Maybe it’s the early mornings, maybe it’s the sleep deprivation, or perhaps it’s an early sign of caffeine intoxication, but a certain mythical feeling hits me when I walk into the OR. Not that I’m much of a spiritual person, but there’s just a whole hushed reverence that takes place. It’s a special “hallowed” space.
No, I’m not trying to imply that the surgeons that I’ve worked with have such egos they demand to be treated like gods.
The reverence that is ingrained within the OR seems directed towards the patients. Everyone there respects the patient. While the patient may be the one putting his or her faith on the line during the operation, they are the subject to which the surgical staff is devoted.
As I pondered on how surgery could be seen as mythical and divine, my mind wandered to a hypothetical thought experiment. If scholars from a far distant future were to investigate the practice of surgery in our current time, would they be able to differentiate it from other practices of worship? There certainly are elements that could be found in both: sacred vessels, the altar table, the elaborate ceremonial gowns and headdresses, ritualistic acts of cleansing, infatigable guards that work without sleep, wise shamans who control powerful drugs, and a common motif of healing the sick.
One of our cases was an abdominoperineal resection to remove a mass in the lower end of the rectum. The surgeon dissected open the abdomen and proceeded to mobilize the colon from the retroperitoneum in search of the tumor. Reading that previous sentence, it may seem that doing this task would be a very simple thing. It certainly was not. Deeper and deeper he went while chasing the tumor. When I peered into the abdomen I was surprised at how much depth there was. The patient was not particularly large in any sense, but the colon seemed to be swallowed by the cavernous pelvis.
My eyes could not make out where the colon went, nevermind trying to pick out where the tumor was, in the dark abyss. Yet the surgeon, with his headlight glowing like a third eye, reaches in with a steady hand. He probes, searches, ties, snips, then pulls, and a free length of sigmoid colon emerges. Bulky, misshapen, and venomous red, our quarry appears. The tumor comes to light.
I watch this scene unfold and it evokes another in my mind: the myth of Thor and his fight at sea with the monstrous serpent Jormungandr. The Norse god had hooked the giant snake, which was violently spitting out poison and blood, out of the black depths of the ocean and dragged it out to battle. Cloaked in an immaculate aegis and armed with hardened steel, Thor struggled for hours before the line snapped and the monster retreated back to the water. The difference between that saga and this scene was the very ending — the surgeon was able to swiftly resect the tumor head and reattach the bowels.
It is these similarities with the epic and mythical that drives forward the mystique of surgery to me. In the OR, the work of the surgical team to cure the patient seems the perfect physical representation of medicine’s constant, and often epic, fight for life against death and darkness.
And if that isn’t the stuff for legends to emerge from, I don’t know what is.
The clerkship experience can be the definition of tumultuous. As we’re suddenly tossed into the wards, it’s easy to become caught up in the shuffle as we move through our service rotation. These posts try to take a step back and become “a fly on the wall” observing and reflecting on the overall movement through clerkships.