Pretty Little Butcher: Memoirs of a Female Thoracic Surgeon

coffee and complications

I performed two major operations in one day. Between the break, I went down to the food court and got myself a cup of coffee while I waited for the second patient to be put under anesthesia. The first patient was in the postoperative recovery room, waking up.

Sometimes I think being a surgeon isn't that hard. You don't need an exceptionally high IQ and everything is pretty much done according to the protocol. There are rules and guidelines for everything and they are updated regularly. Treating a patient isn't like decorating a room or writing a book. You don't have to be creative. You just need to do it over and over again until you make no more mistakes.

I love the saying in one of my surgery textbooks: Amateurs practice until they get it right; professionals practice until they can't get it wrong.

The thing is, sometimes things do go wrong and the worst part is you don't know why, just like the way my laptop shuts down on me occasionally (but the only difference is I can always reboot it). You think you did everything the way you always do, but somehow you get a surprise. I hate surprises when it comes to patients. I don't order a CAT scan to find out what's going on; I order it to confirm my suspicion. When things rapidly go out of control, it's when I find this job the hardest to endure.

The woman sitting next to me in my office is a pediatric surgeon, and we often share thoughts when we run into each other.

"I still think guys are more suitable for this job," she says. "They seem to handle it so well. When their patients suffer from a complication, they just shrug and say that's life and it happens. Not me. I get so upset."

I tell her I feel the same way, but I don't tell her how I completely broke down outside the emergency department once when one of my patients experienced an acute brain infarction and never woke up again. It was the only time I seriously thought of quitting my job even though I complain all the time. I can endure long hours, skipping dinner, huge amount of paper work and going to meetings at seven in the morning every day, but accepting complications is something I have yet to learn.

I remember performing an open heart surgery with another doctor when I did my rotations in the cardiovascular department. I was only the assistant and everything went smoothly according to plan. I tied one surgical knot during the whole operation, but when it was over, the patient suffered from aortic dissection.

Was it because of the one knot I tied? Thinking back, it was highly unlikely. But I blamed myself, and I remember how the other doctor blamed himself. He had tears in his eyes and said he had lost all confidence in performing future operations like this.

I remember how he was criticized for being unfit for the job, not because of his techniques, but because of his mentality. We are expected to suck it up and do a better job next time. Everyone knows that practice makes perfect and humans are bound to make mistakes. We try our best to avoid complications, but sometimes we learn through our experiences.

But how can we accept that when there are human lives at stake? There is absolutely no room for error and I understand him perfectly. I would hesitate to tie that knot the next time I'm in the same position, too, and I know everyone makes mistakes but I don't want that person to be me.

At times like these I wish I was a pastry chef.

I watched the steam rise from my coffee mug and thought of the operation I just did. It was a lobectomy of the right upper lobe of lung, and during the process I had to divide the feeding pulmonary arteries. I find the pulmonary artery both respectful and intimidating. It carries a huge amount of blood and the blood pressure is extremely high, and when it's injured, it doesn't ooze but it squirts. During the operation I danced right on its white ridge and hoped to God we get along peacefully.

It was a successful operation, and as I sipped my coffee, I felt a sudden lump in my throat.

My patient does not know me. He hasn't seen all the videos of the surgeries I have performed and I can't provide him with a definite answer on how well he's going to recover. I can offer him data and statistics, but other than that, all he has is blind faith in me, to trust me to open him up and get rid of the tumor and wake him up again.

To what do I owe this honor, to have this kind of privilege? I'll never stop being grateful and I'll always try my best to be careful and thorough, to be kind and caring, to give him the best I can offer.

So I sipped my coffee and I watched the people eating their food around me. They didn't know what I just did and what I was going to do later. I'm just a girl in a white coat who looks too young to be doing the job I do. I finished my coffee, changed into scrubs, performed the next operation, skipped dinner, went up to the ward to check up on my first patient, who appeared to be in good spirits and was chewing on a piece of bread.

"Get some rest, doc," he said. He looked fine. Relaxed. He was breathing normally.

I drove home and it was close to midnight. The city lights sparkled off in a distance. Nobody knew that I did something big today, but I know.

And there's something inexplicably beautiful about that.

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dedicated to allybuckle for being sweet and lovely and fab.