clothes. She snaps latex gloves over my freshly doused hands. From behind
me a nurse ties my gown and I twist 360 degrees to cocoon myself in a
sterile microenvironment.
After all the busyness of collecting Lisa from the preoperative holding
area, dealing with her sister’s anxiety, hustling to finish a basketball
player’s physical so he can play this weekend, phoning my office assistant
to hear the results of a rugby player’s MRI, and readying the patient for
surgery, it’s time to cut. Dr. Cohen and I catch each other’s gaze,
connecting in a deep sense of trust over the dominion of life. His somber
eyes and a gentle nod of assent confirm that we are ready to journey on.
The scalpel is made of two parts, the handle and the blade. The scalpel
handle is flat and made of stainless steel, which allows for repeated
washing, sterilizing, and packaging. A scalpel handle can last for years,
even decades. The scalpel blade, however, only lasts one case. Instead of
stainless steel, the blade is made of carbon steel, which is much sharper. In
many operations, a blade loses its requisite sharpness in the middle of
surgery and must be discarded.
As a surgeon, you always ask for instruments without turning toward
the scrub tech or without taking your eyes away from the surgical field. An
experienced tech knows, within a few tools, the instrument the surgeon will
ask for next, along with the proper orientation to place the tool into the
surgeon’s hand. To the close observer, surgery looks as well
choreographed as oceangoing sailors maneuvering their craft with
minimal conversation and maximal coordination.
My gaze is now firmly fixed on the purple line I’ve drawn over the front
of Lisa’s shoulder. All the acts of positioning, scrubbing, gowning,
prepping, and draping have come down to this. It is time to make an
incision. It is the moment of truth beyond which there is no turning back.
“Scalpel.”
There are two ways of holding a scalpel. In one position, you hold the
stainless steel handle like a pencil; in the other, you hold it like a
conductor holds a baton. The former technique makes the majority of
incisions, while the latter is employed during larger incisions. When I
perform the incision on Lisa, I steady my hand and wrist, and use the
muscles around my elbow and shoulder to direct the blade across the skin.
With the scalpel in my right hand, I hold my gloved left thumb and index
finger on either side of the incision site, stretching the skin tight. Nothing
marcin
(Marcin)
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