by Annginette Anderson Moos
In 1992 I was a graduate student majoring in health care management. We were preparing for careers like hospital administration or pharmaceutical marketing. Our department arranged a weekly “shadowing” opportunity, where students spent the day with a physician, nurse, or health professional in a clinical setting.
With no clinical background, I took every shadowing opportunity I could. My first was observing surgery at the Hospital of the University of Pennsylvania. I was nervous; I’d heard stories of students fainting and causing a big disruption.
It was absolutely fascinating. In hospital scrubs, I was shown how to wash to enter the OR (operating room). Nurses and techs prepared the room then sprang into action when the first patient was wheeled in. The surgery — a biopsy of tissue from a woman’s breast — began.
As I sorted out everybody’s job, and understood how they meshed together, I became awed by the efficient and elegant way these eight people coordinated their concentration and skills around this complex procedure.
In a breast biopsy like this one, there is a period where everybody must wait. The removed breast tissue was sent to the lab, where a pathologist would examine a frozen section for cancer. If found, the operation would resume as a lumpectomy or full mastectomy. While the lab created and analyzed the frozen section, the surgeons, anesthesiologist, and nurses watched the unconscious patient, relaxed, and chatted. Then the phone rang.
The pathologist informed us that the tissue was benign. Suddenly everyone sprang into action again. Surgeons closed the incision. Nurses assisted the surgeons or prepared the room for the next surgery.
Then the anesthesiologist started to wake the patient, talking to her in a loud voice. As she groggily came back to consciousness, she seemed like a minor character in the drama that had just taken place. Everyone’s back was turned to her as they worked busily.
The anesthesiologist said “We will transfer you onto a stretcher, and you’ll go back to your room.” “I don’t understand,” she said. “Why am I going back to my room? What happened?” The anesthesiologist, concentrating on his equipment’s readings, simply repeated that she’d go back to her room.
Finally, the patient clearly asked the room in general, “Does this mean I don’t have cancer?”
Everyone stopped moving.
They all turned to her, smiling. The chief resident came over, touched her shoulder, and said kindly, “That’s right: you don’t have cancer. The lump was benign. You can go back to your room and sleep, then go home.”
With her simple question, the patient reminded everyone of the worry and fear in the anonymous, unconscious patient they had just operated on. Of the purpose of their activity. Of our common humanity. Not only did the patient wake up, she woke up the rest of the room.
Today, as a staff member of a hospital system, I carry her lesson with me always.