Friday, February 25, 2022

Last Night in the OR


Routine scheduled surgery during daylight hours always reminded me of church services on Easter Sunday or Christmas Morning, packed with posers and pretenders making a show of strutting their stuff.  Members of the administrative office sitter bunch taking advantage of a new day to spread their feathers like a peacock on parade. The more routine the procedure, the more garish the display.

 Midnight surgeries were of a far different persuasion and akin to a mid-summer church service during vacation season where only the true faithful showed up. The daytime pretenders were a totally different breed from the passionate middle of the night doers. It took a determined personality to crawl out of a warm bed on a frigid Chicago night. Owing to a phobia of authoritative administrators, a craving for an adrenalin boost or a youthful naiveite (choose whatever works for you), I'd rather crawl in for a midnight trauma than scrub for an 8AM vein stripping.

Dr. Slambow, my favorite trauma surgeon had lots to say about these late-night adventures and with his jowls dangling below his mask like a giant croissant he would often bellow. "Everyone here believes in let's get this done before the daytime herd heads through the door." Sometimes he would expound at length as to why the only valid surgical intervention was for serious traumatic injury. "Things can only get better from here, but so many elective procedures invent new surgical complications. When was the last time a radical mastectomy or Whipple really cured anyone?" I could see his point. Thank heaven contemporary surgery with its repair and replace mentality has taken place of the old -ectomy for all free for all's. 

Middle of night surgeries often began with a call to the honeymoon suite which was actually a repurposed vintage operating room at the end of the hall in the oldest part of the hospital. There were 2 sets of bunk beds and a wall phone midway off the floor so it could be answered by upper or lower occupants of the bunk beds. The room's light switch was permanently taped in the off position with autoclave tape, so entrants did not arouse those at rest. Call rooms like this were gender neutral and the only prerequisite for use was being bone tired.

Shenanigans were a great way to pass the time and deal with late night tensions while awaiting that phone call to hop to it. I always tried to set a positive tone for our late-night ministrations and frequently started my dialog with the prep and  a lengthy description how I just loved the radiant pinkish glow of Zephirin scrub solution.

 Janess was a frequent partner on these late-night traumas and I usually bunked on the top bed while we awaited the call god's page. When the call abruptly awakened us at 2AM, a shocker awaited me. I glanced down to put my battle tested Clinics on, and lo and behold, my toenails were painted that lovely pink shade of Zephirin prep solution. Janess just grinned from the lower bunk and admitted she had been busy with nail polish while I was sound asleep.

Janess and I had a long history beginning with a procedure partner pairing in nursing school where we bloodied each others arms attempting IV starts. Like so much that happened during our on call trauma . rendezvous, Janess's presence was a paradox. She presided over emergency surgeries like an angel watching  a cemetery. She was monumental in a demure sort of manner.

The call gods could be an unpredictable lot, but everyone knew to pay close attention to the lunar calendar posted in the light just outside the door. Most nurses did not even bother to rack out when there was a full moon, action was imminent.  

I never gave a thought to circadian rhythms or the pitfalls of staying hyper alert for late night surgeries when I was young and foolish. Trauma surgery was a mission and I had always sensed that I would be completely lost without it. Looking down at blood spattered shoe covers at the end of a rough trauma, I could never imagine not being a part of this mission. This was timeless. 

Later in life looking down at varicose veins and arthritic knees, I came to realize I could be just as lost as a result of it. The very thing I thought I needed the most was the thing that drew the shroud of futility around my soul. Helping others while ignoring self-wellness never has a happy ending. and thankfully, most whippersnapperns are more aware of self care than the Oldfoolrns of days gone by.


  1. I worked six months of night shift on a thoracic surgery floor and the full moon was always a challenge. Fresh post surgery patients pulling out inflated Foley catheters and anything else they thought shouldn't be there and remembering nothing the next morning as to why they were in restraints.

  2. Only thing worse than pulling out Foleys is self removal of chest tubes!

  3. It took me quite a long time before I was able to define myself as an interesting person who also happens to be a nurse. I love the ER career I have chosen, and it suits me perfectly, but there's a danger in living for your job and defining yourself by your role at work. When the higher ups at the job inevitably change things enough to frustrate you, or you go through a hard time, it's definitely easier to manage when there's more self-wellness happening and a life outside of work.

    I really took to heart your statement of being just as lost with something as without it. Thank you for your continued oldfool words of wisdom. I always appreciate hearing them.

    I hope you're doing well! More garden pictures to come soon on my blog - I just got the first round of spring stuff in this week!

  4. Thanks for your kind words, Shrtstormtrooper, but my infinite foolishness takes precedence over any pearls of wisdom!

  5. Well, to definitively answer Slambow's question, to my certain knowledge it was March 13, 2014. Might be a later example, but that was the date I had a Whipple for pancreatic cancer. My training is GI; I knew exactly what was what. An open Whipple was the best option of a bad set of choices. You'll note the date: it's 2022. My surgeon swore he got it all (they all do); in this case, he was right. Every now and then the horrendectomy works.

    1. I'm so happy for you! Sometimes aggressive surgical procedures have good outcomes. I remember quite clearly working in an outpatient clinic for surgery follow-up as a student nurse. A very pleasant Japanese man came in for a 3 year post-op follow up visit after a Whipple procedure and the surgeon proudly announced, "See IT IS possible to have a good outcome from a Whipple." I will never forget the perplexed look on the patient's face.

      Thanks so much for taking the time you took to leave such an uplifting comment, so glad you are doing well!

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