the anatomy of surgery

Disclaimer: (This means you James) 

1.  This post is not for weak stomachs...

2.  This is a long post...sorry....it got out of hand, but I couldn't decide what to trim...

I love surgery. I got my first taste of guts and gore when I was working as a nursing assistant (CNA) in Boone, NC.  It was after college at LRC, before PA school.  For those of you who don't know, CNA's are pretty much glorified butt wipers, doing the grunt work no one else wants to do. Labor intensive chores like baths, putting people in bed or getting them up and dressed, feedings, cleanings and even (Lord, I can't believe I ever used to do this stuff)... enemas!  Nasty work, but someone had to do it and it was definitely a learning experience for me.  I had worked as a CNA in nursing homes, an ER, and, finally, in a birthing center at a local hospital.  I loved that job.  I still had to do some nasty stuff there, but most of it involved infants or cleaning up a new mama so she could be with her baby.  And that is also where I got to feel a persons "innards" for the first time.  The birthing center had their own surgical suite dedicated to c-sections.... planned or emergency. I worked night shift, so I usually saw emergencies or at least unexpected deliveries.  It was a rush.  It was crazy and, at times,  it was absolutely a mess!  But I loved it.  They took me to the OR, taught me the instruments, how to pass them, how to help the doctor, how to scrub.  My mom thought it was fun to ask me what I did at work that day until the day I answered (truthfully), "I caught the ovaries".  She didn't ask so much after that :D  

Then I came to PA school. Just in case you don't know, PA means "Physician Assistant".  In this state (NC), I can see patients, diagnose them, treat them, write medicines for them in prescriptions and all sorts of stuff. And, after a few years, I now work with a surgeon, back in the OR, except, this time, I'm  asking for the instruments, not passing them.  I help with surgery, suture ("close") from time to time, my opinion is heard, I write orders and help manage patients.  I understand more about what is going on.  And here is a truth that I have noticed in the OR.  

As you walk the halls of the operating room, you will see a lot of scrubs.  At our hospital, everyone in the OR is decked in green ones. All the same color of green. A few of them may be a "girl" style (2 lower pocket shirt, elastic waist pant) vs. a "boy" style (one pocket shirt, drawstring pant) but pretty much we all have on scrubs. We wear masks and protective eyewear, booties and caps.  It's pretty hard to tell who's who!  There are also a lot of people in the OR.  There are patients (obviously, they have on gown or are naked), nurses, scrub techs, PA's, residents, doctors, CRNA's, any variety of student from any of these groups, and OR assistants.  All varying levels of education depending on the job they do.  The patients lay on the table, the nurses chart and run the room, the CRNA's monitor the patients while they sleep, the scrub techs pass instruments, the PA/resident/student for these may scrub in to assist/help suture/hold instruments, the doctor operates and the OR assistant, well, they get the dirty work.  They clean up the beds, take specimens to pathology or the lab or mammography, they clean up the scrub spaces, they physically help move patients, then they take the trash and linens out of the room, mop and clean for the next case. They get the grunt job.  So, if we're all dressed the same and we all have the same external anatomy, how can you tell who's who????

Here's the truth I've seen in my observations:  By their words.  

Just so you know, I'm just talking about "instances" here... I'm not stereotyping each group...  Many times, I have come upon two doctors (surgeons or anesthesiologists) talking to each other about their day.  Could be their cases, could be their homelives, could be "the man".  You have to be prepared when you listen in, because you're probably gonna hear some words you don't want to hear.  The f-word comes to mind among others.  Or you'll hear someone joking about an ex-spouse or how many hours they can work in a month/how many cases they can get trying to make more money, which subdivision they plan to move into next and which private school their kids are going to. Their OR conversations are more likely than not about politics, the stock market, housing prices, etc.   The nurses, well, they are always a lot of fun.  You'll find them talking about patients usually with compassion, trying to decipher what's best.  Sometimes they gripe about "the man" but you usually don't hear so much cussing.  They are trying to finish shifts to get home to family and they talk about their families often.  Then there are the scrub techs and ORA's.  These guys are the lowest paid employees in the OR.  The scrub techs do a job that even the nurses don't do, take call like nurses, but don't get paid half what nurses get paid.  But as you walk down the halls of the OR, you will hear them encouraging each other... with scripture... with prayer... asking earnestly about each other's families....asking about church or Bible study.  They remember details about you that you forget you've even shared with them.  

The scrub techs and ORA's are the "guts" of the OR.  The doctor may be the head, directing all the hands... the nurses are the lymph nodes, cleaning up and keeping order.... the CRNA's keep the heart and lungs working... the PA's/residents are like hands and feet running here and there to help hold things in order for the doctor to do more... but the techs and ORA's, dirty as their jobs may be, are the guts.  They do work that is down and dirty at times.  They even get treated like poo from many surgeons and even PA's/residents who talk down to them or act like they don't exist or throw temper tantrums. But they are the ones who have the guts to live with a Christ-like heart. They are unafraid to speak of the love of God in the halls. There is even a transporter that tells every patient that she rolls from one area of the hospital to the other... "Have a blessed surgery."  I honestly believe that as she pushes these stretchers with patients of all sizes that she prays for them with each step.  

When I was a CNA in that birthing center, I talked about Bible studies at work.  The girls there invited me to some and I went with them and loved it.  We encouraged each other and prayed for families and sometimes even over the babies in the nursery if they had odd home situations (like abandonment or any dangers we could feel).  When I was a PA student, I led Bible studies in my house. I had scripture crammed everywhere!! I was constantly studying in different books and notebooks and I had sticky notes of scriptures to encourage me at some place in all of them (I still find them now sometimes).  I knew other students---med students and PA students who did this, too.  Many who claimed they would carry God into their practices and share God with their patients.  I wonder how many actually did?  There are occasions when I get to pray with patients or share my faith or encourage with scripture. I feel so blessed when I see those opportunities, because I know that I did not create them, I am just speaking up to fill the position that was created for me.  There are a few times that I've even discussed faith with co-workers, but that seems to be tougher.  

What opportunities has God made for you to encourage someone or for you to carry your words to someone that you may see every day or maybe even never again?  Who cares if someone is watching you as you pray for someone if the person has asked you to or finds comfort in it?  Who cares if you support a co-worker who may not be of your "class" by encouraging them with scripture or a note or even, "I'm praying for you and your family."  Who cares if you don't wear a dress and heels to church?  Who cares if you give you shirt to a homeless person? or hold hands with a drug addict?  God cares.  What has he called you to do?

John 15:15-17

"I no longer call you servants, because a servant does not know his master's business. Instead, I have called you friends, for everything that I learned from my Father I have made known to you. You did not choose me, but I chose you and appointed you to go and bear fruit—fruit that will last. Then the Father will give you whatever you ask in my name. This is my command: Love each other."