I cut out dead tissue
Then I go home and look forward to my date
By TJ Jamshidi
May 13, 2002
The Iranian
I start my Friday morning with a cup of my favourite espresso. Today feels a bit
different from the usually days. Maybe because after a long time, I am going on a
date.
Her name is Lama, she is Lebanese and I am quite fond of her. For a long time when
I heard the word "date", I automatically thought of the sweet delicious
fruit that comes from the Middle East. That is how long I have not gone on a date.
It is 8:55 am and my pager is ringing. I go down to the ER, Emergency Room. I am
briefed about the condition of Jerome, a 35-year-old, African American who is overdosed
with cocaine. The ER team has given him activated charcoal, to reduce the drugs absorption.
However, the patient's condition is not improving.
Despite being a surgeon, I always loved pharmacology, the study of drug actions.
This case had was sepcially interesting because it involved both my loves -- surgery
and pharmacology.
Cocaine is a potent vasoconstrictive agent. That is, it cuts the blood supply to
the major organs shutting them down one by one and leading to a condition that we
call "shock". If not treated the condition is deadly.
In the case of Jerome, his condition was worsening by the minute. The ER docs think
that the problem is in Jerome belly. Cocaine may have cut off the blood supply to
his intestines and if not operated upon, he could die.
I take my stethoscope and examine his belly looking
for bowel sounds. A healthy intestine makes healthy "crackling" noises.
In Jerome's case he had no bowel sounds. That is when I made my decision to operate.
In the operating room I make a ten inch cut starting from below his sternum (breast
bone) all the way to near his naval. After I open his belly I practically take out
his intestines and put them on the table looking for the potential dead areas. Soon
I found it. An area that clearly looks black and definitely "dead". I cut
out the dead tissue and reconnect the healthy portion of the intestine back together.
In a matter of minutes Jerome's condition improves. I know once he is out of this
hospital, he will probably take more cocaine. But I can't worry about people's actions.
I should only do my job to the best of my abilities and move on.
I finish my shift at 7. I go home and look forward to having a date. I feel like
an 18-year-old all again.
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