A Case of Senioritis

The leaves in Connecticut are starting to change which reminds me that I have been here too long.
In a week, I won't have to get up at 4 o'clock in the morning.
I have senioritis.

Just the other day, I was standing in the surgery suite, doing nothing, as usual, scrubbed in, while I observe the surgeons muck around. I cross my hands, fully aware that my armpits are not sterile. The whole notion of what is sterile and not sterile boggles me.



If you raise your arms above your nipples, you are not sterile.
Yet, surgeons raise their arms above their head to attach sterile handles to the surgery lights above.
If you let your arms down below your waist, you are not sterile.
Although all you touched was air, you somehow crossed a different stratosphere between your waist and your knees, where the unseen microorganisms have unionized and gathered.
Your armpits are nasty. I guess since the armpit hair is exactly similar to your pubic hair and the sweat glands in your underarm crevice produces the same type of sweat as the glands in your crotch, you tend to associate your armpits with something less then cleanly and you won't exactly relish the thought of snuggling next to something that smells and looks like crotch, unless, of course, you sway that way.
Hence, we have the psychological aversion. In the OR, however, we have clothed this armpit area with an undershirt, for some, scrub tops, and sheathed a sterile gown, which has a waterproof barrier, over the nastiness and yet somehow, the thought of sweat seaping through those layers of material to stop at the waterproof barrier, is too much to bear.

With that in mind, I conscientiously crossed my arms. Of course, the nurses in the OR, who don't usually use their brains and are as intractable as a tire iron, who put up a placard and say they do it "for the benefit of the patient", says this to me:
"You can't cross your arms in your armpits; they aren't sterile."
Six weeks ago, I would have bit my tongue and asked if their royalty would like me to break scrub and change my gloves. Today, my patience is nowhere to be found.
"Well actually," I ventured. "My hands are by the side of my breasts and they are still sterile."

The surgeon laughs as I drew back my whip and holster it.
There is more politics in the OR than all of Capitol Hill and I have had my intelligience insulted for one of the few last times.

Say, did I just do that?

I guess if I was the resident, I would try to get the medical student to do jobs I probably don't want to do; rectal exam, urinary cathethers, rectal tube, that sort if thing, just to justify the "education" bit of my job description.

And there's the gullible medical student, eager to explore new terrains, broaden new horizons (and definitely also to ensure the grade in the course), waiting to jump on anything to do with "surgery", including body part amputation, not realizing that "minor procedures" meant all of the above minus the body part amputation.

So it was my turn to insert the humble Naso Gastric Tube, or NGT for short. As the name implies, it goes from the nose into your stomach at one end and at the other end, it gets hooked up to a mini vacuum cleaner. It's purpose is humbling; it empties your stomach contents and prevents it from blowing up like a balloon so vomit won't projectile itself out of your mouth. Especially useful if, for some reason, there is a blockage in your plumbing that doesn't allow you to pass feces from your rectum.

I get my tools out; a set of gloves, some K-Y Jelly (oh yeah, more uses than one) and grasp the tube in my hand. The Peruvian resident is on the side for moral support as he tries to explain the concept of how to place an NGT in his spanishsized English.

"One smooth movement," he says. "Don't stop."
And so revved up, I go, like a banshee out of hell, stuffing this thin plastic tube down the nose of my spanish speaking patient who's having abdominal distention and pain.
"Traga! Traga!" I said.
"Very good, very good." The Peruvian says.
"Ahhhh!" says the patient.
And I am in! I am close to elated when I hear:
"And remember to clamp...."

Yellow vomit spills all over the resident's face and down the front of his doctor's coat.

"...the end of the tube." The Peruvian says, ten seconds too late.

Opps, I said, did I do that? Well, there you go for having the inexperienced handle anything to do with bodily excrements.