphylactic shock right after they finished stitching his veins up, which made it impossible to normalize his blood pressure without giving him some kind of antidote. This is where I sound really professional. Anyway, there was lots of drama.
Watching the anesthesiologist first stop and then start the heart, and watching the heart muscle react, was awesome.
Standing for five hours is completely exhausting. I’m sure it’s even more exhausting to be operating on a person for five hours.
Doctors talk about funny things in the OR. Lots of chit chat. Lots of dark jokes. At one point, they had to dump icy water into the chest cavity, and Pierre turned to me and said (in English), “Heart on the rocks. Kind of like a bloody mary.” Stuff like that.
I could not stop thinking about how excruciatingly painful it must be to recover from a surgery where your ribs get sawed and clamped open, and where your tissue inside and out gets burned and cut. Ouch.
The whole experience was completely exciting, and the patient woke up feeling relatively okay after I left. I got an open invitation to watch more, which was an honor, and would’ve been a fantastic opportunity, except that a few days later the surgeon (who is married and has small children) began sending me inappropriate and embarrassing amounts of text messages on an almost daily basis.
I think that segues nicely into a post on gender relations and what it’s like to be a woman in Salta…