Complications

I'm at the point in time where there is so much work I have to do and I don't know where to start; it's disabling. Like most colleagues in my year, I am afraid of upcoming examinations. The only reassuring advice we exchange between us is don't worry, you know more than you can recall.

This post is actually a story within a story. In Gravity II, I mentioned attending an interesting hernia operation with the ASU consultant, Dr. HL. I have been thinking about something that happened during the laparoscopic repair, though I thought writing it in Gravity II would make it ever so long!

So the insufflation had kicked in and the patient's abdomen was distended to the point where carbon dioxide was seeping out through the laparoscopic incisions. The camera kept getting blurry and it was annoying Dr. HL, even with the new camera. I just stood there, hands folded together in the I'm scrubbed and would love to help position. Everything was going well until Dr. PF walked in from the back of the theatre.

Dr. PF was the hospital's only thoracic surgeon. He was a good teacher and was well known for his short temper with junior staff. It's not every day one consultant walks into the theatre during another consultant's case and it was plain weird because he's come to see the upper GI surgeon.

G'day Dr. HL, what are you doing? Sorry to interrupt. 


Hello Dr. PF, it's a hernia repair. What brings you into the realm of the inguinal canal? Aren't you in the rooms this afternoon?


I got called into a neurosurgical case. There's been a complication. I need your advice.


What's the story? 


There's a 40-year-old lady with metastatic breast cancer diagnosed 12 months ago. She had cervical spine metastasis resulting in a fracture of the C3 vertebral body. They reduced it with hardware 6 months ago. They went in today to replace the hardware and perforated the posterior oesophagus. 


Oh no. What happened?


It's an anterior approach. They called in another consultant to contain the bleeding, but it seems they are worried about oesophageal and laryngeal extension. Now I've had a look and it seems the larynx is intact, but there is definitely a hole in the gullet. We'll need you to have a look at some point. They're still trying to contain the bleeding, so come when you have a chance. 


Sure. I'll be there in about 15 minutes. 

Okay sure. 


What a tragedy. This poor lady. I couldn't stop thinking about her that night. I hadn't met her, and I wish I visited her in theatre, but I didn't think it was professional given the circumstances. It's times like that where we just need to step aside and let senior staff manage the situation.

But I still think about her. I don't know her name, where she is now and what the outcome of the operation was. There was talk about an oesophageal stent, but it's only what was going around. Hopefully I'll run into the consultant and find out what happened.

Then again I'm still thinking about the poor lady with the bowel perforation after the hysterectomy. I've bumped into the upper GI registrar but didn't have the chance to ask him how she was going. I'm accumulating these patients within me.