Working strange jobs has become something of a common thread throughout my life. I’ve worked as a teacher in Spain, a bartender in Harlem, a chef at a country club and a park laborer in a seaside marsh. But one of the most meaningful jobs I’ve had is one that I’ve recently returned to: anesthesia work in operating rooms.
Hospitals are never nice places. When people think of hospitals, they say it’s the smell that they hate the most. “The sterile hallways and everything so cold… it’s just creepy,” a friend once told me. It’s somewhat nightmarish, but it’s become my daily routine — blood and guts and everything liquid in between. Over my three years, I’ve seen legs removed and tumors peeled off. I have seen brains, livers, lungs and muscle tissue from just about everywhere you could think on a human body. No, hospitals are never nice places, but I decided to work in one.
* * *
On the fourth floor of the Jackson Building at Mt. Sinai early last week, I found myself in the anesthesia workroom with April, my co-worker…
“So… wait… are you saying they need a CO2 absorber or an actual air tank?”
“Give me the beeper. You’re fired.”
It was my second day back in the operating rooms and as I stood there with a ringing pager in my hands, I couldn’t help but feel back at home. In the bowels of the city hospital, there is a little workroom where all of the operating room supplies are stored. Lactated ringers, syringes, suction tubing, airways, pressure bags, fluid warmers. If anything was used in any surgery, it was stocked here.
It wasn’t easy running the tools. Names of the tools changed, or nicknames were given in their stead. A CO2 absorber can also be referred to as a canister, a soda absorber, or a lime canister. In this case, it was none of the above. The pager’s message read:
– – Need a new tank in or36 ASAP thx aurora – –
I forgot how much stress this job entailed, but was soon reminded when I read the “ASAP.” Whenever the page had STAT or ASAP in it, you tend to put in a little more effort. Aurora, the anesthesia resident in room 36, was making it difficult.
April, however, signed off MySpace and flipped her hand over, palm silently waiting for the pager. Over her years in the workroom, she had become something of a supply-room guru. She seemingly knew everything, backwards and forwards. She was a veteran of seven years, but somewhere along the way her attitude had given out. Or maybe it just peaked.
Either way, her humor was bent on this sense of exaggeration and she “fired” people whenever she called them out. If you were three minutes late to work, you were fired. If you asked her to hold the pager during the last half hour of work, you were fired. If you had a stomach ache or needed 50 cents for a pick-me-up coffee, you were fired. If you gave her any attitude whatsoever, you were fired. Simple as that. But there was no questioning her value to the operating rooms. She knew the equipment better than most of the anesthesiologists.
“Give me the pager,” she continued, eyes rolling. “They need the CO2 canister. I just changed the air tank last week, they shouldn’t need that.”
“Oh, right,” I said sarcastically, “I forgot that you put the tank on last week. You know, when I wasn’t working here…”
She sighed heavy as she flipped the beeper with her hand, balancing it like a waitress. Her jaw jutted out, pissed. I had crossed the line.
“Have fun changing it by yourself,” she said as she resumed her session at the workroom’s only working computer. “You think you remember everything, huh? Good luck putting that thing on.”
April’s attitude took some of the urgency out of the situation. I decided to let her have her MySpace and grabbed the yellow tank, looking for room 36.
It being my third year, I knew that just about anything could be behind these doors. Burn victims were usually the worst. These cases ranged from house fires to car accidents and anything in between. I say “usually” because the Jackson building, where I was stationed for the day, had a wide array of surgeries. Gastro-bypasses, limb amputations, whipples (a hell of a lot easier than saying pancreaticoduodenectomies), head fractures and organ harvests. There are the elderly, the overweight, the malnourished. Burn patients had to have extra care, though. The temperature of their rooms have to somewhat resemble their body temperature, which usually meant 95 degrees plus. In that sort of heat, long cases seem to take days.
I thought I had seen it all. I really did. I could feel the heat seeping through the doors as I slipped my paper oxygen mask on, shouldering the CO2 tank.
What waited for me was a grown man, I’d say 40-something, completely sprawled out and surrounded by a team of people. (It’s easier to age people by their feet, I’ve found, as most of their body and face is kept hidden by some medical sheets and whatnot.) Residents, fellows and nursing assistants all looked on as two surgeons were elbow-deep in the man’s stomach, suctioning, as I later found out, excess blood as they tried to pinpoint the diseased liver.
There is usually a kicker to most surgeries. Something about the operation that makes them a little “out of the ordinary.” Maybe it’s just something that I look for, a detail that helps me differentiate one operation from the rest. An exceptionally fowl stench from a leg being amputated, for instance, or an abundance of tattoos on a gangrened arm. In this case, it was weight. And this man had it. Rolls and rolls of skin seemed to sag off the side of the bed. I had never seen weight like this, not in these layers. His stomach was not a pretty image, like raw ground beef.
“It doesn’t help that he’s a boozer, either,” Aurora explained, as she scooted her chair back and made room for me. I got on my knees to autograph and date the CO2 canister, and pop it beneath the anesthesia machine. It wasn’t often that you find an approachable anesthesia resident, but Aurora was young and she seemed to enjoy talking with people outside the medical field. Her vague beeper message was easy to forgive.
“I’m going to be here all night,” she explained, “And this guy is going to take up my entire afternoon. Awesome. Thanks so much for the CO2, by the w…”
Her words were cut short. Panic struck as a loud hissing burst from the anesthesia machine and the measurements above the canister dropped to zero. I had slipped and put the canister on too loose, setting off an alarm. I could feel the operation come to a halt and the room’s temperature doubled.
“What is that?” someone asked.
The surgeon looked up.
“His signs are still reading normal,” Aurora said to a completely motionless room. “The CO2 might have slipped off when the anesthesia tech tried to… don’t worry. He’s working on it.”
I was fumbling to put the canister back on straight, Aurora standing above me. This hiss was horrible, and it just got louder and louder. HURRY! it seemed to scream. Aurora was turning knobs and double-checking his syringe pump, readjusting his breathing circuit.
Jesus, I thought, this is it. This man is going to die because of me. Right now. He doesn’t even know me. I’m a 24-year-old English major and someone put me in charge of this shit? CO2 tanks? And now this man is going to die. Going to die.
I remember blinking hard with my mouth shut as I felt April’s hand pull mine out of the way. She slid the canister on, locked it in place and silenced the hiss. She was crouched beside me, sighing again beneath her mask.
“Don’t feel bad,” April told me on the way out later that day, “because it’s not easy. It’s your first day back.” She smiled and laughed when she told me I was fired.
Over and done with, I can look back and almost laugh at what happened. It’s strange that, of all people, the patient will never know what happened in OR36 that day. The loose CO2 absorber wasn’t going to kill anyone, certainly not this guy. It’s meant as a simple precaution in most cases. From what I understand, it simply cleans the air that’s going into the patient. But the experience got me thinking about my job choice and why I came back; what pulled me to the operating rooms again.
I guess I do it because it reminds me of the fragility of everything. And not only that, but it serves as a reminder of the choices we make through life. It’s strange enough to live in a city where people come to be and mix with each other, so close like a hive, but to work in a hospital with so many dedicated people makes for a humbling experience. The OR community lives in a quiet, unnoticed layer of the city but its importance is invaluable.
* * *
Ground beef, though. Fucked up.