My second core rotation in my junior year of medical school was surgery. I started out on the cardiac surgery service of the then already famous George Noon – a protege of Michael DeBakey. There were four of us on his service; Rhonda whose dad was a pathologist and who went on to become a pathologist herself, Charles who like me chose Internal Medicine, and a gregarious, lanky fellow whose name does not come to mind – he went into Infectious Disease.
The four of us dressed in scrubs every morning and waited to be called to the OR to observe and to perform menial tasks. Before each case, we scrubbed, donned a surgical gown and gloved our hands. The OR suites in the Methodist Hospital in the Texas Medical Center were always cold. We were scantily dressed, and the cold was only partially offset by the radiant heat of the surgical lamps that illuminated the operative field. Dr. Noon always worked up a sweat during his cases, and a nurse was always there to dry his brow with a sterile wipe. Most of his surgeries were coronary artery bypass grafts (CABG) and an occasional heart valve replacement. The medical student’s principal chore was to hold the heart still while the surgeon sewed the venous grafts in place or operated on a valve.
CABGs were a production. There was an anesthesiologist, a surgical nurse passing instruments to the surgeon, a medical student holding the heart cradled in a sterile towel, a technician handling the external perfusion system (extra-corporeal membrane oxygenator – ECMO unit), a nurse handling the instrument tray, and a second- or third-year surgical resident operating on the patient’s leg to harvest the saphenous vein that would become the coronary artery graft material. It was a highly choreographed production with little left to chance.
There was always music. In 1977, the music was most often Staying Alive from the movie Saturday Night Fever. It seemed strangely appropriate since we were literally holding the patient’s life in our hands. Now and then the music was Maniac from the movie Flash Dance. That item seemed less relevant than did Staying Alive; nonetheless, there was something oddly maniacal about these surgical productions, and the lyrics did include at least one reference to knives. It was a strange clinical rotation in which I decided that whatever my future in medicine, I would not be a surgeon.
Recently, I have gotten a bit tired of listening to Cologuard commercials pushing non-invasive screening for colorectal cancer. Don’t get me wrong, I am 100% behind (no pun intended) such screening, and a non-invasive test is certainly appropriate for people at low risk for the disease. Still, I can’t help but wonder whether gastroenterologists play Sinatra’s My Way in the GI procedure suite while performing colonoscopy on their anesthetized patients.