This morning we had an office procedure: taking out a breast implant and its strictured capsule, and replacing it with a new one. The patient was pretty nervous, although after a couple doses of oral sedatives she went off to sleep nicely. (Dr. Mark refuses, on principle, to go through the paperwork required to accredit an office OR for iv sedation. So he manages with oral meds and a very sweet nurse. If it needs more than that, it has to go to the hospital or surgery center.)

The catch was that, before she went to sleep, the patient was very cold. So we turned up the temperature in the room pretty high. Then we scrubbed up, and turned on hot fluorescent lights too. Which adds up to, an hour into the procedure I was about ready to faint. I am so disgusted with myself. I had to step back and sit down for a couple of minutes, because I figured, embarassing as that was, it would be better than falling into the sterile field.

That’s the third time something like that has happened in the last seven months; and this time I wasn’t sick at all, so absolutely no excuse. I know it was just the heat in the room; but no one else was bothered by it. Resolved: to drink more water.

Afterwards, I was apologizing for interrupting the procedure, and Dr. Mark said, “That’s ok; I understand; a lot of medical students have that kind of problem. You know, they just can’t handle all the blood.” I was all ready to start explaining that it wasn’t the blood at all, when I saw that he was laughing at me falling for his joke.

Actually I was very bothered by all the blood from the boy who jammed his teeth all out of place, but no one saw me that time.

We just saw a patient in the ER who fractured her maxilla. She’ll need arch bars placed; there should be OR time sometime later this afternoon. But that one walk back through the halls of the ER, past the trauma bay and the elevators up to the OR, reminded me of how much I love this hospital, and the surgeries that happen here. Including the blood. It’s not just about proving that I can do it; I wouldn’t be happy away from the mysterious closed society of surgeons and their nurses. This is real medicine; this is worth doing.

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