Friday, March 17, 2017

A Teeter Toter Surgeon

What goes up..Comes down..Hard
Play grounds from my youth could be very dangerous places with heavy moving objects,  very hard  unforgiving landing places, and young toughs on the prowl in search of  unsuspecting  victims to intimidate. Teeter toters were a favorite playground  implement for bullies to ply their trade. A hard wooden plank moving up and down with a  fulcrum in the middle was too much to ignore for those with devilment on their mind.

The bully's pitch went like this, "You wanna have some real fun, lets go play on the teeter toter. I'll even let you get on first." The unsuspecting victim was seduced by the bully's jubilant grin and happy go lucky demeanor.

Once the hapless victim was in position on the end of the teeter toter, the corpulent bully promptly planted his overstuffed backside on the opposing seat. The victim was suddenly thrust high into the air with amazing force. If he was strong enough to hold on, the finishing  move was about to present itself. The victim would be held captive on the elevated end of the teeter toter as the bully began his verbal torture.

"You sucker, now you are really going to get it," the bully taunted. As the victim screamed and cried the bully suddenly hopped off the depressed end of the teeter toter sending his high- flying victim crashing to the ground with a sickening thud/crash/cry cacophony.

We had an aging, well  past his prime, ENT surgeon that everyone  referred to as the teeter toter surgeon. His well earned nick name was indicative of his smooth preop pep talk followed by a harrowing experience once the patient was situated in the operating room proper.

His life long obsession was rhinoplasy and he even invented specialized surgical instruments that carried his surname. Whenever Dr. Cuddle asked his scrubnurse for an instrument, he made a point of accentuating the "Cuddle" in it's nomenclature. "I'd like the cuddle speculum followed by the cuddle elevator." was a typical command issued in his carefully modulated, stilted speech pattern. "Yes Dr. Cuddle," was the canned scrub nurse's reply.

He could convince just. about anyone with a nose that they were a candidate for rhinoplasty. His sppech, like the playground bully, was filled with false promises and fantastic benefits. I remember how he extolled the vitality benefits of his nose jobs because they increased the oxygen carrying capacity of the blood. Then he went on and on about how beautiful their new nose would look. Hollywood would soon be calling. That beautiful new look and rejuvenated persona would be too much for a movie producer to resist. Better days were as close as a lateral osteotomy fracturing the nasal bone structure to smithereens all the while an awake patient teetered at the maximum elevation of the teeter toter OR table.

For those who question my comparison of  Dr. Cuddle to the playground bully, understand this: The positioning of both victims is identical when receiving their punitory ministrations. The play ground victim receives his coccyx shattering impact sitting bolt upright and Dr. Cuddle performs his proboscis punishment with the victim  patient in the identical configuration. The OR table is positioned with a break in the middle and the back of the table raised at a 90 degree angle.

Dr. Cuddle was one step ahead of the playground bully who was content with letting his crying victim to quickly vamoose from the scene of the crime after receiving his butt busting punishment. There was to be none of that flight or fight syndrome business for Dr. Cuddle's patient who was physically restrained to the table with an airplane type belt around the waist. This served the dual purpose of arresting the patient's departure and also prevented him from throwing blows in the direction of  Dr.  Cuddle. The ankles were also tacked down with another robust belt to avert kicking. The coup d grace' was an elastic bandage wrapped  around the forehead  and secured behind the table for stabilization.

Once he had the patient in the OR, he had that same look in his eye as the playground bully. Someone was about to experience torture on the same level as the teeter toter victim. Dr. Cuddle performed all his procedures under local anethsia if you could call it that. That look on a wide awake patient's face  as they surveyed the Mayo stand directly in front of them loaded with a multitude of glimmering sharp steel instruments was eerily similar to that of the teeter toter victim.

Their was a reason for his making sure the patient was restrained on the table. Even if the local anesthetic was effective, that sound of a mallet impacting with an osteotome and fracturing your nose has to be worse than the crash/cry after a playground victim's  teeter toter free fall. The stuff real nightmares are made of.

Whenever I was anywhere near Dr. Cuddle, my nose was covered with a surgical mask. I did not want to give him any ideas about "fixing" my nose. As a youngster, I was the victim of that teeter toter free fall prank and I did not want to repeat the performance at Dr. Cuddle's crafty hands.

5 comments:

  1. Sounds like he enjoyed cruelty.

    I miss teeter-totters. The ones in playgrounds now have a spring, and it bounces up maybe a foot in height at the most.

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  2. Playgrounds were really fun before the risk management rubrics were implemented. My favorite was the giant all steel sliding board. We sat on sheets of wax paper and flew down the chute at what felt like the speed of light. The tricky part was getting your legs moving before hitting the bottom or you landed flat on your face.

    Some surgeons were totally obsessed with doing a particular procedure to the extent that the care was not very patient centered.

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  3. In paediatrics where I work sometimes, both as an old fool HCA and a new fool ODP, (UK acronyms) we borrow Mr Cuddle's nasal speculums from the ENT department to use as speculums for an altogether different orifice for smaller patients. We don't tell ENT what we are using them for, and I wonder what Mr Cuddle would think of us, if only he knew...

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    Replies
    1. I was always a believer in using whatever works to get the job done. Nasal speculums sound like the perfect instrument for the task used with peds pts.

      When I was working in neuro ICU we would occasionally get interrupted by a frantic technician from the primate lab located downstairs. "Our Chimp is seizing and we need to borrow your hypothermia unit to bring her fever down." When the unit was returned full of ape hairs we tried to clean it up, but always had a quick answer if a patient asked about the loose hairs.

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