If you have no idea how it feels to vasovagal (a.k.a. symptomatically faint), consider yourself pretty damn lucky. It’s very unpleasant.
Imagine you are in a scenario in which your brain says “Oh, hell no.” You are minding your business– walking, talking and breathing– when your brain makes the executive decision to shut this shit down. Suddenly and with zero warning, your body gets hot and flushed. You feel the blood drain out of your head and your legs become heavy. Black fog swirls at the periphery of your vision. You might puke. You begin to panic if you know the symptoms because you know exactly what happens next.
And most of the time, you end up closing your eyes and opening to them to a circle of worried colleagues standing above you and assessing you for injury. You suddenly hope you’re bleeding internally so you can die quickly and not from this slow mortification.
No such luck.
Today, I performed a c-section on a woman who stopped dilating at 5 cm despite us cranking the pitocin to high heaven and trying every physical way of delivering her vaginally. Didn’t happen. But a funny thing happened. When you’re in someone’s abdomen, the body doesn’t particularly like it. It knows there is something fundamentally wrong. The autonomic response is for the patient to puke.
And puke she did.
Repetitively.
Forcefully.
So forcefully, in fact, she eviscerated herself through her incision. This has never happened in the ~200 c-sections I’ve done. Loops and loops of pink, fluffy small intestine become ejected from her abdomen. And this in turn causes her to vomit MORE. So now her transverse colon is popping through and the surgeon across from me is asking me to help push it back in before she perforates. She is in essence accidentally strangling her bowel.
This is not normal OR events. And the patient is awake. So tact is essential. This is why I didn’t say anything as I began to feel the sweats, turn green, and drop my own blood pressure in panic of seeing someone’s colon explode while I am first assisting.
I pinched myself. Hard. Then I took three deep breaths. I looked away for a second. And while anesthesia loaded her with anti-emetics (i.e., stop puking drugs), I got my shit together and reminded myself that I am a goddamn professionals and professionals don’t fucking faint.
After what felt like 873 minutes (about 1 minute in real time), I normalized. We managed to put all the parts where they belonged. I closed like a champ. I even did a beautiful plastic surgery closure so her incision will look like a bikini wrinkle rather than a huge incision.
I unscrubbed. And for the hundredth time, I think about getting an IUD.
Loading comments...