Chalk that one down for a learning experience.

The fact that we had admitted half a dozen patients the previous evening, and booked nearly all of them as add-ons in the OR should have been a clue that it was not going to be an easy day. Nevertheless, the plan was for all the other residents to be in the OR, and me to do work on the floor until one of the last cases, when I could do a minor amputation. Which was fine with me. Amputations are exactly the kind of case where they let the intern do the whole thing.

So I was just hanging out and watching, unstressed, letting everyone else worry about the busy ORs, when one of the seniors paged me: “Hey Alice, Dr. X had to go do this, and Dr. Y had to cover that, so I’m going to be with this other attending. . . so you need to go scrub in OR 12. All right?” I started explaining how thrilled I would be to work with the attending who had OR 12 booked solid for the day, and he hurried off.

It was supposed to be a simple case: access the artery, do an angiogram, maybe put a stent in, get out. I’m starting to learn that nothing in vascular is that simple. If these patients weren’t complicated, they wouldn’t be having vascular surgery. The procedure took twice as long as planned due to difficult anatomy. Finally, we were pulling all our wires and sheaths out. “Alice, just put your finger on the artery here while the nurse gets us a suture to close it with.” Famous last words. This is the third time Dr. Xavier (we’ll call him) has told me something like that, and every single time it ends with blood all over me and the patient. So I put several fingers and a good deal of pressure on it, and somehow there was blood coming out anyway. I’m not sure what happened next. I can’t believe that either Dr. Xavier let go of the proximal controlling loops, or that I was so stupid as to pick up my finger to see where the blood was coming from. However it happened, the next thing I knew there was a fountain of blood all over my face, my neck, my gown.

I pushed the rest of my hand over the artery, and it stopped. Dr. Xavier calmly looked across the table at me. “Carla, would you clean off Dr. Alice’s glasses please?” Silence throughout the OR. “Actually, perhaps it would be better if Alice went and washed off.” Grateful for the confirmation, I let the student get his hand on the artery (with a very determined look on his face), and scurried out to the scrub sink to wash my face.

I thought I had most of it fixed, but as I walked through PACU, pre-op holding, and the nurses’ lounge to get to a bathroom (they don’t provide much for female physicians at my hospital), I got some weird looks. Come to find out I’d missed large sections of the carnage, and looked like nothing so much as a zombie from a horror movie. Back to the sink. . .

A couple of CRNAs standing by assumed I had been banished from the OR in undeserved disgrace, and tried to comfort me. “Are you ok?” “Oh yes, I’m fine. I just should not take my finger off the artery ever again; stupid of me.” “Oh dear, honey, I’m sure that’s just what they said; it’s ok.” “No, I mean it seriously, I should not have taken my finger off the artery. On the other hand, I made a hole in it in the first place.” “It’s not that bad, I’m sure it wasn’t your fault. They’re just choosing to blame you.” “No, really, we made the hole on purpose.” “Oh. . . well, I’m sure it was a learning experience.” lol, talk about crossed wires.

Moral: never assume that any vascular case is going to be straightforward enough not to need a shield on the mask. But I hate the way those shields hit my glasses and pick up glare. . .

 (If you want to hear an even bloodier story, click here.