My Stay in the Azores Islands: Day #2 at Hospital: Please Don't Faint, Please Don't Faint

July 1, 2013
After having jogged to the hospital last time, arriving sweaty and late, Erica and I tried to make sure that we would make it there dry and on time today. Sadly, the mini-bus (public transportation) wasn't on schedule, so we still arrived 10 minutes late. At least we came dry!

Today was my first day in the operating room. I would see a gastric surgery on a man who had stomach cancer. Like some of the patients I saw at consultations and the one we checked up on who asked me if I wanted to go for a ride, this man was about to have his stomach removed. (This must be my doctor's specialty or something.)

Last night at the festival, we started talking about donating blood. For anyone who knew me when I was younger, you know that I would get queasy even at the mention of blood. It made me really dizzy and at that young age, I suspect I never would have dreamed of being a doctor. That phase has pretty much passed, but sometimes, it still washes over me. There's no rhyme or reason to when it happens and when it doesn't (or at least not that I have learned yet.) Though, when I get blood work done, I always get super dizzy and cry, which is slightly embarrassing. (I know the nurses doing it get annoyed... it's no longer cute at age 18.) So yesterday, when we were having this conversation, it started happening. I started feeling light-headed and really uncomfortable. I didn't say anything though because I didn't want anyone to judge me. I think it came on especially strong because I've been nervous about whether or not I can hold up in the operating room. The big question in my mind has been: Can I handle surgery? Can I even end up being a doctor? The idea of being a doctor and performing surgery sounded great. But I didn't know if I could handle it when put to the test.

So here I was... first day in the O.R. I changed out of my clothes and into my scrubs (so comfy.) I put the hairnet on, the mask on (I put this on wrong the first time and it was embarrassing), and the shoe coverings on... I was super excited, but in the back of mind, I still had that doubt. Teresa told me to leave the room and put my head between my legs if I felt uncomfortable. A lot of the students in session 1 had fainted before. I nodded, finding comfort in the fact that she understood if this happened. So I geared up mentally and stepped into the room to watch as the patient was prepped. Eventually, the drugs kicked in and he passed out, so the nurses started cleaning him. This was all easy-peasy. Then, the nurse needed to stick this needle in his arm for some reason. I didn't have time to figure out the reason why because as soon as she stuck it in, blood squirted everywhere and covered his whole arm. It was just pooling. (NOTE: This where things start going downhill.) I looked at it and started feeling uncomfortable. I focused really hard on controlling my breaths. In, out, in out. And I did. I controlled myself. Until I took another look... In, out, in, out. But it was no hope. My head was spinning, breaths were shallow, I could feel myself starting to space out. I asked Teresa to go to the bathroom in what I hoped would be a nonchalant way. I did NOT want her knowing I was feeling faint just in the prep work. By the time I stepped outside the room, I was losing sight. There were spots everywhere and I'm sure I was swaying when I walked. I managed to find a bathroom, sit down and regain myself. I didn't faint, but I was only a hair away from fainting. I couldn't even remember getting most of the way to the bathroom. If I couldn't survive the prep, I most certainly couldn't survive the actual surgery. I was ready to call it quits and switch departments. I couldn't go back into that room. But... I did. I went back.

I took some deep breaths, washed my hands, and walked through the doors for a second time. I watched as they started cutting open the stomach. The smell of burning flesh was strong in the air. I saw all the layers of fat and skin and then his insides. I was really concentrating on remaining calm. I started to lose myself occasionally again, but never badly, and always regained composure. For some reason, I started yawning uncontrollably.When they started cutting some more, the other doctor Louis eventually turned to me and asked, "Do you want to see the tumor?" The tumor was white and huge. Like, really huge. Suddenly, all my anxiety and sickness and discomfort vanished. In a single instant. Seeing the tumor, I was reminded of why they are doing this surgery. The purpose- they are saving this man another couple years of his life. I was so focused on the blood and gore that I lost sight of why (which is silly, but I did.) These doctors are fixing him. Suddenly, the rest was easy, and I knew I could do surgery and medicine if I wanted to in the future.

Seeing the surgery was really awesome. Louis, the other doctor, spoke great English and was really interested in showing me what was going on (unlike my doctor. Not that mine is bad at that, just not good.) He answered all my questions and offered up information at the right times. They removed the stomach as well as some layer of fat that sounded like "the great momentum." I have no idea what the real name is and google isn't helping. They then attached the esophagus to the intestine, so the guy could eat. Seeing all the instruments they used was really cool. It made me realize how important bio-medical engineering is (Go, Jenny!). There was this one tool that dehydrated and sealed off the ends of any blood vessels/veins. It was awesome. The surgery took about five hours, and it was tiring being on my feet that long. If I were the one actually doing the surgery though, it would be super interesting. Being a surgeon would be awesome. We'll see how the cards for my future play out...

Miscellaneous Thoughts:
- I never thought about what they did with the organ after they remove it. It just kinda is scooped out of the body and thrown into a bin. Like, the thought of just throwing out a stomach is really weird.
- Also as a side note- before the organ is discarded, it is examined so that they can find out definitely what stage the cancer is.
- The doctor Louis said that one thing America is behind in is gastric surgery because they don't remove the inside layer of the colon because it takes more time/money. They also don't have a good way of detecting gastric cancer. Apparently, Japan is #1 at this, and Portugal follows Japan's methods. I was surprised America wasn't number one at this. What a stereotypical American midset of mine... Always thinking America is #1.
- I really need to read up on technical medical terms as well as the different between public and private healthcare. America has private healthcare and Portugal has public. I'm supposed to be studying the differences, but I don't really know what to look at. Some background knowledge would be useful. One thing I have learned about this so far is that doctors aren't paid for the hours they put in here. They put in way more hours than they're supposed to and don't get money for it, says Richard. And if you don't put those extra hours in and complain about not being paid for what you're working, you gain a bad reputation. It's kind of a vicious cycle because all the doctors hate it, but they don't do anything about it because of the consequences of speaking up.
- Something that is a little annoying is that my doctor would sometimes laugh at me when I asked questions during the surgery. Maybe the answers are obvious to her, but she's a doctor. She knows I just finished one year of college, am not even sure if I am pre-med, and I definitely have not been to medical school yet. It made me feel kind of bad. She also always uses fancy medical terms when she talks to me, and I don't know what they mean a lot of the time. She doesn't explain them and her english isn't great, so those terms are the only things she says. Again- I need to do some readin up on it.
- Erica and I have decided we're going to start watching Grey's Anatomy from season 1 while we're here. (We're also going to do zumba every night!)

After the Hospital:

When I got home, I attempted to catch up on blogging. Then around 6:45, Alberto surprised Erica and I with an adventure. We went to the Lake of the Seven Cities (seven lakes clustered inside a volcano... I got that info wrong earlier) and looked down at the Green and Blue Lakes from the top. It was gorgeous. The drive there was so pretty; we took the street the King is supposed to ride on when he comes to visit. There are blue hydrangeas and some white flowers lining it the entire way. (Blue and white are the colors of Portugal's flag.) Once we got to the top, we drove around the volcano. I kid you not- we literally drove on a thin road that was big enough for one car going only in one direction. There was cliff on either side of us. It was terrifying, especially since Alberto didn't seem to have a worry in the world. It was also exhilarating. His car got so dirty from the dirt road and you couldn't see out of the back window. He joked by telling us we needed to wash his car to pay for the tour. I then took some of my first cow pics after and we headed to our last stop: Ferraria. Ferraria was actually the place I went to on my session 1 tour where it was a wave pool with a mix of hot water from the volcano and cold water from the ocean. I explored near the tidal pools. (I still have a lingering sense that marine biology would be a cool career.) There were little crabs in them and weird looking fish that kinda looked like tadpoles. But why would tadpoles be in the ocean? The sun was setting, I could see tidal pools and natural hot springs, there was a volcano behind me... life was good.