Monday, 25 July 2011

The A - Z of Body Parts...

After the emotional turmoil of my last post, I feel compelled to write about something a little more upbeat. But try as I might, I just can't...

Only kidding, guys !

These days, my life is all about doctors. With all the constant trips that I've been making to hospital to get my wound checked and dressed, I've realised that I see more of doctors and nurses at the moment, than I do my own family and friends. Since we exist in such a workaholic culture, we can often feel this way about our work colleagues, but when I'm finding that my book of choice of an evening is a complete encyclopaedia of the human body rather than some throwaway chick-lit, I know that something in my way of thinking is beginning to change.

So, given my constant involvement with all things medical, it's probably not surprising to hear that I'm currently obsessed with bodily functions. So much so, that every couple of days I think about retraining to be an oncologist, nurse, or failing that, a nutritionist. This is probably due to the fact that I'm picking up so many scientific facts and details as I interrogate my caregivers, that I fool myself into thinking what a breeze it would be to study anatomy in more detail. Unfortunately, a quick look at the years and years of training, not to mention cost and academic requirements that you need before you can even qualify as a doctor, soon puts me in my place. This, and two other very important events that happened recently.

The other day, I went to see my doctor's stand-in to have my wound checked and to find out if I needed to still wear a stoma bag. He is a kind, cordial man who looks unbelievably young to be a consultant surgeon and who sometimes betrays his vast knowledge and experience by revealing just a touch of indecision every now and again.

He welcomed me into his office, but had that busy, distracted look that people often have when they've just got too much to do.  He continued to tell me about the twelve hours worth of work that day that he was trying to force into eight hours. Pictures of his two children hung on one wall of his otherwise sparse-looking office and two framed university certificates sat proudly on the adjacent wall. He examined my wound and suggested that I take off the stoma bag since the wound seemed to have healed. I told him that I could still feel fluid under my implant but he reassured me that that this should flatten in time and attach itself to my chest wall and then be reabsorbed by my body. If the fluid leaked again, all I needed to do is re-attach the bag and contact the hospital. I felt so confident and articulate when I questioned him that I began to congratulate myself on the fact that I could keep up with all his medical jargon.

At some point in the conversation though, I'm distracted by a poster that hangs just behind me. It is about lung cancer and seems to have lots of information about lymph nodes. The letters are in different sizes and colours and this may well have been what draws me to the poster in the first place. There are lots of medical terms that I have no idea about but the poster dominates the wall and I find myself a little mesmerised by it. He sees me looking at it and in an instant his demeanour changes.

'Ahhh, Lymph nodes in the lungs !'

He proceeds to tell me how there are two different types of terminology to describe different types of lymph nodes depending on where you are in the world. I learn that in Asia, they have different words for different types of lymph nodes than we do in Europe. This poster is an attempt to create one unified world of lymph nodes, since it is confusing to talk to a surgeon in Korea about a procedure that you've just carried out when you're using different terminology. I see his expression change. He looks more animated than he has been since I walked into the room. I wish i could tell you how excited I was too to discover this piece of information, but when I looked at the indecipherable collection of convoluted scientific words, I felt as though I truly was attempting to read Korean. My only thought that sprung to mind was, 'how the hell does he remember all those words' ?

It was then that I realised just how difficult it must be to for someone like him, a young, brilliant, successful surgeon - part physician, part scientist to endure the dumbed-down vocabulary that us normal mortals use on a daily basis. Here was I feeling smug at being able to grasp definitions like seroma and stoma and when to him, my questions were probably equivalent to a child learning the basics of language. I began to remember why it was that I never really enjoyed studying science at school - too many abstract concepts and far too many mathematical equations. My vision of becoming some kind (any kind) of future health professional began to vanish before my eyes.

This leads me on nicely to my second revelation. Since I was obviously off in the land of nod during the four hour operation that I endured recently, my curiosity recently got the better of me and I decided to find out just how the procedure was carried out - on Youtube.

Nothing exactly matched the operation that I have just had, but there was a close contender. The removal of the sternum to gain access to the heart is a common procedure in the world of cardiac surgery.

The next day, I find such a procedure on youtube and click on it.. What I witness reminds me never, ever to consult youtube for videos that involve surgery. I see a body covered with plastic and the hands of two surgeons. One has a scalpel. In the video, he makes a long incision from the top of the chest to the stomach. Okay, I hear you say. Nothing wrong with that is there ? But what comes next makes me feel as if I'm watching some kind of slash movie. Next, he brings out an electric saw and starts sawing along the sternum. This seems to take ages. Blood spurts up from the comatose body. Once they've finished sawing, they pull the sternum apart, and begin to prod and pull at the red, pulsating organ which I'm guessing is the heart, while at the same time sucking up blood and fluids that seem to be flowing uncontrollaby out of the body. There doesn't seem to be much hi -tech equipment around - nothing to guide them by camera or scans. It just seems like a lot of blood, bones and organ to me - not that much different to watching a butcher dissecting a cow. I find it hard to imagine myself on the operating theatre with just my chest and part of each breast visible, while my surgeon attacks my sternum with a saw. Even though I didn't have open heart surgery, I think we can all agree that bone is made from pretty strong stuff. The image is so disturbing that days later, I make the most of being in the company of another thoracic surgeon to mention what I saw. 'Oh yes, he says casually, I didn't know that youtube was now showing thoracic surgery ?  What did you see ?'  I mention the saw and tell him that the whole procedure looked pretty brutal. I ask him how the hell he knows where to start and where to stop. He confirms that what I saw was open heart surgery, but tells me that yes, a saw is often used in thoracic surgery and then continues to question me about the direction of the sawing, 'Was it upwards or downwards ? downwards ? yep, it's pretty brutal stuff.' He tells me that there is often a CT scan in the room that they refer to, or sometimes they simply use the ribs or another part of the body as a reference point. But he tells me that the real skill of a surgeon is knowing exactly where and when to cut.

You see, I'm not really sure what I was expecting when I typed in those words. Perhaps I would have felt more reassured had I seen a body marked up with diagrams, or a surgeon's hands gently cutting along a felt tipped line. The funny thing is, when I speak to doctors about chemo and surgery and radiation, they often make a point of leaving out all the really gruesome points, like I guess, just how toxic those poisons are that they inject into you, or how traumatic it is for the body to experience surgery. We then process it in our minds that things will be not so bad because we know that the body will recover eventually. Somewhere along the way we skip the actual reality of the experience and focus on our feelings, which like the terminology on the lung cancer poster, are often so abstract that they take us away from the reality of the present. And it works quite well. When I first thought about the operation I was having I thought about how I'd feel before and after, perhaps because I didn't want to dare consider the reality of what my body would have to go through. I realise that these guys have to deal with this kind of reality every day. I also realise that I know nothing about the human body. And I'm sure that I'm not alone. For a piece of living and breathing machinery that is often more precious to us than life itself, it seems strange that we often know more about the inner workings of our cars than we do our own flesh and blood. I realise that I don't think I've got what it takes to be a nurse or doctor. I'm way too squeamish, too easily distracted and am bad with names.  Perhaps I'll just stick to blogging about chemo in future...

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