“Alright Dr. Cameron, it appears that the patient is going to need a triple bypass if they are going to live,” Dr. Ericson casually quipped over a lukewarm cup of joe.
It did indeed appear that the patient was having a difficult time with getting his poor heart to cooperate with him, as he had apparently recently taken to participating in butter drinking competitions all around the United States.
I thought to myself for a moment, then replied “Yeah, I guess so. Probably time to move him to the ER.” The patient had been very unconscious for the past 15 minutes or so.
The patient was strapped to a gurney and transported from the waiting room and wheeled into an operating room by a team of medical personnel. It was about 3:00 AM, and all of the staff were nearing exhaustion. I followed the rest of the nurses to the operating room soon after, and Dr. Ericson was sipping his coffee right next to the operating table.
As a wave of tiredness came over me, I had to strain myself mentally to remember my medical training, lest this man die on my table. Alright first step… Yeah, I think i should probably wash my hands so i don’t give him an infection.
As I scrubbed my hands, Dr. Ericson put his gloves on and pulled out his tray of surgical instruments. “Ready doctor?” He asks me through his surgical mask.
“Yep, as long as I stay awake,” I reply. Tonight was going to be a long night. I put my latex gloves on, and as I approached the table, I saw that the patient was fully prepared for me, ready to go. First, I asked the nurse for a scalpel and made a vertical incision about 8 inches long above the sternum.
And this is exactly where I forgot what I was supposed to do. Embarrassed, I asked Dr. Ericson “So, remember back to med school? If I were testing you now, what would you say the next step would be?”
“Uh, I guess it would help to get through the ribcage,” Dr. Ericson replied. “I think there is probably a hacksaw for that around here somewhere.”
It became apparent to me then, that Dr. Ericson was under the same spell of fatigue that I was. He began clanking around a few drawers looking for the saw, when a nurse began to ask “Hey doctor, aren’t you supposed to…”
“Quiet, nurse,” I interjected. I wasn’t about to have some under-educated peon lecture me on how to do my job.
The clanking stopped, and Dr. Ericson looked up from his drawer “Found one!” he exclaimed as he held it high: a rusted hacksaw covered in white paint chips, clearly last used for woodworking.
I replied to the doctor, “Well, it’ll have to do, I guess.” The nurses were all giving each other terrified glances at this point, but must have been to afraid to say anything else. I took the saw from Dr. Ericson, and as I was about to begin, I remembered something rather important.
“Dr. Ericson, have you administered anesthesia yet?” I asked. The patient was unconscious for now, but probably wouldn’t remain that way if I had begun my violent assault on his sternum.
“Oops.” was his only reply. He strolled over to the medicine cabinet, and grabbed a bottle of morphine. He inserted a syringe into the bottle, and drew the plunger to about 30mL. “This’ll do,” he remarked to himself.
The morphine was injected intravenously, and the operation proceeded. The sternum was hard to make it through with the hacksaw, but five minutes and elbow grease are enough to saw through mostly anything.
I didn’t remember what the device to hold the ribcage open was called, and I didn’t want to embarrass myself in front of these dumbass nurses again, so I told one of them to keep the rib cage open by holding the halves apart. With their hands. Now, I could see the bottom tip of the heart beneath the patient’s lungs. Still mostly inaccessible, so I cut the connective tissue keeping the lungs in place, and spread them out to the sides like wings. Unfortunately, the lungs weren’t functioning any more.
“You. Nurse. Go get one of those things that you pump into his mouth so he can breathe,” I ordered.
“A… what?” The obviously horrified and anxious nurse replied.
Unable to remember what the device was called, I sighed and said, “Just… perform mouth-to-mouth for the remainder of the procedure.”
At this point, the area around the table was beginning to become crowded with nurses crawling all over this poor man, to keep his ribs open and to keep him breathing. I looked to check the EKG to see if his vitals were still good, at which point I realized that I forgot to connect one. I ordered the nurses to set one up, and after everything was set up, I noticed that his blood pressure was very low.
“We are going to need to give this man a blood transfusion,” I stated. “Dr Ericson, would you be so kind to set up the transfusion?”
“Sure thing,” He replied. Taking a bag of O-negative out of the freezer, he thawed it under his armpit for a couple of minutes and then inserted it into IV, commanding a nurse to hold the bag up and let gravity do the rest of the work.
After a few minutes, blood pressure began to return to normal. With his heart exposed, the real operation could begin. At this moment, I remembered that a bypass surgery involved taking veins from the legs and using them to “bypass” the clots, but I could not for the life of me remember which veins to take. From the look on Dr. Ericson’s face, he couldn’t either. Attempting to save face, I asked Dr. Ericson “Would you be so kind as to perform the vessel removal from this patient’s left leg?”
He turned bright red, and began to look around the room. “Me? Now?”
I just stared at him for a minute.
“Fine.” He grabbed a scalpel and cut into the patient’s left leg, and removed a 6 inch segment of the largest vessel he could find, and what remained of it began to bleed profusely.
I had no idea what to do at this point, I was just too tired. "Well, shit. I guess we’ll have to amputate. I don’t think we can save that leg.
The nurses obviously didn’t agree with what was going on, with their judgmental, wide-eyed stares and heavy breathing. They weren’t the ones holding the scalpel, so they could piss off for all I cared.
I took the hack saw from before, and went to work. The leg was faster to come off than the sternum, that was immediately apparent. However, it was also bleeding much more heavily. I ordered another nurse to throw on another bag of O-negative and squeeze. I couldn’t remember the rest of the amputation procedure, but I remembered back to an episode of The Walking Dead that I saw in season one, where some redneck cut off his own hand to escape some handcuffs and sear it with a hot pan, cauterizing the wound. I elected to go with this procedure.
We threw the leg in the bio hazard bag, as it probably couldn’t be reattached and we already had the vein we needed. I cut it into three sections, one for each of the vessels that we need to bypass. Then another reality hit me; I had forgotten which three of the four vessels needed to be bypassed. A cold sweat came over me, my vision began to tunnel. I done goofed. I can’t even remember how to test for which ones needed the bypass. Time to wing it, I guess.
I decided to go with vessels 1, 2, and 4, because of a video I saw with three numbered escaped greased pigs that I saw earlier, with the prank being that the #3 one was nonexistent and people would keep looking for it. I cut small holes on either side of where I believe a clot would be, and attached the veins with my trusty tube of Elmer’s super glue. Monitoring the patient’s vitals, it appeared that it worked, since some of the numbers began shifting around and it wasn’t beeping at me.
I glanced at Dr. Cameron, who gave me a wink and a thumbs up. I knew that two doctors couldn’t possibly be wrong, so everything must be going well. Only three nurses left during the procedure, two of them due to physical exhaustion from holding the patient’s ribs open and one due to a bout of unconsciousness. Must have been too squeamish to assist during open heart surgery, they shouldn’t have even been allowed to graduate med school.
I placed the lungs back to their native position, and used super glue in the place of where I made the earlier incisions to disconnect them. I relieved the rib-holder nurse of duty, and stapled the sternum back together. I asked Dr. Ericson to finish sewing the patient back up while I remove my gloves and wash my hands. After taking one last look at his vitals and determining that they probably looked fine, I ordered the nurses to bring the patient to a recovery room where he would remain until he woke, at which point he would be sent home.
Due to reasons unknown to me, none of them responded, or even looked in my direction for that matter. They cleaned the blood off of the patient and wheeled him out. Sighing a sigh of relief, i turn to Dr. Ericson. “Just another day on the job, right?”
“Yep. I guess we’ll see what tomorrow brings.”
“We sure will.”
Dr. Ericson and I donned our coats, and returned to the parking lot. He finished his coffee on the way to his car.