THESE CRAZY SURGEONS

Though I never liked surgery, as an intern in surgery,during that summer of 76, at medical college,kottayam,I hurried to the theatre around 8 am.The theatre is the only place which comes to life the earliest, with the matron efficiently supervising the nursing staff and the orderlies running around, preparing the theatre with the silent monotonous efficiency, with the stainless steel drums with the packs and instrument trays boiling and the autoclaves being deloaded,everyone dressed in bright green pajamas and gowns,masks and, caps concealing their identities,the atmosphere reeking of spirit and phenol.It is a world in itself with the death and decay as its only sentinels.The 8 tables ready and the first anesthetist[the protector] already waiting for the chief surgeon.As I hastily scanned the operation list for that day about 28 patients had been posted for the day with 15 of them major surgeries,8 GJS[gastro jejunostomies,now almost extinct],2 thyroids,2 appendectomies,1 exploratory laparotomy[surgery for diagnosis] then the usual minor surgeries like hernias,heamarroids and cysts in plenty,for the interns’ training.
The anesthetist ,the most unsung hero of the theatre,loses the command as soon as the surgeon makes his theatrical entry followed by his assistants and interns in that order and move to the 1’st table like the commandos taking charge,the anesthetist moving to the back stage.Once the main assisting sister moves to the opposite side of table,facing the surgeon,the patient goes under the towels and only a 6inch* 6 inches of bare abdomen is revealed under spotlight,the rest under the wraps, and the patient ceases to exist as for as the surgeon and spectators are concerned,the anaesthetist taking charge of the rest of the body for safe keeping and delivering him intact after nother hour or two, that too if nothing goes wrong.Once the scrubbing by the assistant is over,the surgeon commands ‘sister, scalpel,please’ and the show begins and the adrenaline starts boiling all around the theatre.
I am not interested in the usual scenes that follows,but on the various species of surgeons that one comes across in one’s practice in different hospitals.The most common perception of the surgeon being cool tall and hefty with large hands with long fingers,with early graying hairs and commanding voice,a beard will be an added attraction, .but they come in all sizes and shapes .As far as I know, surgery is an inborn trait and not something which you acquire by getting more degrees or more training.Ofcourse a good surgeon will be enhanced by further training,but a mediocre one will remain in the same class how ever much you train him,may be a better mediocre one.
1. The clumsy one, who makes the theatre a hell,who blaims the instruments,the assistant,the staff, for all the mess dished out by himself,the result being all the support staff lose their cool and the situation becomes messier and tantrums follow.The theatre sister who bears the brunt of attack will pray to almighty for the day to end.Even a routine normal surgery becomes a battle where nobody wins,offcourse the patient always the loser.
2. The meticulous ones,though they are very good surgeons,in their quest for perfection and neat job,they take a hell of a long time and though the surgery is very pleasing to watch and the finished product good,the post operative complications mar their results,a wasted good surgery indeed.
3. The fast freaks,who race through their surgery like crazy, as if slowing down would lead to crash,infact it is their low self esteems which hurries them and causing silly mistakes,but costing the patient a lot.But most of the time the results are good because of lesser trauma and fast recovery.
4,The really good ones,born to be surgeons,,they are a pleasure to watch and the surgery transforms to the level of a good painting,or a tendulkar innings.The economy of movements is their trademark,.combined with a cool head and self confidence it becomes an art in itself.Each step is calculated,precise and sure and the hands and the instrument become unidentifiable.Though the surgery looks a little slow compared to the hurrying ones,when we look up at the clock after the surgery it would have finished much ahead of the speeding ones.It’s when a complication occurs that we can separate a great surgeon from a mediocre one.He takes his own sweet time to assess the damage and the precise source of the bleeding or rupture ,much to the surprise of the support staff who expects him to hurry along to tackle the issue,then with lazy indolence.he takesover and repairs the issue like a seasoned pro,where as a mediocre one becomes tense,the composure totally shaken and he hurries to stop the bleeding in a blindfold fashion unable to locate the source and every thing turns out into a mess and doesn,t know how to come out of it.
Coming to my innings as a surgeon, I was a reluctant surgeon,infact surgery was forced up on me and I took it up as a challenge,since it is the only exciting thing about ophthalmology.So what is an art becomes a terrible struggle.The tinge of adrenaline coursing my body for each and every surgery right from the go to the finis,was the only intoxication I craved for.What, for my colleagues was another routine cataract surgery, was like a hurricane century in a difficult pitch as for as I was concerned.So every theater day was a hidden thrill for me, associated with my usual anxieties and fear of failures. But for my assistants and staff I was considered a bold dare devil surgeon[ that means I cannot be a controlled liesurly surgeon]..the classical example of my surgery can be compared to my driving in the highway where I cannot tolerate any body travelling in front of me and I will try to overtake and somehow I survive,I don’t enjoy driving ,but it gives me a kick ,that’s all.But the funny part is my results have been not that bad as my surgery was.But if anything goes wrong in the theater,I make a heavy day of it and my wife and children can vouch for it.
The cruel fate of a surgeon in his o.p day is that the only patients waiting in the o.p[out-patient] are the ones who had complications and facing the music,and those who are coming to fix the dates for their surgeries and their interaction before the o.p begins,that’s a tight situation to handle and needs acting skills of a high order;the few successful ones[I mean the patients] will never again come to his o.p since they will be busy with their work. I can smell these[the cruel victims,offcourse] patients a mile away from my clinic and only if I had an A.K rifle I would have blown them to bits before the harm is inflicted on the new arrivals. Offcourse there are the exceptions like the ones with 100% success who will never admit it to me but nag me with a lot of minor symptoms and the other few who inspite of a messy surgery will boast that now they can see every thing and in such cases I will never ask them to read my snellens chart,lest they change their opinion there after.So don’t envy a surgeon,he deserves your pity and prayers and given another chance I will never marry one for sure..