Today, I Had My First Surgery

When I was a boy, I had a dream.

Everybody was busy attending and monitoring their patients on that sunny morning. Left inside the Surgery quarters for interns was me and another member of the rank. Some of us were deployed in the out-patient department while others were inside the medical school building to attend a lecture conducted by a Japanese speaker. The senior interns had their own “interns’ hour”, leaving them no choice but to endorse their work to us, juniors. Indeed, if only the two of you are left inside the quarters, you’d surely feel the pressure and lack of manpower all around the place. Dr. C, one of the seniors, passed me the torch embellished with three tasks: One. A scheduled emergency appendectomy requires me to find three junior interns to send to the operating room. Two. Inform each junior resident about the whereabouts of the patient. Three. Keep calm and hope for everything to be okay.

I was lucky to immediately get two junior interns to scrub in after the lecture. To fill in for the third, I volunteered. We got inside the operating room around five in the afternoon. In my mind, I was expecting to be the circulating intern, the one who goes in and out of the operating suite to get extra sterile materials, sutures, do errands, and even take pictures of the specimen. However, with the green doors closed, air-conditioners buzzing, and every other human busy preparing the patient lying steadily  supine on the operating table, the surgery resident swiftly tells me, “scrub” as he entered the suite passing right in front of me. I was startled for a few milliseconds causing me to have a brief hang time before finally storming out of the operating room to scrub on a nearby sink. I hurriedly scrubbed hard using the clean hard brush provided beside each sink together with a liquid antibacterial soap. I rushed back inside the suite and grabbed my sterile gown and gloves. A few minutes later, the operation started.

The patient was a 19-year-old male who came in with a chief complaint of right lower quadrant pain. He was scheduled for an emergency appendectomy a few hours after he was admitted in our institution.

The surgery progressed. The knife slid laterally from the skin of the medial abdomen. Upon reaching the deeper layers, Dr. U started using clamps to separate muscle fibers and fascial tissue. Finally, after about half an hour, we’re inside the peritoneal cavity. The surgeon meticulously looked for the inflamed appendix. He poked and pulled and pushed the gut in and out of the incision in desperate search for our specimen. Finally, after almost an hour, we found it. He started isolating our patient’s unusually long and thin appendix. Along its course, we started ligating and tying blood vessels that may bleed profusely if not done. When we reached its base, Dr. U placed two clamps, one at the immediate base and another one a centimeter above it. He asked the scrub nurse for the knife, which was soaked in povidone iodine. Moments later, he handed me the scalpel and told me to cut the appendix just below the upper clamp. I carefully started cutting the appendix until I reached the end point and finally hearing the words “specimen out” ring in the air.

When I was a boy, I had a dream.

Today, I had my first appendectomy. (technically)

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Take a look at that massive appendix. It’s almost the length of a scalpel!

Que Deus nos bendiga y nos proteja!
RA

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