First day.......boobs!

I recently started my first hospital surgical tech job and I can’t tell you how excited I am about it. Granted, up to now I had been dreading it because I love my job at the college and I didn’t want to have to cut back on that but I’ve since changed my mind. The minute I scrubbed in on a surgery the other day all the love and excitement for the clinical aspect of my job came flooding back.

Being new is never fun but I’ve tried to make the best of it. So when the “mentor” I had been assigned to for the day told me that I could jump in whenever I was comfortable I knew that it was do or die time. See, the O.R. is a lot like high school. You have your groups of people who stick together no matter what, you have your catty women who you know you need to watch out for, you have the jocks that make you swoon, and you even have the silly boys who always go for the cheap laughs. And just like back in high school, these people can smell your fear. When you’re new, you can’t hesitate when someone gives you the chance to show your skills. It’s a timing thing. If you try to observe and learn the lay of the land for too long…..it’s going to be a feeding frenzy. And just like high school, you’ll never recover from it.

So anyway, I knew when she told me to take over when I was ready it was time for my first test. So I observed for another three to five minutes and I took over the table. At this point the surgery was underway so I didn’t have to worry about setting up my table or draping or anything like that. All I had to do was run the table, pass instruments, handle specimen, and maintain the sterile field. After the first minute or two of holding my breath, I exhaled, relaxed, and found my groove. It was fantastic and I didn’t realize just how much I missed it until right then.

The case I took over was a bilateral mastectomy with breast reconstruction. What does that mean? Well basically the patient was at high risk for developing breast cancer and decided her best chance would be to have both of her breasts surgically removed and then have a plastic surgeon reconstruct them using implants. This is what we call a prophylactic surgery-surgery done to prevent a disease. At first it may seem like a pretty radical step when thus far the patient was healthy but when you’re faced with the knowledge that there is a very good chance you could develop cancer you look at it as a live saving decision.

This was not the first mastectomy I’ve done and they have never bothered me before ( I know that sounds harsh but in order to cope with this job, once the patient goes under and is draped out I stop thinking of them as a whole person. Otherwise, I’d never be able to stop thinking about what the patient might be going through.) Anyway, recently I had a student drop out of my program after observing a mastectomy because it disturbed her so much that she decided she was on the wrong career path.

So, as I worked on this woman I got to thinking about what this might do to her psychologically. Would she wake up and feel like less of a woman? Would she feel undesirable and be afraid to let her husband see her? Would she feel ashamed every time she went bra shopping because those weren’t really “her” breasts?

Let’s face it- what is one thing that makes most women identify as a woman? I’ll give you a hint…look down. Yep, breasts. And why wouldn’t they be an identifying factor? I don’t know if you’ve noticed but our society is obsessed with them. Water bras, cleavage baring tops, those “chicken cutlet” inserts, Pam Anderson….and every day woman have elective cosmetic surgery to enhance their own, um, assets. These things not only make them feel better about themselves but can also make a difference in how other people look at them.

My point is breasts are not just an accessory that just happens to be connected to our chests. They make us feel feminine. They instantly set us apart from men and are desirable objects. What would it do to the way we identify with ourselves if they were suddenly gone? Would you feel like damaged goods?

All of this ran though my mind from the first incision. The tissue was dissected away from the skin with the cautery and removed and a pocket for the implant was created below the pectoralis major muscle using cadaver skin. As the first implant was inserted, I realized that this patient should not feel like any less of a woman after surgery. She made a decision that will potentially save her life, not to mention spare her the heartbreak of developing cancer. She opted for reconstructive surgery so that she’ll still look the same physically but even if she hadn’t, she could have altered herself perception. One body part doesn’t make you who you are.

By the time this amazing plastic surgeon finished, we had used 124 sutures (which was super fun to keep track of by the way), two pieces of Alloderm (cadaver skin), three implant sizers, and two silicone implants.  From first incision to wound dressings the surgery took about four and a half hours and seven surgical team members. It was routine. But what we gave that patient was anything but. When she woke up in the post-surgical recovery until, she had piece of mind that she had just undergone something that will save her life. She won’t have to worry every time she does a self exam or has a mammogram. She doesn’t have to live in fear of that “C” word.

Yes, being a surgical tech is a job. It pays well and it’s fun. But it also gives us a chance to help people in more ways than you could ever imagine.

Always,
Lisa Marie