poured out before bed
The attending and I have long finished our pimp/teach ritual – meaning we’re at least an hour and a half into the case – and have fallen to paperwork and studying, respectively, glancing intermittently at the monitor. The room is silent but for the high-pitched beat of the pulse ox and soft snores of the patient, coupled with the sporadic buzz of the bovie and the almost whispered conversation of the surgeons just beyond the drape. Every so often a surgeon raises his voice to direct Mrs. Jones – under MAC sedation – to move this way or that, and without a word she does as commanded, then recommences her ketamine stare and restful breathing.
Suddenly, with an echoing clarity and a volume misplaced in such a quiet setting there rings out a barking, “HEY!!!”
Startled, my attending and I gawk at each other. His eyes are wide and piercing.
“Was that you?!” he asks, incredulous.
“Um, I think that was the patient,” I reply, turning to look at the motionless, still staring Mrs. Jones.
“Mrs. Jones,” Dr. B hovers over her face. “Mrs. Jones, are you comfortable enough?!”
She continues to stare past him into nothing, blinks only when he places his hand on her temple. The surgeon’s head floats uncertainly over the drape. The pulse ox beats on at a steady, normal pace, the blood pressure cuff finishing it’s cycle to reveal an unchanged reading.
“Mmm. Mm-hmm,” she mutters slowly, softly, her blank expression unchanged.
Dr. B shrugs. The surgeon shrugs. The resident shrugs. The surg nurse shrugs. I shrug, just to feel professional.
But we push a little extra druganyl, just in case.
– Step 2 CK Throw Back, From Anesthesia