The O.R.

The operating room (henceforth, O.R.) is a hypnotic place. It’s cutting edge. It tears me in two.

Last week I got to see an open heart surgery (replacement of the tricuspid valve) and a whipple (the patient had pancreatic cancer, so the surgeons went in, cut out the pancreas, cut out a piece of the liver because the tumor had begun to spread there, and also removed a chunk of the large intestine).

On the one hand, I love the guts and gore of surgery. The surgeons are merciless—they hack and saw and rip away at the patient’s body as if it is the only right thing to do, as if the body-patient is made specifically and only for that purpose. That’s troubling, but I will talk about the troubles later. Right now, let’s talk about love. I love the instruments. They’re all so orderly and intricate; each have their own identity and function and place on that sterile field. No infringements of purposes; no excess of use. In the company of competent surgeons, they become extensions of dexterous hands and nimble fingers. There is a system for everything and everybody; each action has a purpose, no randomness exists. Don’t misunderstand, I think randomness is a vital force of nature. Serendipity is the opening of the universe, a chance to experience life and love larger than our selves. But sometimes, lack of randomness, oddly, also feels right (maybe because so much of nature is not random). And what I love most of all, most of all, is the mystery of the body (seemingly) revealed. It’s beautiful. It’s mesmerizing. I could watch for hours and hours and not get bored. It’s the ultimate voyeuristic experience. It’s spellbinding.

Unfortunately, the operating room is also Janus faced. While it fascinates me to no end that I can look so deeply inside the body, see where things are and how things rise and fall, beat and pulse, I also feel extremely uncomfortable at how quickly one can forget the patient who owns that body. It unnerves me how one can immediately be completely removed from one’s body. As soon as the anesthesiologist has you subdued, your body becomes a thing. Your face is covered, draped over, eyes taped shut, you are already sectioned. Then you become a piece of meat—that’s what I kept thinking when I saw the surgeons cut through the bones and tissues to get to the organs. And by consequence, I think, because you’re removed from the body, you’re also removed from participating in your health care. How much participation can there be if you’re knocked out and have no idea what’s being done? You don’t know that while the surgeons are cutting at your heart, they’re also taping their feet, humming a tune they’d heard on the radio this morning, and occasionally interject a joke about the pancreas? And everybody in the room is so casual about it, as if this cutting into your body is nothing more than wiping away spilled coffee. The circulating nurse may even do a little dance to the beat that’s radiating from the speakers in some corner of the room.

And then there’s the standing. So much standing. And standing in one place at that. Who likes that, seriously? If you have to stand in one place, you might as well stand on one leg, but that just may be my cut off point.