Saturday, October 3, 2020

All Nighters in The O.R. Were Real Stinkers


Bovie smoke carried olfactory nightmares into every 
nook and cranny

As lengthy night time trauma surgeries came to a close, nurses were often presented with a cafeteria-like  assortment  of wounds to dress. The deep stab wound on the medial thigh called out for iodoform packing which had a nice, sweet, iodine like scent. After the thigh wound was ram rodded  packed to the hilt with ribbons of iodoform, it was time to dress that monstrous midline abdominal wound. Tincture of benzoin would be applied to secure Montgomery strips in anticipation of frequent dressing changes. Montgomery strips spared the patient the pain of abrupt removal of adhesive tape; just loosen the ties to swap out ABDs.

This juxtapositioning of one scent (iodoform) on top of another (tincture of benzoin) often led to the creation of a completely new and frequently unsavory smell that I thought of as the third effect. Under this principle, when two smells are brought together, their individual effects are irreparably  altered  and potentiated into a novel, foul, lingering witch's brew completely  unlike that of the initial contributors. I think the technical name of this newly created stink fest was compound smells.

 The addition of residual  Bovie  smoke made  the foul smell penetrate every nook and cranny of  just about any object or person in it's path. Just as a syringe and needle transported medication to a site, the Bovie smoke delivered the stink as reliably as a  mailman.

Underlying scrub attire reeked of the compound smell when our impermeable surgical gowns were removed. I always thought of this as the diaper principle, because as long as the gown was intact the smell was relatively contained. Removing the diaper...OOPS...I meant surgical gown was another story as the foul odor homed in on awaiting olfactory senses like a cobra strike.

The best part of a  long night  in the O.R. was the beautiful sunrise over Lake Michigan as this usually signaled an end to the mayhem and the arrival of reinforcements in the form of day shift nurses. Fresh, kindly arriving nurses always stopped to help the  worn out, bone tired trauma victims and I'm referring to personnel-not patients.

One July morning, my friend Janess, bounced into the room as a case came to a conclusion to act as cheerleader and help us off with our gowns. I noticed her eyes and jaw roll as her eyebrows popped toward the top of her head as she assisted. She looked distressed - to say the least.

 The next day I thanked her for the moral support adding, "We must have looked pretty bad, Dr. Salmbow and I felt like we had been beaten to a pulp after that doozy of a case."  I'll never forget her immediate response, "It wasn't how you looked. It was how you both smelled."


  1. I'm glad Janess is back OFRN - I've always liked Janess and we haven't heard about her for a while!

    I may find myself in hospital as a patient soon (I will know tomorrow), so if it happens that I am unable to comment for a while, that will be the reason.

    Your blog gives me a great deal of pleasure (& laughs!) as well as being informative - good to have you there OFRN! Cheers, Sue

    1. Thanks, Sue, I hope your hospital visit goes well. It certainly is different being on the other side of the bed rail-a problem I know all to well. All the best to you!

    2. Thanks for those recollections of olfactory nostalgia. As always, well done, sir.

    3. Thanks for taking the time to leave a comment and kind words. I probably spend too much time living in the past, but it's a kindly refuge in turbulent times.

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  3. Aaah, yes! Hospital stink. I never got into the specialized chemical odors, but I was getting to discern the types of bacterial infections by their fragrance. It surprises me that nurses can ever retain their sense of smell after years of abuse.

  4. Good to hear from you, Jono. I was never able to identify specific bacterial infections by scent, but no matter how olfactory limited, nurses could always sniff out an anaerobic infection by that organic like putrid smell. I could detect a bacteroides or ecoli infection from across a ward. WHEW!