There’s a first time for everything in life, and for a young surgeon, the significant first time is when you do your first operation, without your boss being there to assist. It is you, the anesthetist, the nurses and let us not forget, the patient. In some ways, it is like riding a two wheeled bicycle for the first time, except you’re not allowed to fall off!
For me, my surgical virginity was lost in Gibraltar. I had been there about three months as a Junior Surgical House Officer, my official title. What this meant was that I was in my pre-registration year. That is the year following graduation, in which you work under supervision, and if deemed competent you are then fully registered by the Medical Board and can work outside the confines of approved hospitals. The medical hierarchy does think about the public’s well being, and keeps novices from inflicting too much harm.
I was called to Casualty one evening, as a Russian seaman had been brought in with pains in the belly. Pains acute enough for them to full steam ahead to Gibraltar. I placed my (not too) practiced hand on the abdomen, and there were all the classic signs of appendicitis. Tenderness and guarding over the right lower side of the belly and my seaman was running an increased temperature.
I rang my boss, apologizing for contacting him in the evening and explained the situation. He went through the diagnostic checklist with me and agreed that an urgent operation was needed. “Set up the theatre and contact the anesthetist,” he said. He then floored me by adding, “and you can do it.” “By myself?” I ventured somewhat tremulously. “Yes, I am here on the phone if you need me.”
In textbook fashion I slowly removed the appendix and sewed up the incision. As Sergei was wheeled out of the theatre I thanked everyone profusely. I didn’t have to tell them that it had been my first solo experience. It was obvious, but the nurses told me I had done a good job, and nurses can be a young doctor’s harshest critics.
However, half an hour later I received a page from the surgical ward. With shaking hand I dialed the ward sister. “What’s wrong?” said the novice, imagining hemorrhage, unconsciousness, or death. “Please come and look at your patient – now,” she said, and the phone went dead.
Flying down stairs without touching the ground and into the ward, and there was Sergei, my first surgical operation, standing to attention at the foot of the bed, dressed in his uniform, cap and all. He saluted and said, “Vodka, vodka!” I could have wept with the release of all my anxiety.
I reassured Sergei that he could have a vodka, but I wanted him to wait a couple of hours, and then I would bring him one myself. Not only did I bring Sergei his vodka, but I brought one for myself as well. Sergei had no appendix and I was no longer a virgin surgeon.But in case you are worried – none of our surgeons are virgins!