Seal Family Sleeping on Rocks
It was so hard to sleep because it was so easy to not feel sleepy. That’s what I remember most about that night. I had adrenaline rushing through my body in multiple waves. I had witnessed some terrible things in the OR and was anxious about what I was about to witness a few hours later – something very unnatural and so unfamiliar. That’s when the rush was its most intense, but throughout the night there would be multiple volleys bombarding me.
We were starting a new case in the afternoon and towards dinner time, our patient had a terrible complication. I could just remember thinking over and over again how people who need CPR have such a poor prognosis. I also kept thinking how privileged I felt being a witness to what I had just seen in the OR. Was this patient going to die in front of my eyes? The surgery was to remove a liver cyst. Midway through, after the cyst came out, she started having dangerously low blood pressures despite several anesthesia interventions. Anesthesia was rushing, making calls, giving fluid, blood products, tons of pressors and the patient kept dropping. The surgeons were getting more and more frustrated. I cannot recall the specific turning point, but could vividly remember the aftermath. She had gone into Vtach or Vfib. I vividly remember that somehow there were tons of people in the OR. They – the people who found their way into the room – made sure internal paddles were ready and closely monitored the heart rhythm, while the attending and resident traded off giving CPR. The brutality with which they forcefully pushed their body weight into the women’s chest was stunning. The fellow in the room told me to just leave after they somewhat stabilized the patient. Still it was a continuing struggle for her life. There was a chance that I could eventually go on my first organ procurement late that night with the transplant team, and thus I needed some rest. It was already late into the evening. One part of me wanted to see the conclusion of this drama, but I didn’t need to be there. I could somehow telepathically or cosmically understand that I should go. Not because I shouldn’t see this, or because I didn’t need to be there for this patient. I felt I should go because I was being a burden on the frustrated medical team. This patient deserved better in this situation.
I ended up attempting to sleep on a friend’s couch while I waited for the text later that night that would call me up to go see a dead patient. It was so surreal driving across town. I really did not know what to expect at all. I hesitantly changed into my scrubs and then began to find my way to the patient’s side. I remember not being able to comprehend that this was a dead patient. They looked, sounded like, felt like a very sick unconscious patient. The chest was rising below her gown with the ventilator, the monitors were beeping and whirring. I also made the mistake of asking one of the nurses about the patient. Knowing her story, even the slightest snippet of how she ended up in the hospital made her alive in my mind. We soon rolled back to the OR from the ICU room. That’s when the second wave of brutality I would witness began. We made a gigantic vertical laparotomy incision and slowly worked our way towards removing organs.
Wow, what a learning experience, seeing all that anatomy. The situation divulged into education. I was not seeing a human body, but an anatomy lesson. However, when it came time to close the body, and I was allowed to sew up the huge incision, I remember thinking again how privileged I was. I began to see this lifeless body with half their body cavity carved out as a patient again. I noticed how sewing this incision needed to be done carefully to line up her tattoos. I noticed how closing her up, she would again look whole. Finishing up, I needed to take a pause, not to sleep, but to think and process. However, the surgeons were finishing up on the back table and prepping to go transplant their next patient, telling me to make my way back to UCH. I switched my mind back to the patient who was going to receive the pancreas and kidney we had just procured. On my way back to UCH, morning traffic hit and I don’t know why I couldn’t process much on that hour-long drive. I did not need to sleep, but could only think about the next thing, and feel this buzz in my body… I wonder why I did not think about the patient coding in the OR last night or contemplate my feelings about death in light of the patient I met who was already “dead”. The whole night I didn’t feel the need to sleep. Maybe sleep allows you to reset instead of pushing forward with the next thing. Maybe sleep allows renewal for processing the day’s next challenge. However, I’ve slept many nights since and still don’t really know what to make of that intense night.