The Cutting Room Table

by NotDownOrOut

My doctor chose to have a surgical oncologist perform my hysterectomy. The surgeon taught a pair of female surgeons. The three of them came for rounds several days before my surgery. At the time, I continued to receive transfusions of blood. My hemoglobin at admission was 3.7. A normal reading would be 12-16. The reading had to rise to 10 before my surgery. While blood dripped into veins so parched that they collapsed when tapped, my blood pressure cuff operated every fifteen minutes. My blood pressure had been sky high ever since the diagnosis. I kept insisting that my blood pressure was normal when I was not facing cancer and major surgery. No one believed me.

In anticipation of a CT scan scheduled for that afternoon, I was instructed to drink two glasses of icy cold contrast medium. The milky white fluid was tasteless but filled with iodine–a substance some find irritating. I had consumed one Big Gulp-sized dose and had a second at the ready when the surgeon approached, held out his hand, and identified himself.

The surgeon took my hand and gave it a firm shake. I reciprocated, forgetting for the moment that I was tethered to a blood pack. An entire cup of contrast medium and ice chips splashed down my torso and pooled in my lap.  My teeth chattered helplessly from the chill.

The surgeon did not acknowledge my discomfort. He asked me to climb into my bed and let him examine my stomach. The young doctors reached for paper towels. I lifted the wet hospital gown and let the remaining liquid run onto the floor. While the surgeon watched, I backed up to the bed and hitched my behind up onto it. I managed to lie on my back even though needles lodged into veins at my wrist prevented me from leaning on my right fist or grasping the bed’s railing as I reclined. I dragged the wet gown up to my waist to bare my stomach for his examination. I was cold, sticky, and miserable.

“We’ll perform an abdominal procedure rather than a laparoscopic one,” he announced. I knew this might slow my recovery. “We’ll enter at the bikini line.” Never having worn a bikini, I was not comforted by his choice of entry points. This would be a painful incision that would leave a long scar. I had never undergone major surgery before. I was still whole.

I shut my eyes and tried to imagine myself someplace else. Cold liquid dripped over my stomach and down onto the bed.

One of the young doctors helped me to sit up and rang for the nurse. I stepped down from the bed and into a puddle of the splattered medium. The surgeon looked down at the mess and addressed me formally, “I am . . . sorry that I . . . that you spilled that drink on yourself.”

I closed my eyes again, then opened them, and smiled broadly. “I was just excited at the prospect of meeting you.”

The surgeon frowned.

The two female doctors lowered their heads to conceal broad smiles.

The hospital moved me to another floor and room after my CT scan. A technician arrived before I had settled into my new space. It was time for my echocardiogram. There was something oddly gratifying about watching my heart pulse on a black and white screen. The technician’s fascination with the organ was evident. He searched and searched for a defect and appeared to find none. Yet another test was passed.

Cholesterol – normal. Thyroid – normal. Blood pressure – normal. Chest x-ray – normal. Abdominal and chest CT – normal. Electrocardiogram – normal. Diabetes – no. Hemoglobin – still an issue, but rising. That left cancer. No big deal, right?

I underwent surgery on Friday, October 7, 2011. Thursday was a long night. I made a list of my blessings and the many “angels” in my life. In particular, I was grateful for my friend Barb. She had been to visit me every day since I was admitted to the hospital. I had seen a priest and accepted the last rites. I had informed my family that I had a Do Not Resuscitate order in place in the event that my heart stopped during surgery. I was certain that there was an afterlife, but afraid that if I were to die my mother would never get over it. She had already buried my father and her parents. Her sister had recurrent breast cancer. I was grateful that my sister and brother had flown in to support our mom during my hospitalization.

The emptying of my intestines prior to surgery began after lunch and continued throughout the night. I felt certain I watched my life pass before my eyes with every flush. The fact that the nursing staff would not allow me to walk to the bathroom without assistance meant that someone observed every painful moment. In the hour before surgery I started to bleed yet again. Bright red blood spread across the sheets of my hospital bed like evidence at a crime scene.

An orderly wheeled me to the OR. I was frightened, but there was no alternative to surgery. This was cancer. It was unpredictable. It was dangerous. At that moment it held the surgeon’s knife at my throat. I had to go on with the operation or (I imagined) face what could be a painful death. I was tired of the uncontrolled hemorrhaging that I had been experiencing, particularly the hemorrhaging that had brought me to a doctor’s office earlier in the week. I had to undergo the surgery.

The OR staging area was lit with natural light. My three surgeons, dressed in pristine scrubs, sat in a row with their smart phones out. In the corner, a group of young orthopedic surgeons boasted about procedures they had recently seen. They were somewhat cocky, somewhat vulgar. I was glad to have the classier team waiting for me to be prepped for surgery.

The anesthesiologist came from an Eastern European country. She was dissatisfied with everything about me. “Do you have sleep apnea?” she asked. I shook my head. “Because if you do, then your heart could stop when the surgeon lowers your head and raises your lower limbs.”

She studied my arms which were bruised and swollen from transfusions, I.V.s, blood tests, and constant squeezing from a blood pressure cuff. “You are a hard stick,” she accused. “We will have to keep your arm straight out to one side during surgery,” she complained.

She found a place to lodge a port for her medications. I could feel the invasion to the base of my teeth. She tipped my head below my shoulders, asked me to open my mouth, and studied my throat for signs of a blocked airway. Yet another test passed. It appeared that my only “complaints” were slightly elevated blood pressure, slightly elevated triglycerides, and uterine cancer.

A surgical nurse asked me to tell her my name and my birthdate. She checked each of the products that had been ordered for me: antibiotics, anesthesia, blood, and painkillers.

Moments later I was moved to the OR. Surgeons and anesthesiologists gathered around me. The attending anesthesiologist introduced himself. I could not recall a time in my life when doctors had ever been so polite while maintaining so much emotional distance. I had not shaken so many hands in twenty or more years of practicing law. We all knew each others’ names, but very little else about each other. Yet I trusted them with my life. I have never had to trust anyone as much as I had to trust them.

The attending anesthesiologist started the medicine flowing. My eyes closed instantly and I entered into my first sound sleep since having been admitted to the hospital. It was nothing like falling asleep. There was no counting back from 100. There was a moment of clarity and then dreamless darkness.