Let me tell you a little secret. For a short period of time during my school days, I wanted to be a surgeon. Not only was it a glamorous thing to say to friends at school, but also a good way to impress my biology teacher and get a few extra marks in my tests and exams.
21 years later, I happened to be in an OR witnessing a fairly standard surgical procedure – the Cesarean delivery. I didn’t see much of the actual surgery though. I wanted to. The doctor instructed me to, ‘be near the head of the operating table, talk to wifey and don’t come in anyone’s way’ and wifey wanted me to, ‘hold her hands’ thru the procedure. There was a green cloth put as a screen near her chest and from the head of the table where I was asked to stand, it obstructed my direct view of the abdomen. I did catch bits of it though, the cutting of skin, the gaping hole which was held in place by the retractors, the plum-coloured uterus after the baby was delivered and the stitching at the end.
As an aside, if you are interested in reading about the Cesarean section, there is a nice essay by Atul Gawande that describes it (look for it 2/3rds into the essay). If you want visuals instead, here is a very nice video of it (warning – it’s a little gory and not for the weak-hearted).
I would strongly recommend you read the Gawande essay though. It gives some nice insights into why the Cesarean section is so widely used nowadays, why forceps deliveries are not that prevalent anymore and how a new born baby’s health and the clinicians performance is measured just after delivery.
Coming back to the OR, if you have seen a surgery being performed, you will really understand the true meaning of a surgical strike! It’s precise, quick, extremely well planned pre and post, each person involved knows his / her exact role in the whole operation. Yes, for a patient it might be an agonising wait, but, I as an observer was awed by the speed once it started.
This is what I observed…
First there is the pre-operation ritual… Everyone necessary is called in. They change into their surgical attire – sterilised green scrubs, disposable mask and cap, sterilised rubber clogs. In parallel, the necessary equipment and medicines are rationed in. Once these are ready, the prepped patient is wheeled into the operating room and arranged as required.
While this was happening, I saw the strangest little ritual, a person brought in cups of tea and all doctors who had changed into their surgical overalls, picked one and started chatting and joking which drinking it. Guess either Cesarean section is not that complex a surgery or all of them wanted a little relief before the intense activity ahead.
Then one by one, the doctors scrub in and make an entry into the room pushing the door with their butts. I saw, a pediatrician and his assistant, the obstetrician’s assistant, and an assistant surgeon do this one by one and enter the room to join an anesthetist and two-three nurses and a couple of other observers who were already in the room. I was the last one to enter without a scrub or a butt entry along with the obstetrician!
While entering, the obstetrician, who was leading the surgery, instructed me to keep out of everyone’s way. Once in, she ensured I was at an appropriate place so that I will not obstruct anyone.
Everything afterwards went like a breeze. A few cuts, pulls and pushes and the baby was out in minutes. Announcing the gender, the obstetrician asked me to note the time. Once the cord blood was collected, the umblical cord was cut and the baby handed over to the pediatrician. The pediatrician took him to another table, checked him thoroughly, wrapped him up and brought him back to the mom. While the mom got to plant the first kiss on the baby, I was allowed to click a few pictures. The baby was then handed over to the nurse who took him away. Sometime while the baby was being checked and while I was clicking pictures, the placenta was delivered and handed over to another nurse. Once this was done, the anesthetist knocked out the mom completely. The stitching completed in the next few minutes. And done.
The entire procedure probably took 15 minutes and this time wasn’t without its ‘light moments’. The anesthetist and the obstetrician called my wife’s bluff that she was in pain. Once the baby was out the obstetrician announced,’you didn’t listen to me, now there is a guy who’s not going to listen to you. Every one here is a parent and we know how it feels when it happens!’ The surgeon asked, ‘which loop of the suture do I cut I am loosing it it nowadays!’ And then there was this one thing I cannot forget, at one time during all the pulling and pushing, the petite anesthetist climbed atop the head of the table with one leg, rested the other on the oxygen cylinder and pushed on wifey’s stomach. I was so aghast and worried for her that I didn’t notice the baby had popped out already.
Net-net, it was the strangest operations that I have seen and one that I’ll probably pleasantly never forget.
