March 29, 2011

Hypothetical

I'm up to my elbows in a difficult cesarean section, the woman's abdomen retracted on both sides and about to slice into her womb to retrieve her baby.  The lights overhead sizzle and with a pop we are plunged into darkness.

I freeze.

"No one move.  Does anyone have a cell phone on them?"  A few murmurs go around the room as the anesthesiologist and the one nurse that isn't scrubbed in pull out phones, mashing buttons until their iridescent glow illuminates their owners' chins.

"You, go and find out what's going on.  I need power back in this room and I need a flashlight, now!"  The nurse hurries out of the OR.  The anesthesiologist looks at me, and I look back and wonder what we're going to do for this woman.

"We need to monitor her vital signs, and I don't have any monitors."  His face is tense, his mouth narrowed into a thin line.  His fingers come to rest on the woman's pulse.  The woman is fine, for now, but the surgery needs to continue; she can't remain open on the table for long.

"What's going on?  Why is it all dark?  I'm blind, I'm blind!  I can't see!  What's happening?"  One of the pediatric nurses steps next to the patient and begins to speak in a low, soothing voice.  The patient's shrill cries die out as she grabs tightly onto the nurse's hand.

The nurse I sent out of the room returns with a flashlight.  She brings it to the table and puts it in a sterile bag, like they use for other reusable equipment.  "I need your hands," I tell her.  "Is there any way you can hang that above us from the lamp?"  She looks at the lamp and decides it's doable.  We use suture thread to snag the top of the bag and then loop it over the handle of the OR lamp.  The light is dangling a couple feet from the sterile field, and I pray that it won't fall and that I'll be able to see enough to finish what I'm here to do.

I take a few deep breaths before I pick up the scalpel again.  I make the incision into the uterus and even though the rest of the OR is in pitch blackness, the table feels almost like any other c-section.  At the same time, I feel linked to the surgeon who first performed this act, hundreds of years ago, with no more light than an oil lamp or a candle.  The baby emerges from the womb and gets handed over to the pediatric nurses immediately, who cradle him in towels and wipe his face, and suddenly he cries out.  It is a miracle, and he is alive, and now the only task I have is to save his mother here, in the dark.

I peer closely at her abdomen.  I take up the suture needle and thread and begin to stitch her organs back together, repairing her uterus and weaving her flesh back into a whole piece as I work my way toward the surface.  I am securing the subcutaneous fat when I hear an electric hum in my ears.  It is followed quickly by the blinking on of bright fluorescent lights, and now the OR is bathed in light.  I finish stapling the woman closed and once her bandage is on, we lower the sterile curtain.  The nurses bring the baby over to the new mother and she has tears in her eyes as she looks at him, her baby from the darkness brought here into the light.

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