Death Brings New Life

"Let us take a moment to reflect. Reflect on life, on death, and those rare but miraculous circumstances when death leads to new life. Now, I didn't know Sheri*, but what I do know is that this was her final gift. I spoke to her family for only a few moments. But it was clear that they had said their good byes and were ready for closure. They told me Sheri spent her life giving back and that this is her final gift. Let's take a moment in silence to remember why we're here. To honor Sheri and the new life her death brings." 

We were in the OR in a city in northern Wisconsin. The woman on the table before us had been declared brain dead and the machines were keeping her heart pumping to allow blood to continue to circulate her organs. She had offered her organs before death. I had traveled along with the procurement team (composed of a manager, PA and a transplant surgeon fellow) from Madison to procure these organs and to deliver them to individuals with chronic diseases back at UW.

The transplant surgeons hurriedly got to work. The anesthesiologist was using machinery to keep the heart beating and the lungs expanding with air. A large incision from the top of the sternum to the public bone was made. The ribs were opened. I stared at the opened chest. The heart beating, the monitors beeping, the lungs expanding. Entrancing me. Mesmerizing me. Consuming my thoughts.

"LIZ! What is this!??!" said the transplant surgery fellow, snapping me back to reality. I gambled a guess and was correct. "And this?!" Another guess. "Good. And this?!" I guess. "WRONG! Liz, Liz, Liz, this?! This is nothing!" With a swooping movement of her hand she cut the nothing quickly and moved on to the next task at hand.

We are taking back two kidneys and the liver. We let blood flow to these vital structures as long as possible. Once we were ready, a main artery was cut, and the blood removed. The machines turned off. The anesthesiologist no longer needed. The heart stopped beating. The lungs stopped expanding. Sheri had already been declared death because her brain no longer functioned. However, in that moment, I felt overwhelmed with emotion. Though the machines did the work, I had just watched the heart take its final beat and the lungs take their final breathe. All signs of life officially gone. I took another thought, to once again thank Sheri for her gift. 

The organs were procured and placed in coolers. Through the utilization of private vans and airplanes, we were swiftly transported back to the Madison. Within hours, I was back in the OR at UW. The man before me now, Jon, had been ill for many years. His liver was failing. His skin colored yellow from jaundice.  Jon told me that he felt a mix of emotions. He had been waiting for years for a new liver, but deep down he knew that in order for him to continue living, someone had to die. I stayed up all night, watching the transplant surgeons take out the damaged liver and put a new one in its place. Upon reconnecting the blood supply to the new liver, it slowly turned pink, indicating that Jon's blood was adequately perfusing Sheri's organ.

Death, indeed, had brought new opportunity at life.

*all names changed

The date with the smooth hot guy.

Went on a date with a super hot guy and things like this happened...

 Him: I really need to become a vegetarian. I love animals and hate factory farms... My dream job as an attorney would be working to protect animals and the environment.

Or... Him: While I know this can't be rushed, I just can't wait to spend my life with my soul mate.

*his phone rings*
Me: You can get it if you need to
Him: Oh, it's just the blood center calling me, reminding me it's time to donate again.

He HAS to be lying to me. I'll get to the bottom of this.

Life on My Surgery Rotation

First the attending is all like "Liz, what's the answer to this impossible question?" And I'm all like:

 And then I make a guess at it, which 99% of the time turns out to be wrong. Then she says "WRONG!" And I'm all like:

 As if that wasn't enough embarrassment for the day, the scrub tech asks me to complete a simple task which I have no clue how to do... so I'm all like:

 Finally, a boat-load of super intelligent people (plastic surgeons, neurosurgeons) all enter the OR and everyone starts asking me question I just don't know. And I'm all like:

 I answer wrong. They ask me to guess again. And I'm all like:

 By the end of the day of not knowing answers, saying stupid stuff, and being scarred for life. I'm all like:

5 Simple Ways to Survive in the OR

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1. Smile with your eyes
This is the most important thing you can do in the OR.

Your hair is covered with your bouffant cap and your mouth and cheeks are covered with a mask. How will people know your extreme interest with so much of your face covered? Just SMILE with your EYES. My mouth stays mostly stationary, but my eyes take on a life of their own. They squint, they smile, they enlarge, they react and they ENGAGE. Did I think the scrub tech's joke was funny? Hell no. But did my eyes think the joke was funny? Yes and they spent at least 60 seconds exploding with laughter.

2. Glove with confidence and flair

The more confidently you put on your glove, the less likely it is that two of your fingers will accidently go into one finger hole.

A little flair with your hand movements while gloving distracts everyone from all the times you accidently get your finger caught on your sleeve causing your finger to bend which therefore fails to make it into the finger hole. No one will even notice!

3. Know your audience 

The scrub tech with tats and a crude sense of humor. I throw out beaver jokes like it’s my job, laugh hard at her “that’s what she said jokes” and reference my favorite local tattoo parlor (I didn’t even know I had one).

The male nurse from Latin America? Easy. Let a small, barely perceptible blonde lock poke through the side of my Bouffant cap. Winks don’t hurt either.

How about the attending who plays guitar on the weekends? “Sir, your choice of OR music is impeccable.”

Compliment everyone on their original and unique Dansko selection.

“Mary, I just love your Danskos.”

“Tiff- I’ve never seen such cute Danskos. You’re rockin’ them.”

4. Thank the Scrub Tech for Being Crabby

-“Liz, you need to stand straight on or you’ll ruin the sterile field and we’ll have to start this whole surgery over. Pay attention”

-Me: “Oh my! Thank you!” [Smile with eyes]

-“Drop your hand another inch and you’ll have contaminated the field possibly giving this patient an infection where they’ll die slowly, painful, experience multiple amputations, spread the infection to their young child and then bleed out from their orifices.”

-Me: “Oh! Thank you for watching out for me!” [Smile with eyes]

5. Realize that they’ll give you insignificant jobs, which you’ll be sure to mess up.

One job I often do is cut ties with the scissors. My success rate for this simple job is approximately 50%. I’ve gotten fired from “cutting” over 5 times. I thought I mastered the art of cutting in kindergarten, but apparently not. Here are just a smattering of the 100s of corrections I’ve received.

“Oops Liz, cut that one too short!”

“Leave more of a tail next time”

“Next time, put your hand down on the sterile field to more effectively cut.”

“Be more careful you don’t cut the knot.”

“You can cut more quickly.”

“Ou, next time, take your time. It’s more important to be accurate than quick.”  

“You should angle your scissors more precisely next time”

“Now stabilize that scissors with your index finger.”

Now I just realize that I’ll mess up whatever job I’m given. With the bar of expectations set only inches from the ground, my failures feel like neutrality, and my infrequent cutting successes make me feel like I can conquer the world.

Those beds!

Pretty sure I instilled a lot of confidence in a patient in the operating room when I said "I'm Liz, a med student, I'll be helping to take care of you when you're in the OR" then proceeded to spend the next 5 minutes trying to figure out how to lower the side-rail on her bed. Apparently you just push the lever.

Switzerland: Flying

A rundown building. A dirty bathroom. Half-empty vodka bottles on the table. Beer lined up on the counter. No one here has showered in days. Some even have teeth that are missing. Where am I? A fraternity house? No, I am at the school for paragliding. Take off is in 30 minutes. I’m still a bit frazzled as to why an abundance of alcohol is necessary at the paragliding school and I am tempted to give my tandem instructor a quick breathalyzer. Hopefully he wasn’t one of the people who drank that vodka. Can’t drive, can’t paraglide? That better be a rule in the Handbook for Paragliding Instructors.

The building may have been enough to scare some away. I’m putting my life in someone’s hand- you think they would perhaps have the decency to wipe off the bathroom counter. At the very least, dispose of their empty vodka bottles. Maybe even invest in a machine so they can accept credit cards. But no, cash only.

I will argue that the drive up to the top of the mountain was more dangerous than the act of paragliding. It was a two-lane highway going up the mountain and we took up both lanes. Instead of slowing down to go around the curves, our driver accelerated into them. We traveled well over the speed limit, taking no precautions as we neared the cliffs.

Set-up and take-off went fairly smoothly. Except that, we were given no instructions or safety instructions. In fact, my instructor hardly spoke English. Also he put on my helmet, which immediately fell off. He tried to tighten it, but it wouldn’t work, so I paraglided with my helmet half-on and half-off (50%… not a bad statistic?) As the instructor was putting on my equipment, he kept telling me to “Look away, Leeeez, look far, far, far away.” I wasn’t sure why I couldn’t watch him hook up my equipment (sketchy), but I didn’t want to piss off the instructor by disobeying him so shortly before we flew over the mountains.

At one point during the 40-minute paragliding session, we kept flying over the same trees by a cliff. My instructor kept yelling things in French. I was a bit confused, and a bit worried since we were a few feet from touching the cliff and a few feet from touching the top of the trees. Seems dangerous. Eventually he explained, “One of my friends Joe has had some bad luck. He made a mistake and fell into these trees.” Shit. After about 10 minutes of yelling for Joe, Joe finally responded saying that he was “Alright.” And we continued to fly upward further away from the trees and the cliff (thankfully).

One of the things that I loved most about my unshowered, possibly drunk instructor, was his ability to carry on conversation. “Leeez, do you know Kama sutra?” …. What?… “You know, Leez, you know kama sutra?” … I guess so? … “Leez, you might know, but do you know French Kama Sutra?” …. I guess not? …. “Here we goooo!!!” He then whipped the parachute around in a circular motion for about a minute. Breathless from the exhilaration, he leaned in and said “Leeeez, now I know you like it.”

I’m glad to report that I landed safely. It was amazing to feel like I was flying for a full 40 minutes overlooking Mount Saleve and Geneva at sunset. Despite the sketchiness and near death experiences, my paragliding experience was absolutely breathtaking.

 

Switzerland: Obesity and Life Expectancy

It is excellent. The Swiss have the best of both worlds. Delicious, fat-filled foods and fit bodies. Cheese, wine, beer, chocolate, pastries. Nice abs, slim figures, small rounded butts. Even Grandma looks good! There goes 80-year-old Grandma eating a chocolate croissant and drinking beer, all while maintaining her 40-year-old figure by biking up that mountain.

I noticed the lack of obese (and especially morbidly obese) people during my first week in Switzerland. To verify my observations, I did a quick search of obesity prevalence in the US vs. Switzerland. In the United States, 30.6% of people are obese. In Switzerland it’s 7.7%. It is more common here to find people outside walking around, riding a bike, rollerblading, hiking etc. Even the elderly really get after it.The nation as a whole looks more fit, less sloppy, and overall healthier. Consequently, the Swiss also lead a longer life. The life expectancy at birth in Switzerland is 82 years old (Ranked 4th). In the United States, it’s 78 years old (Ranked 36th). We really need to take a few steps back and learn a little something from the Hottttt Swiss Grandmas.

Obesity around the world (We win!)