Witnessing a heart surgery

When I was 40, I had the fascinating experience of being in the operating room to watch an open-heart surgery. I was the only bidder in a silent auction and, for a $50 donation, got to scrub in and stand with the anesthesiologists next to the top of the patient’s head and watch a quintuple bypass.

I’m squeamish. I have trouble watching medical procedures in films and on tv. Those scenes stay with me for life. To prepare myself emotionally for the surgery experience, I tried to watch medical tv shows but it was upsetting me and interfering with my sleep. Instead I tried to envision the surgery, but my visions included spurting blood and were too disturbing for me. I stopped the visualization exercises and stopped trying to prepare myself emotionally.

Fortunately, in reality, the surgery was not at all bloody. It is very clean and blood vessels were continually cauterized leaving a clean and visible workspace. Also, the patient was smooth and covered in yellow antiseptic, so his skin appeared like rubber, making him seem less human. My one big instruction was that if I was going to faint, I should fall backward and not into the patient’s open torso.

The team of doctors and nurses and everyone else in the room were impressive. And once the patient’s heart was stopped, they were all business. There was no music and no chatter until the heart was again beating.

What surprised me the most about the procedure was how they stopped the patient’s heart. They put ice on it. It was so basic that it bothered me. It seemed like there should be something more technological than ice. And to start it beating again, they put warm water on it.

There were a couple parts of the surgery that really disturbed me enough to etch a negative memory. When I was scrubbed in and watching through a window in the door to the operating room, waiting for the patient to be intubated, I could see that they were having a really hard time getting the tube down the throat. I was told that, due to his obesity, this procedure was unnecessarily difficult. The doctors showed no signs of panic but their intensity made me fear the patient was never going to make it to the surgery. Watching them open the chest cavity looked more like wood shop than medicine to me. They used a small electric saw to cut open the middle of the rib cage and then spread the ribs. But the worst part for me was when they closed the chest cavity. They threaded wire through both sides of the chest like they were sewing with a thicker metallic thread and pulled the two sides of the rib cage shut like it was a corset. Also, they inserted and left a small tube in the patient’s side as a drain. One of the things that bothered me about this process was the realization that our bodies are flimsy. Although the patient was obese, it still seemed like he didn’t have much substance. Not much separated his organs from the air. Skin seemed more like a membrane that is easy to permeate than an armor that will protect the vitals that keep us alive. Until this moment, I never realized how little substance there is to a human’s physical being.

Watching the surgery, I thought a lot about life and death. The patient was 50 years old. He was not much older than me at the time. Before scrubbing up and entering the operating room, the head surgeon took me to his office and told me about the patient and the surgery I was about to witness. He showed me a video of the blockages causing the need for the bypass. He told me that the patient had a previous heart attack and didn’t change his lifestyle. He drank a lot, smoked, and ate poorly. This second heart attack was major.

Although I wasn’t obese, I was not taking great care of my own body. I didn’t play sports anymore. I wasn’t a particularly healthy eater. I was no longer skinny. For all intents and purposes, it could have been me on that table. The surgery lasted about 5 hours. The room was cold and had a slight smell of antiseptic. I was never bored for a second. Because one of the anesthesiologists only had to monitor some dials once the patient was under, he was willing to answer my questions. I asked if everyone has this much fat on their heart. I was told that we all have some but this patient had excessive fat because of his obesity and that made it very difficult to intubate him and made the surgery way more invasive in terms of finding and harvesting veins for the bypass and for doing the mechanics of the bypasses. I looked around the room and everyone working there seemed to be in decent shape. This included the patient advocate who was there just to make sure there were no improprieties in the operating room. There was also a nurse whose job was to count implements to be sure nothing got accidentally left inside the patient.

I was impressed with the medical team. They clearly worked together efficiently. I thought that if I needed heart surgery, I would want them doing it.

I also thought about how invasive this was for the patient. I really thought about bodies and decided to take better care of mine. I went from the operating room to the gym and I have been working out regularly since then. I can’t necessarily prevent the heart attack, but my procedures don’t have to be as difficult, invasive, and destructive as the one I witnessed. There is a lot we can’t control in our lives, but I would no longer take my body for granted. My friend Art Johnston once told me that our bodies take care of us for our first 40 years and then it is payback. That was my experience. I’m not as disciplined about diet and exercise as I should be, but I am pretty good.

I was so happy that when I left the operating room, the patient was still alive. That is all I know about him. There was no follow-up. Although I really didn’t want to have this experience as I only bid to start the process and assumed someone would outbid me, it was a life-changing event for me. I am so glad I had this unusual and profound experience and I am still thinking and writing about it twenty years later. If you ever have an opportunity for an experience like this, where you get to enter a world you could not otherwise access, I highly recommend it. Also, I’m glad my discomfort with seeing medical procedures and automatically envisioning the pain and discomfort of the patient is not a debilitating condition, so I didn’t allow that fear to stop me from experiencing this fascinating opportunity.

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I'm a midwesterner who is living this phase of his life in the arts.

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David Fink

I'm a midwesterner who is living this phase of his life in the arts.