TEN
Elective Surgery
Almost every patient mentions how cold it is in the operating room. We
keep the room around 60° F, in part to keep comfortable in our layers of
clothes and gowns and in recognition that keeping a chillier room helps
keep infection rates lower. Lisa is no exception. As she’s being wheeled in
on the gurney, she’s groggily awake and mutters something about the cold.
Before rolling her into the operating room, Dr. Cohen, my anesthesia
guide today, performed a nerve block injection on Lisa. He used an
ultrasound wand to guide the trajectory of the needle via computer screen
as it delicately plunged through the skin and explored the depths of tissues
around the neck. Once the shadow of the needle tip approached the
brachial plexus (the bundle of nerves that connect brain and limb), he
injected a syringe-full of numbing medicine around the nerves. The
procedure rendered her arm simultaneously numb and paralyzed. On cue,
our little team trekked toward the operative theater.
Underneath her translucent blue surgical bonnet, Lisa’s bright auburn
hair is visible, tucked safely away in our clean environment. She’s another
East Coast transplant who moved west to Colorado in middle age. In the
last several years her left shoulder has become unbearably painful, and
after failing injections and physical therapy, she has opted to undergo
shoulder replacement surgery. In the preoperative staging area, Lisa
nervously asked about how much pain she’d be in tonight, but that’s a
faraway concern now. Her sedative medicine has rendered her punch-
drunk and unaware. Her sister confided that they watched a shoulder
replacement on YouTube last night, only barely enduring the odious
presentation.
While in high school, I saw a television special about Dr. Frank Jobe,
the longtime team physician for the Los Angeles Dodgers, who pioneered