Toolmond
12-01-2008, 12:44 PM
I am a medical student and saw an amputation recently. I couldnt concentrate properly untill I wrote this story. It is meant to be true though pessimisticaly oriented, as well as amusing if one has a slightely sick sence of humour.
I am not usualy the literary type so would like to know what you people think of it...
The operation
I was 26 years old, and for 23 years I had been a student. I had forgotten about most of those thousands of days spent sitting on chairs without remembering even a single detail about them. In fact it seems that I had sometimes managed to forget about entire years: being a student meant one had a boring and very repetitive life.
But things had gotten better since I had started studying medicine. There was occasionally some excitement, something to remember, something that could cause my corrupt brain to have an emotion, or at least a hint of one.
It did not seem like it was going to be one of those days though. Not only was I tired after having only slept four hours; I had also had diarrhea for the past week after eating to much Indian food. But then something changed…
I came to my shift at the Emergency Room where Eric and Mathias were already polluting the hallway with their presence.
“There is a guy with an arm torn off that is coming from Bjelovar” said Mathias, “he should be arriving any minute.”
I immediately felt a surge of adrenaline and excitement overcome my body. This is what I had become a medical student for. This was the real stuff. I have always had an unwholesome fascination for the site of a pale and frightened human, with large drips of dark red blood; the persons very life, falling onto the floor beside him, while overexcited medical staff twirled around him like a colony of angry ants. It was only in the presence of death that I could feel I was alive.
“Is the arm coming with him” I asked one of the young surgeons, “Are you going to try to hook it back on?”
“It depends” he replied, “You have to see the condition of the arm. It is rare that we reattach arms, the wound has to be a clean cut, and it takes very long for reenervation to occur. It also depends on the age of the patient, his occupation...”
“For example for a pianist you will try to reattach it, but for an 85 year old man you won’t waste the time?” I interrupted. “Yes, something like this.”
He told us more technical details about the procedure of sewing a limb back into place. During the conversation I looked eagerly towards the entrance of the ER every few seconds, hoping to see the ominous arrival of an ambulance.
After several hours, the patient finally arrived though the main door. He was a man of about 30, fit and reasonably good looking. His skin was pale from loss of blood, almost gray. He was conscious and looking curiously at those around him who were going to try to save his life, and maybe also his arm. He had been working in the fields when his sleeve had somehow gotten stuck in some machinery. I was disappointed to see that his arm was there after all, and not “torn off” as promised. I could simply see a tear on the inside of the arm, below the shoulder. The sheet under the man was soaked in blood. I had always liked the site of cloths soaked in human blood.
The room was full of surgeons and anesthesiologists injecting drugs and analyzing X-rays, though many were only there out of morbid curiosity, just like me.
The patient was rushed down the hallways towards the surgical intensive care unit. The hospital was so designed that to get from the ER to the intensive care, one had to work through a maze of hallways and almost go to the other end of the hospital. I followed along, like a parasite clinging to its host. Eric also followed, with three packs of type B blood in his hands.
The man was transferred onto a bed of the intensive care unit. Several nurses and doctors started preparing him for the operation. Eric remarked: “It’s funny how the main surgeon, the chief, is the one in this whole room that looks the most like a slob. His belly is bigger then the bellies of all the others combined.”
I looked at 'the chief' with amusement. Although everybody else in the room seemed overworked and panicked, he was simply standing without moving, his gaze stupidly fixed into infinity like that of a drunken homeless man. His legs seemed as thin as those of an anorexic teenager, but his belly formed a huge oval mass protruding far in front of him, betraying a regular and non negligible beer consumption. I wondered if he needed a mirror to be able to see his penis. ‘The chief’s’ red face looked perfectly calm and serene. He was a vascular surgeon, and he would be in charge of the operation.
“He is probably one of those guys, that when he has a day off, he sits down in a bar, and orders beer after beer, saturating himself with alcohol” though Eric.
‘The Chief’ asked the patient if he knew at what time he had wounded himself. “Of course, it happened about an hour ago.” The patient had already been in the hospital for almost half an hour, and the drive from Bjelovar, where he had also been looked after in the local hospital, took two hours. His estimation was obviously completely wrong. Was this caused by the shock and the drugs, or was he drunk? Maybe he just didn’t have a good notion of time. “So basically we don’t know anything” said ‘the Chief’ as he walked away disinterestedly.
Amongst the nurses there was a catholic sister, with a strict look on her face, she had lifted up the patients sheet, and was changing the bag of his urinary catheter as the patients testicles hung loosely nearby.
“Of course out of all the nurses here, it had to be the nun who changed the guy’s urinary catheter” I remarked to Eric “She probably did it because it’s her only way of getting some”.
The medical staff kept on preparing the patient for his operation. There were several other patients fighting for their lives in the same room, but some of them were conscious enough to understand that something serious was happening, and from their beds they also observed the doctors working.
“It doesn’t exactly look like the guy is going to be playing the piano after this” said Eric.
“It doesn’t look like he used to play the piano anyways... maybe more like the clarinet” I replied. I found my reference to masturbation very amusing and so did Eric. He bowed his head forward in a useless attempt to camouflage his large smile and giggle.
The patient was brought to the operating room. He looked at ‘the Chief’ and asked: “Doctor, am I going to wake up from this operation?”
‘The chief’ explained that they were going to explore his arm wound to assess the damage, and that they would do their best to get it back into working order, but that if the wound was too extensive, they were going to have to amputate. “You have to save my arm, I need it” pleaded the patient, probably thinking about his farm.
But it was not time to think about saving arms right then, it was time to think about informed consent: the patient was asked to sign a discharge paper claiming that he was fully aware of the risks and consequences of the operation he was about to undergo. The paper was held above his face, and without trying to read it, the patient painstakingly signed it with the only functional arm he had left. I wondered out loud what happened in cases when a patient could use neither hand. “We just use a fingerprint instead” said a surgeon. “And if he has no more hands” I wondered to myself…
The anesthesiologists inserted all their tubes and needles. The patient would soon be sleeping. He looked at me and Eric and pronounced several sentences of which I only understood the words: “God help me”.
Once the patient had lost consciousness, the bandage over his shoulder was taken off, and only then did I understand how severe the wound actually was. The arm was almost completely torn off, hanging only by a small bridge of skin and muscle in the region of the shoulder. The armpit was a mass of twisted flesh with a stump of bone protruding. In the middle, I could see an artery pulsating with every heart beat. Several surgeons took out their portable phones and took photos of the arm in various positions. Mathias was inspired to do the same, and I regretted not to have my camera with me: this operation would have been a great hit on youtube.
The patient was lying naked on the operating table that had two special arm holders attached to it, giving it a cruciform shape. For a moment, the patient looked like a replica of Jesus Christ on the cross, except that unlike Jesus, there was no cloth covering his penis. The nurses quickly changed this by covering most of the man’s body with sterile green sheets: the operation could start.
After a brief exploration, ‘the chief’ and the other surgeons decided that the arm could not be saved, and they patiently started dissecting it off, ligating arteries, and cutting away pieces of torn flesh.
“The poor guy” said Eric empathetically, but then adding: “But it’s going to look ****ing cool when they take the arm off!” Of course I wholeheartedly agreed, and added: “If you had the choice between doing an operation that lasts 6 hours to reattach an arm, or doing a one hour operation to amputate an arm then go home, I mean, which choice would you make?”
Not only was amputating much quicker, but it was also simply more amusing because of how destructive it was. I had always found destroying to be not only much easier then constructing, but also somehow pleasurable. Considering the situation worldwide, I apparently wasn’t the only person to have that philosophy.
A young surgeon explained: “It is not only a physical trauma for the patient, it is also a great psychological trauma.” Eric had to add his personal touch: “And also a trauma on his sex life.” “Who has sex life with his left hand?” asked the surgeon, and they laughed loudly as ‘the Chief’ continued the amputation. Until now I had not noticed that it was his left arm that had been wounded: the patient had been lucky.
Finally, the arm was separated from the rest of the patient’s body. The nurse carried it away from the operating table, then dropped it onto the floor amongst a collection of blood stained bandages(??) that were waiting to be counted. As the arm limply hit the floor, it produced a loud slapping sound.
Back in the changing room, Eric heard the sound of glass clinking when I put my bag on the floor. “What’s that?” he asked with blue eyes glinting. I gave him the bottle of rum, and he unhesitatingly gulped down several mouthfuls. The Rum was from Guadeloupe, and was delicious. One would never guess it was 40%. I also gulped down three mouthfuls, ignoring the fact that the bottle was supposed to be a birthday present for my girlfriend.
As we walked down a hallway towards the exit, I pulled the bottle out again, ready to drink some more. “Put that **** away” urged Mathias. At the same moment ‘the chief’ appeared in front of us, belly first. There was an awkward moment as he walked by us: had he seen the bottle?
“Don’t worry guys” I said, “he probably doesn’t give a **** because he is going to do the exact same thing.”
That night at the clubs, the music was so loud that at every beat I could feel my lungs being compressed and my pant legs vibrate; but no music could have been loud enough to prevent me from hearing, again and again: “Doctor, am I going to wake up from this?”
I am not usualy the literary type so would like to know what you people think of it...
The operation
I was 26 years old, and for 23 years I had been a student. I had forgotten about most of those thousands of days spent sitting on chairs without remembering even a single detail about them. In fact it seems that I had sometimes managed to forget about entire years: being a student meant one had a boring and very repetitive life.
But things had gotten better since I had started studying medicine. There was occasionally some excitement, something to remember, something that could cause my corrupt brain to have an emotion, or at least a hint of one.
It did not seem like it was going to be one of those days though. Not only was I tired after having only slept four hours; I had also had diarrhea for the past week after eating to much Indian food. But then something changed…
I came to my shift at the Emergency Room where Eric and Mathias were already polluting the hallway with their presence.
“There is a guy with an arm torn off that is coming from Bjelovar” said Mathias, “he should be arriving any minute.”
I immediately felt a surge of adrenaline and excitement overcome my body. This is what I had become a medical student for. This was the real stuff. I have always had an unwholesome fascination for the site of a pale and frightened human, with large drips of dark red blood; the persons very life, falling onto the floor beside him, while overexcited medical staff twirled around him like a colony of angry ants. It was only in the presence of death that I could feel I was alive.
“Is the arm coming with him” I asked one of the young surgeons, “Are you going to try to hook it back on?”
“It depends” he replied, “You have to see the condition of the arm. It is rare that we reattach arms, the wound has to be a clean cut, and it takes very long for reenervation to occur. It also depends on the age of the patient, his occupation...”
“For example for a pianist you will try to reattach it, but for an 85 year old man you won’t waste the time?” I interrupted. “Yes, something like this.”
He told us more technical details about the procedure of sewing a limb back into place. During the conversation I looked eagerly towards the entrance of the ER every few seconds, hoping to see the ominous arrival of an ambulance.
After several hours, the patient finally arrived though the main door. He was a man of about 30, fit and reasonably good looking. His skin was pale from loss of blood, almost gray. He was conscious and looking curiously at those around him who were going to try to save his life, and maybe also his arm. He had been working in the fields when his sleeve had somehow gotten stuck in some machinery. I was disappointed to see that his arm was there after all, and not “torn off” as promised. I could simply see a tear on the inside of the arm, below the shoulder. The sheet under the man was soaked in blood. I had always liked the site of cloths soaked in human blood.
The room was full of surgeons and anesthesiologists injecting drugs and analyzing X-rays, though many were only there out of morbid curiosity, just like me.
The patient was rushed down the hallways towards the surgical intensive care unit. The hospital was so designed that to get from the ER to the intensive care, one had to work through a maze of hallways and almost go to the other end of the hospital. I followed along, like a parasite clinging to its host. Eric also followed, with three packs of type B blood in his hands.
The man was transferred onto a bed of the intensive care unit. Several nurses and doctors started preparing him for the operation. Eric remarked: “It’s funny how the main surgeon, the chief, is the one in this whole room that looks the most like a slob. His belly is bigger then the bellies of all the others combined.”
I looked at 'the chief' with amusement. Although everybody else in the room seemed overworked and panicked, he was simply standing without moving, his gaze stupidly fixed into infinity like that of a drunken homeless man. His legs seemed as thin as those of an anorexic teenager, but his belly formed a huge oval mass protruding far in front of him, betraying a regular and non negligible beer consumption. I wondered if he needed a mirror to be able to see his penis. ‘The chief’s’ red face looked perfectly calm and serene. He was a vascular surgeon, and he would be in charge of the operation.
“He is probably one of those guys, that when he has a day off, he sits down in a bar, and orders beer after beer, saturating himself with alcohol” though Eric.
‘The Chief’ asked the patient if he knew at what time he had wounded himself. “Of course, it happened about an hour ago.” The patient had already been in the hospital for almost half an hour, and the drive from Bjelovar, where he had also been looked after in the local hospital, took two hours. His estimation was obviously completely wrong. Was this caused by the shock and the drugs, or was he drunk? Maybe he just didn’t have a good notion of time. “So basically we don’t know anything” said ‘the Chief’ as he walked away disinterestedly.
Amongst the nurses there was a catholic sister, with a strict look on her face, she had lifted up the patients sheet, and was changing the bag of his urinary catheter as the patients testicles hung loosely nearby.
“Of course out of all the nurses here, it had to be the nun who changed the guy’s urinary catheter” I remarked to Eric “She probably did it because it’s her only way of getting some”.
The medical staff kept on preparing the patient for his operation. There were several other patients fighting for their lives in the same room, but some of them were conscious enough to understand that something serious was happening, and from their beds they also observed the doctors working.
“It doesn’t exactly look like the guy is going to be playing the piano after this” said Eric.
“It doesn’t look like he used to play the piano anyways... maybe more like the clarinet” I replied. I found my reference to masturbation very amusing and so did Eric. He bowed his head forward in a useless attempt to camouflage his large smile and giggle.
The patient was brought to the operating room. He looked at ‘the Chief’ and asked: “Doctor, am I going to wake up from this operation?”
‘The chief’ explained that they were going to explore his arm wound to assess the damage, and that they would do their best to get it back into working order, but that if the wound was too extensive, they were going to have to amputate. “You have to save my arm, I need it” pleaded the patient, probably thinking about his farm.
But it was not time to think about saving arms right then, it was time to think about informed consent: the patient was asked to sign a discharge paper claiming that he was fully aware of the risks and consequences of the operation he was about to undergo. The paper was held above his face, and without trying to read it, the patient painstakingly signed it with the only functional arm he had left. I wondered out loud what happened in cases when a patient could use neither hand. “We just use a fingerprint instead” said a surgeon. “And if he has no more hands” I wondered to myself…
The anesthesiologists inserted all their tubes and needles. The patient would soon be sleeping. He looked at me and Eric and pronounced several sentences of which I only understood the words: “God help me”.
Once the patient had lost consciousness, the bandage over his shoulder was taken off, and only then did I understand how severe the wound actually was. The arm was almost completely torn off, hanging only by a small bridge of skin and muscle in the region of the shoulder. The armpit was a mass of twisted flesh with a stump of bone protruding. In the middle, I could see an artery pulsating with every heart beat. Several surgeons took out their portable phones and took photos of the arm in various positions. Mathias was inspired to do the same, and I regretted not to have my camera with me: this operation would have been a great hit on youtube.
The patient was lying naked on the operating table that had two special arm holders attached to it, giving it a cruciform shape. For a moment, the patient looked like a replica of Jesus Christ on the cross, except that unlike Jesus, there was no cloth covering his penis. The nurses quickly changed this by covering most of the man’s body with sterile green sheets: the operation could start.
After a brief exploration, ‘the chief’ and the other surgeons decided that the arm could not be saved, and they patiently started dissecting it off, ligating arteries, and cutting away pieces of torn flesh.
“The poor guy” said Eric empathetically, but then adding: “But it’s going to look ****ing cool when they take the arm off!” Of course I wholeheartedly agreed, and added: “If you had the choice between doing an operation that lasts 6 hours to reattach an arm, or doing a one hour operation to amputate an arm then go home, I mean, which choice would you make?”
Not only was amputating much quicker, but it was also simply more amusing because of how destructive it was. I had always found destroying to be not only much easier then constructing, but also somehow pleasurable. Considering the situation worldwide, I apparently wasn’t the only person to have that philosophy.
A young surgeon explained: “It is not only a physical trauma for the patient, it is also a great psychological trauma.” Eric had to add his personal touch: “And also a trauma on his sex life.” “Who has sex life with his left hand?” asked the surgeon, and they laughed loudly as ‘the Chief’ continued the amputation. Until now I had not noticed that it was his left arm that had been wounded: the patient had been lucky.
Finally, the arm was separated from the rest of the patient’s body. The nurse carried it away from the operating table, then dropped it onto the floor amongst a collection of blood stained bandages(??) that were waiting to be counted. As the arm limply hit the floor, it produced a loud slapping sound.
Back in the changing room, Eric heard the sound of glass clinking when I put my bag on the floor. “What’s that?” he asked with blue eyes glinting. I gave him the bottle of rum, and he unhesitatingly gulped down several mouthfuls. The Rum was from Guadeloupe, and was delicious. One would never guess it was 40%. I also gulped down three mouthfuls, ignoring the fact that the bottle was supposed to be a birthday present for my girlfriend.
As we walked down a hallway towards the exit, I pulled the bottle out again, ready to drink some more. “Put that **** away” urged Mathias. At the same moment ‘the chief’ appeared in front of us, belly first. There was an awkward moment as he walked by us: had he seen the bottle?
“Don’t worry guys” I said, “he probably doesn’t give a **** because he is going to do the exact same thing.”
That night at the clubs, the music was so loud that at every beat I could feel my lungs being compressed and my pant legs vibrate; but no music could have been loud enough to prevent me from hearing, again and again: “Doctor, am I going to wake up from this?”