What it’s like to talk to patients, then cut them open

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Every time I walk through the automatic sliding doors, that strong smell of ammonia stings my nose. The lobby is clean — too clean — with a vast amount of open space leading to the front desk. The just-below-comfortable air brushes against my skin, raising the hair on my arms and legs. Almost cold enough to be a morgue — but that’s later. The room is silent, except for the automatic piano playing its pre-programmed rotation of classical music as the keys ghostly strike the chords under its lid. No man in tuxedo nor woman in gown sits on the cushioned bench. It all says so much about this place.

To some it may be scary, or make them nervous as they walk in — visiting loved ones in sickness and in health. They try to make it feel inviting and comfortable, but everyone knows exactly where they are. For others, it’s just going into work. Not nine to five though, more like seven to six, and that’s without being on call.

I walk in as a pre-med student volunteer, not scared but ambitious, eager for the experience and hoping to witness something beyond the norm. I leave with exactly that.

Dressed in my business casual attire of khaki pants and a pressed button-down shirt tucked into my waist, I give a smile and head nod to the elderly volunteer behind the desk as I briskly walk past him.

It’s funny how both of us are volunteers, officially registered under the same job, yet our experiences will vary drastically. I’m about to see the wondrous insides of a human being, while he directs their loved ones to a room full of chairs and year-old magazines.

In the locker room I begin to undress — it’s even colder now. I unfold the creased, light green scrubs and slip the thin garments over my pale bare skin. Nothing is heard but the buzzing of the fluorescent lightbulbs above me and the whoosh of my arm and leg hairs being brushed from perpendicular to parallel.

At 7:30 a.m. I meet the surgeon and anesthesiologist who I’m shadowing for the morning. I follow them into the patient holding area, where the nurses are prepping the patients. The first patient is female, 53 years old, slightly overweight, smokes, and is having her ovaries removed. I’m told it’s a common procedure and will decrease her risk of cancer immensely.

The three of us surround her bed as she lay there comfortably holding her husband’s hand. Hooked up to the monitors and an IV in her left arm, I can see her vitals and hear the monotonous BEEP … BEEP … BEEP. It’s all I can focus on. Then, in a thin comforting tone I hear, “Hi Linda, I’m Dr. Adams, I will be doing your anesthesia this morning. I just wanted to say hello before we get started and make sure you’re feeling comfortable and ready to go. This is Dr. Rosen, he’s the attending surgeon, and Ethan is a pre-med student here to observe. I’m going to give you a light sedative to relax you before we go in; it may burn a little at first, but that is normal. Any questions?”

She replies with the transparent confidence of a strong “No,” as she shakes her head and grasps her husband’s hand even tighter. “Go wait with the kids, I’ll be back before you know it,” as she turns her head toward her husband. He kisses her on the forehead, whispers, “I love you,” and walks away to read year-old magazines.

Dr. Adams converses a bit more with Linda, constantly smiling and telling her calming jokes. I help wheel her into the operating room as she becomes quite loopy, “I need to come here more often, whatever you gave me doc is definitely working!” she exclaims as she rolls towards unconsciousness. “It’s the only place you can legally get high,” Dr. Adams jokes. The nurses know all his punchlines but still chuckle in response.

The last bit of doctor-patient interaction occurs as he asks her to count backward from ten. I stand in the corner as he injects her with a tallied concoction of drugs I’ve only heard about from popular culture. She reaches eight.

Suddenly, the smooth lull of Dr. Adams’ reassuring voice changes to grunts and groans of surgical techs trying to position her on the operating table. They press play on the speaker system, and Bob Dylan begins to belt out “Mr. Tambourine Man.” The surgeon is directing people to get out of his way as he fiddles with the flashlight attached to his glasses. The hairs on my arms and legs rise to remind me that the operating room is as cold as a morgue.

With the patient asleep, this place transforms into another dimension. What happened to the empathy and bedside manner? Raising my concerned awareness to the compassionate Dr. Adams, even he crassly said that “Right now, they’re a slab of meat on the table.”

Those who walk into the cold lobby, dress in the even colder locker room, and work in the frigid operating room, need their hairs to constantly lay flat. I’m not there yet, nor am I qualified to calm someone down before slicing them open. The perception change — from a breathing, thinking, human being, to a slab of meat — is essential. The atmosphere keeps the work environment relaxed and normal, and the fact that a human life is on the line more bearable. At this point, they’re doing their job just like anyone else.

They spoke to Linda, then cut her open. Both the speaking and the cutting must be done in their own manner, and the mental separation is vital to being a physician. As an observer, I was not expecting this type of emotional oscillation. I saw her speak; then I saw her innards. She is human, she is meat. And all the while I hear the monotonous BEEP … BEEP … BEEP underneath the cooing of Bob Dylan’s sweet, sweet songs.

The author is an anonymous premedical student.

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