The Day the Surgeon Cried

It was an experience that no one could ever forget unless of course the shock of it made total repression the only real choice.
I was a student nurse at the time - not yet out of my teens - and I was lucky enough to be training in a major Manhattan Hospital. I was back for another few weeks in the Operating Room, having chosen this specialty for my senior rotation. On this particular date, I’m working the evening shift which typically is not a terribly busy time in the OR as all the scheduled surgeries are over for the day.  Basically, it is a time to do peripheral, preparatory type tasks and be physically present in case of an emergency. My OR instructor was with me this particular evening. I remember she had a rather strong foreign accent, an unusually mousy appearance and a nurse's cap that looked like a pleated upside-down cupcake holder.  She also exhibited some rather atypical mannerisms that gave her away as a woman from another country.  She she was quiet, serious and smart as if she were still trying to prove her worthiness in this country.   I really liked and respected her.
In the midst of the quiet, we suddenly got a call to set up for an emergency cardiac surgery.  A woman who had cardiac bypass surgery earlier that day was experiencing problems and was being brought back to the OR.  I remember the massive amount of surgical instruments we quickly assembled; every imaginable tool that could possibly be needed was laid out meticulously on the tables. The complete set up was configured in a large L shape and we stood ready to assist with anything the cardiac surgeon required.
I remember feeling very relieved that my instructor was present and appeared to be in control as I definitely lacked the experience to assist with such a complicated emergency. We were prepared and ready for anything,  or so we thought.
A loud commotion ensued as staff members, including the surgeon, crashed through the OR doors dragging the gurney alongside them. There wasn’t time to transfer the woman from the gurney to the OR table, so the physician began immediate emergency measures right there and then.  Drugs were administered directly through the freshly created breast bone incision and external cardiac massage and electrical shock were applied.  The cardiac surgeon worked frantically to bring his patient back from the brink of demise. Clearly I could see the anguish, the distress, and the desperation that flooded his face as one thing after another failed to get the desired results. His patient was slipping away and there wasn’t a damn thing he could do to stop it. I felt helpless. My calm, highly competent, and completely prepared Instructor stood helplessly at my side. All our attention to detail, all our perfectly arranged tools, all our correctly lined up medications, were absolutely futile.  The Surgeon yelled for a scissor, quickly cut open her sutures, grabbed her heart into his hands and began to pump it manually.  He literally held her heart in his hands, but to no avail.   When the realization finally sunk in that nothing he could do was going to make her live, he stood there and cried.
Being a young student nurse, I wasn't responsible for anything more, other than the clean up of this area of the O.R.  I did not envy him, having to tell the family of this 35 year old mother of 5 that their beloved had died.  
Addendum: This real life incident occurred in 1964-1965 when Open Heart Surgical Intervention was in its' infancy.  St. Vincent's Hospital and Medical Center in Greenwich Village, NY had also recently instituted something called a Code 99, basically a "crash team" that would spring to action when a patient unexpectedly arrested.  I do not recall a Code 99 being called that particular night. I do not recall the Surgeon's name although I can picture him in my mind.  The nurse at the top pf this Blog entry is my Surgical Instructor, Ms. Danute Mikulskis, R.N, B.S.

Memories,Terrors and True Confessions - More bullets

·         Some of my memories are vague but the feelings surrounding the next memory are as vivid today as they were in 1963.  I remember getting on the elevator and squeezing as far back into the corner as I possibly could.   I was holding a package that was quite heavy and looked exactly like a nice fat, rolled piece of roasting beef.   Other people got on the elevator and I averted my eyes and tried to look nonchalant.  I wanted to say, “no, I can’t do that” but how could I refuse to do one of the first assignments that I was given as a Student.   I was told to bring a freshly amputated leg down to the morgue. I was sure that everyone I met knew what I had in the package in my arms. 

I remember:

·          Routinely giving aspirin for temperatures over 101⁰.  The connection to Reye’s syndrome hadn’t been made yet.

·         The kids on Peds would get soaking wet in those clumsy square oxygen tents.

·         Sitting in a 4 bedded “baby” room during feeding time.  I/We would pick up and feed one baby and prop up the bottle for the next baby.  In our defense there wasn’t usually enough staff on evening and nights, the kids needed to be fed and we never left the room while a bottle was propped.

·         This leads me to the next memory.  We would have had loads of people who were willing and anxious and ready to feed each and every baby in the most loving manner if we didn’t practice the cruel and inhuman policy of limiting parents’ visiting hours.  I can still hear the wailing and gnashing of teeth and visualize the horrendous scene of parent’s being pulled away from sick, young children who were screaming at the top of their lungs for Mommy and Daddy to stay.   I NEVER AGREED with this policy – NEVER -but I was powerless to do anything about it.  It used to break my heart.  What was wrong with “us”?  Thank God this practice no longer exists.

·         I remember the new “clean room” on Pediatrics.  I believe Dr. Vincent Fontana was instrumental in getting this up and running.  (He was also a Leader in the Field of Child Neglect and Abuse Prevention)  You needed to don all kinds of gear including foot covering before you entered this chamber.  When you walked through the ante-room you were practically blown away by the vacuum jets.  I felt as it I was on a mission to Mars (similar to being in an episode of Star Wars) on those occasions when I was assigned to that room.  I must say it was a bit of a pain in the neck to get in and out of that place.   Do any of my classmates have more details about this special environment for kids with severe allergies and asthma?  Whatever happened to this concept?  Was it proven to help or did it go the way of aspirin for temps over 101⁰?

·         I remember attending a little “party” in the playroom area in the middle of Pediatrics. Dr. Vincent Fontana was in attendance, accompanied by the “heavyset” nun (am I allowed to say that?) who was the Pediatric Supervisor at the time.   Dr. Fontana approached me and said something like, “Hello, there, I don’t believe we ever met?”  I had worked on Pediatrics for near close to a year at that point ( It was the year after graduation so it really doesn’t fit in the category of Memories of a Student Nurse but since we are on the topic of Dr. Fontana I decided I’d throw it in).  I was more than a little bit insulted that he didn’t know that I was one of the nurses on the Unit and I responded, “Maybe it’s because I recently dyed my hair blonde. But I recognize you because your hair is the same color it has been for the last few months”.   The staff within hearing range couldn’t believe their ears.   How could I say such a thing to this big Specialist’s face?  I guess it was because I was now wearing white and was starting to get tired of the philosophy that the doctor was a supreme being and I was an ignorant peon.  This was a time when nurses stood at attention and offered their seats to any doctor entering the room.  Even, I might add, after being tattered and frayed after running ragged all night with the humanly impossible task of giving care to a ward of 40 very ill patients.  

   

Memories, Terrors, and True Confessions - bullet # 2 "I Don't Like To Sleep Alone"

After Theresa left, I was all alone in my small, dorm-style room on the 12^th floor (Kathy Murphy Leventhal - was it the 12th floor? )  at 158 West 12^th St., NY, NY.   As I mentioned in bullet # 1, I had always had a roommate – first my big brother, Charlie, and then my baby sister, Meg.  I came from a very well protected environment.  My dear Father, God rest his soul, should have had the following epitaph placed on his gravestone, “Don’t stick your neck out”.  Our safety and well-being was all he seemed to care about.  When I was a teenager and wanted to learn to drive, he said and probably meant it, “Why do you need to drive?,  I can drive you anywhere you need to go.”  I said, “What Daddy, you plan to drive me around for the rest of my life?” I finally learned to drive when I was 20.    My very first couple of nights at St. Vincent’s, I remember lying in my new bed, looking out the window at the big city lights and realizing that my childhood was over and like the Babes in Toyland, “ I could never return again”.  I cried myself to sleep for several days until my grief subsided.  When my roommate left I felt sad, scared and in need of some company.  But, by this time in my relatively new career as a student nurse, I had developed two marvelous friendships with MM Bonner and M. Geraldine Crowley. They shared a dorm room a few doors down from me, on the other side of the hall and they warmly welcomed me into their room.  The only problem was there was not one centimeter of extra space in our dorm rooms and of course, no extra bedding.  No, problem!  MM and Gerry were most generous in assisting me as I dragged my mattress down to their room.  I placed the mattress on the floor in between MM and Gerry’s beds and I felt safe, happy and content once more.  In fact it was such a positive experience that the next morning I decided to simply push the mattress under one of the beds so I would be ready for bed again that evening.  MM and Gerry were most agreeable and I believed my lonesome days were  over.   Not so.  That day, the house mother discovered that the  mattress missing from my room was stashed under the bed in my friends’ room down the hall.  She immediately reported the “incident “to the nun in charge (I believe it was Sister Delores Elizabeth).  The next thing I knew I had an appointment scheduled with the School Psychologist in order to uncover my deep seated psychological problem, i.e., “I don’t like to sleep alone”. I had several visits with the Psychologist and I really enjoyed our time together.  But the truth of the matter is I should have simply sung some of Paul Anka’s lyrics to him on my very first visit:

“No, I don't like to sleep alone
It's sad to think some folks do
No I don't like to sleep alone
No one does
Do you?”

Mary Beth Fries Buchner - Bio - "The Baby is Yours"

While in my new job as the Patient Teaching Coordinator at Wilson Memorial Hospital , I not only prayed to the Holy Spirit to guide me in this new and foreign territory, I  took immediate practical steps to learn everything I  could about “death and dying”.  Elizabeth Kubler- Ross had recently challenged the status quo in the way we cared for people in the end stages of life and I read every word she put on paper.  I joined a support group at Our Lady of Lourdes Hospital in nearby Binghamton, NY to help me handle my own heartbreak.   Surprisingly the Facilitator of the Group was a Neurosurgeon.  I say surprisingly because at this time in the course of history, most MD’s were still denying that any of their patients were dying.  Since this remarkable physician had experienced a rather dramatic life changing event in his own practice, he decided to start a bi-monthly group for medical personnel who might need a little extra support themselves.  I wanted all the help I could get therefore I never missed a session.   

My position at Wilson Memorial was newly created and the Director of Nursing gave me “free reign”.  I decided to share some of the audio tapes I had purchased for my own learning and development with other staff members throughout the hospital.   Therefore, I started a Discussion/Support group that met once every other week, and quickly discovered that a lot of people at our Institution were looking for some sort of sustenance.   Eventually, I developed a relationship with a young woman, a recent graduate who had come upstate from Long Island to complete her undergraduate degree in Health Education.  She was recently hired and started attending the Support Group on a regular basis.   Eventually she shared that she was attending the support group for personal rather than professional reasons.  While she was away at college, her 15 year old brother, Donald, had died of leukemia and she was having difficulty dealing with his passing.   Intellectually, she knew he had died, but on her first trip back home after college, the reality of his absence broke through her emotional denial.   She was experiencing intense feelings of sadness and loss.  One day, several months after I met Diane, we went out to dinner together after our work day was over.   During dinner she said, “On top of losing my brother, my parents are now dealing with the fact that my 17 year old sister, Laurie, is pregnant.”   She had broken up with the father of the baby and was hoping to eventually become a physician.  Diane explained that Laurie was adamant that she wasn’t going to have an abortion and, as difficult as it was for her, she was seriously considering surrendering the baby for adoption.    Since their “old-school” Italian grandparents would not be too accepting of an “out of wedlock” pregnancy the plan was to send Laurie upstate from Long Island to Johnson City to live with Diane as soon as she began to show.   “Gee, Diane,” I said, “Bob and I are in the midst of an Adoption Home Study with Broome County Social Studies.  Do you think your sister would entertain the idea of allowing us to adopt her baby?”   Diane mentioned that her sister, Laurie, had an up-coming appointment with Catholic Charities in Broome County and she would let me know how this visit went.  

Laurie, barely 17 at the time, was brilliant and mature beyond her years.  She told the Catholic Charities Staff that she wanted to speak personally with the adoptive couples who were being considered as parents for her baby.   She added that she was aware of confidentiality issues; therefore the potential candidates could be “hidden” behind a screen and no identifying information needed to be exchanged.  This was in the summer of 1976, before “Open Adoption” came into vogue, thus Laurie received a resounding, unequivocal NO!  

A few days later, Bob and I had dinner with Diane and Laurie.  Things went very well and the next day, on my desk at work, I found a note that said, “The baby is yours”.   I jumped up into the air as I clutched the note to my heart and yelled out loud, “Oh, my God, thank you”!