I've got a bonechip in my eye...and more substantive updates

We cracked open the head today. "Crack" really isn't the operative word here, since it was more like a wet, sloppy sound as the calvaria (skull cap) was being removed. As any shellfish eater can tell you, it's the sound made when opening a crab or severing a lobster head from its tail. Yeah, that sound. Aside from the prerequisite mechanical saw, a hammer and a chisel were also involved. While the saw was a lifesaver (I can't imagine doing it with a handsaw), it came with a spray radius of approximately 4 feet as bone dust flew literally everywhere. In retrospect, I could also compare the process to opening a coconut, because approximately the same amount of liquid came pouring out, to the delight of our professor wielding the saw, as the rest of us try to hide our grimaces and not think about cleaning up the mess later. At least Barbara's keeping herself hydrated.

It's been brain back-to-back these past 2 days, what with open head surgery yesterday and the cadaver dissection today. I wish the order were reversed, so that at I had more of a clue while watching the surgery. Well, probably not. I still don't have much of a clue, although I did learn that the absorbent pads the surgeon, Dr. M, placed between the brain and the suction tube were there to prevent him from accidentally sucking out the brain. Yep. Accidentally sucking it out. I'm glad he thought of everything.

The most interesting episode during the past 2 days for me actually came from watching how this surgeon dealt with delivering bad news. The surgery mentioned before was actually considered a 'heroic effort' by Dr. M, or as one of his colleagues put it, 'an academic exercise' because of the extremely low survival rate predicted due to the condition of this patient. That explains why Dr. M didn't react when the anesthesiologist reported that the patient's pupils were bilaterally dilated and unresponsive, as this is never a good sign (the brain is dying). As I later found out, the family had requested the surgery even though the patient was found in this state, and had remained there for at least 4 hours, possibly more, at another hospital. The surgical part was easy--it went by without a hitch. Telling the family afterwards that there is less than 10% chance of recovery was hard. Very hard. Lots of crying, tissues everywhere—confusion abounded. I applaud Dr. M for his textbook delivery of the news, despite the fact that he was addressing a crowd of 14 very distraught family members. Still, he sweated a lot.

We grabbed an ABP break. Dr. M devoured a chocolate covered pastry. We went back to his office where he began to review the next case. With a few clicks, his computer screen flowered with images, scans of all sorts, from all different angles. I'm flabbergasted by all the imaging technologies available. From a distance, it looked as if Dr. M was playing Zelda on his computer.
Another patient soon came in. It was more bad news: a brain aneurysm. That meant more tests, and possibly open head surgery. The patient and his wife were young: mid-forties, maybe even less. The wife asked all the questions. Dr. M spent 40 minutes explaining procedures. He had to rush it; the patient wanted to leave to pick up his daughter from school. They nodded awkwardly to me as they headed for the door. I think I smiled, although in retrospect, that was probably inappropriate. How do you smile to someone who's just been told that his aneurysm could pop any moment, and that'll be it? Dr. M, meanwhile, is back on the phone. He had another case coming in. And I was on my way out.