“I’m in good hands.”
If there’s one universal constant about the hospital, it’s that all the patients are nervous. They’re waiting, for answers, for results, for reassurance, for the inevitable. I spent two weeks rotating on emergency medicine and two weeks on anesthesia. Emergency was a long string of evening shifts, then an overnight shift and a day shift right afterwards. I felt like a jet lagged tourist, stumbling from case to wildly different case at dizzying speed. Anesthesia, on the other hand, was the opposite. Regimented, protocoled, every day the same thing in slightly different rooms. Wake at 5:45. Tea to wake up. Shiver in pre-op wearing flimsy almost paper OR scrubs. Talk to the patient, joke a little, make them smile. Drop some Versed, make them smile a bit more. Wheel them in. Give them oxygen. Drop in a tube. And then watch the surgery for hours.
I thrived on the constant hustle in the emergency room. I loved that from patient to patient, I could shift gears from a broken wrist to a perforated colon to a fainting spell to a brain tumor, as easily as flash cards. I loved the challenge of having to have my finger on the pulse of every organ system at once. I loved suspecting uncommon diagnoses scattered among the bread and butter, like congenital anomalies and cannabinoid hyperemesis syndrome. But the best part was talking to all the patients. It’s magic, working your way from complete strangers to joking friends. It didn’t happen with everyone, but when it did, the patient and I would become fellow journeymen, unraveling the story together. I even saw the crankier patients, on the verge of leaving, visibly unwind with a sincere apology. I learned early on how much difference a warm blanket and a “Did you get to eat yet?” could make for a patient and family. One elderly woman, who started off cantankerous from her long wait in the room, was giving me and my attending snippy answers. Finally she complained about how cold it was in the room, which was my cue. I brought her two toasty blankets fresh from the warming machine (life goal: get a towel/blanket warmer), and as I left the room, I heard her remark to her daughter, “I like that girl.” I don’t know what it was about the emergency room, whether it was the constant acuity of patient problems, the jocular camaraderie of the residents and attendings, or genuine human interactions. But I left every shift happy.
I was praying over Colossians 1:29 one morning.
I labor, struggling according to His operation which operates in me in power.
Lately I feel there’s been so much labor to accomplish among the members of my church. I’ve been so swept up in work at school, but life goes on for the middle schoolers and high schoolers I serve, and for the college students on my heart. I felt torn many times between duty to school and concern for these believers. But that morning I felt that God was speaking a comforting word to me. My labor, my struggle, is not according to the depth of the burden or need in the church. It’s not according to the difficulty of the situation or the unwillingness in my being. The struggle, the labor, is according to the operation of God in me. And that operation, as all works of God, is in power. I had been placing so much expectation on myself to provide the power for the work. I forgot that it was God’s work to operate in me, in power; any struggle would issue from that flow of power.
And anesthesia. Miracles happen every day in the operating room. And the people who work there, who work the miracles, have developed immunity to the wonder of it all, the brazen madness of separating the soul from the body, of altering physiology to pathology as a therapeutic modality.
Then there are the surgical miracles. I saw the expeditious removal of a huge flap of hanging belly, and the pulling in of the fat and skin from the patient’s sides to form a whole new abdomen, svelte hourglass dips and all. The only reminder of her former self was her belly button, carefully preserved and nestled in along the zipper-line of stitches from sternum to pubis.
One morning, my scheduled case was pushed aside for another emergency case. I caught the drift from the grumbling nurses in the OR: the patient came to us straight from prison. Apparently hopelessly recidivist, an alcoholic and drug addict. His habits caught up to him now — he was in complete liver failure, on the transplant list, yellow as a yolk, and shunted into our OR today because one of his heart valves had completely blown out, and was flopping back and forth like one of those hapless advertising puppets in front of used car dealerships. He was the sickest patient I’ve ever seen in the operating room. And he was just five years older than me.
His blood pressure on the table was a number I had never seen outside of test questions. At its highest, his blood pressure was at the level of brain bleeds and arteries ripping apart. At its lowest, his blood pressure was the level of car accident hemorrhage and overwhelming bacterial infection. And he careened between these pressures, 180/40, eighty times a minute. More than once a second.
I watched as the usual monitors were stuck on him, to measure heart function and blood oxygenation and all that jazz. I watched a nurse carefully tape a cardiac defibrillation pad onto his back. And that’s when I realized that this operation could end in a code blue — cardiac arrest. CPR, shocks, and maybe death. With his liver alone, he had a one in three chance of dying in the next few months, and that was without risky business like surgery. Then add in the fact that today the surgeons would saw open his chest, redirect all his blood through a heart-and-lungs machine, and meddle with the most vital organ of all, and his chances were even slimmer.
As we wheeled back the patient to the operating room, the anesthesiologist asked, “Do you have any kids?” “Four. Three boys and a girl.” “Then you better get well quickly and see them! You need to be there for them.” She called him sweetheart most of the time; as she started to give him the induction medication, she said, “You’re going to sleep now. We’ll see you soon.”
The surgery itself was like a Hollywood montage. Did you know that when buzzing open the sternum, little puffs of bone smoke rise from the teeth of the saw? Or that the heart, giant and glistening, decelerates to a gentle snooze when nestled in ice? When I got the chance to peek over the surgical drape, there was his whole heart, like the poets and artists and drunks, splayed open, still, like a book, for all to see.
He made it, by the way. I left the room as the case was wrapping up, and the two cops waiting outside and texting looked up. One asked, “So, is he alive?”
Another woman, this time with neurosurgery. My computer wasn’t working before the case, so I couldn’t read up on her procedure. She joked with us and her family in the presurgical waiting area, not a care in the world. As she was breathing in the oxygen, waiting for propofol to come, she started mumbling against her mask. I lifted it up in time to hear her say with a smile, “I’m in good hands.” Then she went off to sleep. I found out as her head was shaved and carefully sawed open that she had an aneurysm — a brain blood vessel that developed an abnormal ballooning at one of its bends. If left alone, the balloon could pop at any time, swift and excruciating, death ex machina. Usually aneurysms could be removed by threading a long wire in through arteries in the groin, but hers was in a tough location, and had to be accessed the hard way. As the surgeon and PA slowly worked to coax arteries off and away from her surrounding tissue, I thought about what she said about good hands. Whose hands was she really in? The anesthesiologist’s, who carefully titrated the rhythms of her body? The surgeons’, dancing around her brain, shaky fingers and all? The nurses, maintaining sterility? Mine, possibly endangering sterility with my ignorance?
When Jesus was called good, He asked, “Why do you call Me good? No one is good except One — God.”
This patient passed through countless hands. But in the stochasticity of it all, whose hands are the good hands but the hands of One?
