I'm going to skip the details of most of this 3rd week (week
2 on the schedule) because, as amazing as the whole week was, by relativity
only a couple of events deserve depth of description. The events that I will
only mention briefly do not lack in importance to the experience of the trip in
themselves, but since this week was saturated with amazing experiences, and
some are, by their very nature, more important than others. So the these 'lesser'
experiences are not so in the common, diminutive sense of the word but only in
relation to the greater events of this week. Theyinclude: bowling with Penn
State (Monday), going on the House of History tour (Tuesday), and the Classical
Concert (Thursday). All of these were rewarding and fun experiences; but with
them stated, I will move on to the greater goings-on of the week. These can be
summed up into two categories: the hospital visit on Friday, and the trip to
Amsterdam in the Weekend, and out of these two only the first is prudent to
recount in this blog.
The Hospital Trip (Uniklink BMEN):
After a Brahms symphony and requiem, in which I had been
trying hard not to cough (and occasionally failing), I found a group of friends
near the coat-check. The feeling of exhaustion and slight sickness engulfed the
room as the many bourgeois classic music loving Bonn-ers chatted in a muffled
German, but my friends and I acted up-beat. And pushed by the feeling of
freedom we felt from leaving the auditorium after four hours, we decided to
reclaim the night and go out. I don't think any of us thought this was a good
idea, but we felt that it was the right idea - that we should not waste one
opportunity whilst living abroad.
Still I think it was right of us to go out, even though the
repercussions were unfavorable to the following days. I slept only one hour the
night of the concert, and by hellish luck, I had to be back in town an hour and
45 minutes earlier than any other day of the semester, and I had to make my bag
for the planned trip to Amsterdam since I had class after the hospital visit
and would not have time to go back home before the train departed. I sprinted
four blocks with my huge stuffed backpack to catch the early bus in which I
found Andrew and Robert. We talked all the way to HBF where I promptly bought
some water because I felt very dehydrated. After getting the group together, we
left to the hospital.
When we entered the changing room before the ORs, I started
getting nervous. We were all dressed up in scrubs, a hair net, and a face-mask.
Partly because of fear of spreading disease, and partly because anxiety was
growing inside me, I asked Dr. Wasser if it would be prudent for me to go into
the ORs while I was ailed with a small cold.
"That's what the face-masks are for."
We walked through an eerie hallway of sliding doors that
lead to on-going operations. And little by little (Kristen Weismantel first),
we were picked off to go into the surgeries and watch. My turn came about 30
minutes in, and I could hear my breathing get faster under the mask while I
followed Robert through the large door. The scene inside calmed me. Nobody was
opened up just yet. In the table in the center of the machine-cluttered room,
lay a serenely sleeping young German girl of about five years. Her eyes were
taped shut with white fabric tape, and she was breathing steadily through a
tube in her mouth.
"What's wrong with her?" I asked, since the only
feeling that hinted at there being something wrong came not from her, but from
the scene around her. The grayish blue walls, the cold machines, the business-men
in doctors' clothes all contrasted sharply with her warm-colored face and tranquility.
It was not right for her to be there, but she was.
When the young surgeon didn't answer, the question became,
"Why is she here?" Now direct with more worry and a sense of misdirected
anger.
"She has lost hearing in her right ear," he said with
a thick German accent as he was covering the body of the small girl with a thin
blue fabric. "So we are doing exploratory surgery to see what is getting
in the way."
Robert stood next to me looking at the patient, arms crossed,
and his face was as surprised and insulted as mine when the blue fabric did not
stop at the neck of the young girl but was placed completely over her face,
leaving just a hole to the side of her face where the faulty ear poked out. We
remained quiet, and watched carefully.
The first incision brought a tingle to my spine. The doctor
was cutting a miniscule hole diagonally from the opening in her ear towards her
temple, and the tearing released blood into the yellow iodine-stained skin.
Cringing, intrigued, amazed, and sickened , I looked on. Using a speculum-microscope-camera
for sight, the surgeon dug into the middle ear, nonchalantly poking at a nerve.
He told us that if that nerve was hurt, the girl would lose feeling in her
tongue. The power this man held in his hands was terrifying, unfair, and yet tantalizing.
He started pulling out white endothelial tissue which he explained was probably causing the
hearing loss and were the result of an infection. He did this for a while, periodically
asking his assistant for different tools. Then he wanted more space because he
couldn't see well. With one of his tools, he started chipping away at some
bone. The noise this produced was enormous compared to its tiny origin. Clack!
Clack! Clack! It was barbaric! I wondered how in this day-and-age we were still
doing things like this, chipping off bone in a delicate middle ear using brute
strength. Robert excused himself from the surgery to get some water. The doctor
kept digging white clumps, and then he said that he would pull out the anvil
because the stapes was gone, and one does not function without the other. I
asked why there stapes was gone. The infection had eroded it off. My heart ached for the partially deaf little
girl, wondering how she would cope with her disability in her life. She was so
young! After the anvil (Incus), the hammer (Malleus) had to go. It seemed, on
the screen of the microscope camera, that he was pulling out a huge bone from
the hole in her ear, but when he pulled the pincers out they only held a white
dot the size of half an ant. Amazed, I
started appreciating this man's skills. Robert came back. I told him what was
happening to the best of my ability, and I left to take a break. I found Dr. Wasser
in the lounge, and told him what was happening, and how much I appreciated
being there. I drank some water, and went back into the OR. The surgeon had cut
off some cartilage from the outer ear and was using it to fill up the space he
had chipped away from the bone. I asked him if there was some devise that could
be implanted maybe on a later date to restore her hearing in that ear. Yes,
there was, and he would put it in a minute. His calmness through the whole
ordeal was strange, but assuring. The surgeon said that the implant would bring
hearing back.
"What?" I said, hope for the girl's well-being was
ripe and noticeable in my voice.
"Ja" the
doctor smiled sympathetically.
What I expected next was a large battery powered implant,
but what was readied was a miniature titanium rod with the shape of a coat
rack. It was put in the place of her stapes and incus, and then a round disk
was put in the place of her malleus. They put foam in her ear to hold
everything in place while she healed, and they stitched her ear. I found myself
leaning over the table, much closer than where I had started. I had almost
forgotten there was a whole girl there under the blue sheet, not just the ear.
As I realized this, I immediately stepped back to restore her personal space. Also,
the success of the surgery really hit me. She is okay! She can hear!
I grinned wide while
I shook the doctor's hand and thanked him.
He seemed not to think much of the surgery and a bit surprised
by my excitement, but he smiled and showed Robert and me out of the OR.
Meeting mostly everyone in the lounge, I told them what had
happened in my small operating room, but was received by even more spectacular
stories. This type of thing happened here every day and many times over. The
ups and downs, the personality, impersonality, the machines, the brute force,
and the power; everyone had experienced it - most of us for the first time in
our lives. It was settled, I wanted more.
And more I got. Robert and I, now together with Rachael and
Kristen were escorted to an on-going double bypass. Since there were already
two students there, only two of us went in: Rachel and me.
The inside of this larger OR was very different. I could see
Allison and Andrew L. who were talking to a Surgeon next to some big machines
that observed and regulated vitals. On their other side (straight in front of
me), was a curtain dividing the students, the supervising surgeon, and the
patient's head from the body and the surgeons doing the surgery. I saw the face
of the patient very briefly before I was told to step up a metal block to see over
the curtain.
Wow. Two meters away from my face was the large man's
beating heart inside his open chest. It was huge, and yellow with fat, beating steadily
beneath the lighting. More disturbing than the open chest was the man's leg
another meter down from me. It was opened straight down the calf, and the inside
of his skin was thick with bulging fat that looked like large larva coming out
of red mud. The vein for the bypass was to be taken from here.
I don't know why I felt so differently about the fat man and
the young girl. The two were completely different externally, but that was not
it. And I don't think it was just me that felt differently. The whole room had
a different atmosphere. In this much more dangerous procedure, the feeling was
lighter. The supervising surgeon talked in a casual manner, telling us of the time
he spent in San Francisco. The other surgeons, actively getting everything
ready for the heart of the procedure (pun), were cracking jokes, and even jiggling
the man's belly. There was no stress in the room. And I didn't think this inhumane
nor indignant. Not nearly as much as I felt it when the girl's face was covered
in my previous surgery.
The old, fat man went into v-fib, and more than worrying
about it, I got excited. Without delay I stepped up the metal block and looked
at the heart which was contracting about 5 times per second! It seemed all the
doctors in the room were expecting this, because they did not even change their
tone. They stopped the heart to finish the procedure. I stood there for a
minute looking at the temporarily dead fat man with an open leg and an open
chest in front of me while the vitals machines ringing one continuous note, and
the doctors talked calmly. They said that the leg was going to be difficult to
sow up, because of the fat.
We did not stay for whatever happened next because it was
time for us to go. Hopefully the fat man is alive and has a fully functional heart. And
hopefully the little girl woke up to hear with both of her ears that her mom is
there; that everything is fine.
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