Saturday, February 18, 2006

harvest moon

I thought I'd be miserable being back at work after my week off, but I actually didn't really mind it. In fact, I kind of like being at work. It makes me feel, I don't know...puposeful. Of course, there are times when I don't like work, like when I'm there starting a case at 3am (about which more later), or when random attendings are yelling at me for no good reason (why must they yell? with the loudness?) but in general, work can be kind of--dare I say--fun.

So. About this 3am case. Organ harvest. Basically, brain dead guy, family consented to donate his kidneys, and we were there to collect. It was something I'd never done before, though I'd done anesthesia for the corresponding surgery on the other end of the arrow (the kidney recipient, I mean), and even though I'm all for organ donation--everyone make sure that little box on your driver's license is checked right now, go on, I'll wait--there's something macabre about the term "organ harvest." I don't know, it calls to mind scythes and hoods and druids by moonlight. It sounds like, "Oooh, we grew this nice big juicy liver, and now it's ripe for the picking!" Ghoulish.

It was the easiest anesthesia I had ever done, because they guy was, you know, DEAD. And yet, so confusing, because he didn't look dead. In fact, on the table, he looked exactly like all my other patients--intubated, pink, warm, lines running out of him every which way. It was easy enough to get started--move him to the table, hook up the vent, a little blood pressure control, let him ride--but I was confused with what we were supposed to do at the end.


MICHELLE
So I've never done one of these before.

CIRCULATING NURSE
I've done one before.

MICHELLE
So, OK, I get that he's dead, but I'm here to basically control his hemodynamics and stuff like that, right? But then what happens after they cross-clamp?

CIRCULATING NURSE
Then you're done. You leave.

MICHELLE
I'm done? You mean I just turn off the vent and walk out of here?

CIRCULATING NURSE
Yup.

MICHELLE
But the patient's still here!

CIRCULATING NURSE
But he's dead.

MICHELLE
So who stays with him, then?

CIRCULATING NURSE
I do.

MICHELLE
And what do you do?

CIRCULATING NURSE
Well, after they're done and he's closed up, I bag him.

MICHELLE
Why do you bag him if he's dead? Why don't we keep him on the vent, then?

CIRCULATING NURSE
(As though to the village idiot)
Not ambu-bag, a BODY bag.

MICHELLE
Oh, right. Duh. And then what?

CIRCULATING NURSE
And then we take him.

MICHELLE
Back to the unit?

CIRCULATING NURSE
No, to the morgue.

MICHELLE
Oh, right. Dead.

CIRCULATING NURSE
Dead.

MICHELLE
You know, this would be much less confusing if he looked dead.

CIRCULATING NURSE
I know. After the first organ harvest I saw, I went home and crossed off the organ donating thing on the back of my driver's license.

MICHELLE
You mean to donate?

CIRCULATING NURSE
No, I didn't want to donate any more.

MICHELLE
Why? Even after seeing all the people you could help? Because I've done a couple of kidney transplants, and the patients, like, cry with happiness when you tell them they have a new kidney.

CIRCULATING NURSE
Yeah, I know, and maybe I'll change it back sometime, but I just didn't like how it was at the end.

MICHELLE
What do you mean?

CIRCULATING NURSE
Well, the last harvest I did, it was a young guy, and they took everything. Heart, liver, pancreas, everything. There were, like 20 people in the room. And after they all got what they wanted, everyone left, and the patient was just lying here, alone. I peeked behind the curtain to look for Anesthesia, and they were gone too. Everyone was gone except for me and the patient. And it kind of left a bad impression.

MICHELLE
Yeah, that is kind of sucky.

CIRCULATING NURSE
It was sort of a bad first experience.

MICHELLE
You should check that box off though. On your license, I mean. I would treat you nice if I had to do your harvest.

CIRCULATING NURSE
Yeah, maybe I will.

MICHELLE
Hopefully it never comes up, though. Hopefully you'll be so old and gnarled when you die that we won't want to touch your organs with a ten-foot pole.

CIRCULATING NURSE
(Laughing)
Yeah, I hope.


Currently reading: The latest issue of "New York Magazine" about the so-called Blog Boom. The Underwear Drawer is probably what would be firmly classified as a C-lister, though it seems you have to damn well hire a writing and business staff posting 24/7 to be on the A-list.

1 comment:

  1. Anonymous11:51 PM

    Hi, I am a CA-1 and recently did a organ harvest on a 29 y/o and the first thing I wanted to do afterward was to scratch off the donor option on my drivers lisence!I totally understand what you write, and the only thing that can make the morbid feeling of being on the harvest team is to be on a transplant team and watch the rainbow of emotions on his/her face, and see a life( many lives actually) reborn. At that moment it seems worth it.

    ReplyDelete