Meeting Healthcare in South Africa: Grey’s Anatomy Edition
By Julie Hugunin, Biology, 2017
A dramatic television show about surgeons is just that; a dramatic television show that’s main goal is to keep its viewers hooked. It is not a documentary or an accurate representation of what the job entails. While completely aware of these facts, a small part of me always believed, or hoped, that the excitement and tension of surgery portrayed on Grey’s Anatomy was somewhat true.
The first emergency surgery I observed was a ventriculoperitoneal shunt (VPS) insertion. The child had come to the hospital presenting with consistent vomiting, bulging fontanelle, and a huge head; all signs of hydrocephalus. His CT confirmed the large accumulation of fluid in his brain and he was quickly booked for an emergency surgery. The VPS functions by diverting excessive fluids from the brain to the abdomen, where it can be adequately absorbed. Cerebral spinal fluid immediately began draining as the shunt was placed, and very quickly the child’s raised intracranial pressure was relieved. The surgery took roughly forty minutes and was almost entirely uneventful. Even so, it saved the child’s life and required a skilled surgeon doing his job well.
A few weeks later, while quietly watching a similar surgery, I noticed nurses one by one leaving our theater, urgently followed by our anesthesiologist. Soon there were only a few of us left. Though curious, I kept my post watching the neurosurgeons. The anesthesiologist came back with big eyes and asked the surgeon if he could survive without her for a while, as there was a trauma case that needed her assistance next door. While still adamantly observing from my spot, a nurse whispered to me “you should go next door and see, a child was hit by a truck”. So I did, and with that I entered a scene on Grey’s Anatomy.
I walked into the theater and the first thing I saw was his left leg. And I mean all of his left leg, every bone and muscle was exposed as his skin had been completely torn off on one side. I immediately felt the urge to cover it and fix it; you can’t leave a leg exposed like that! His toes looked as if they were blue and dead, and as I moved my eyes up I noticed his leg was essentially amputated from his body. It was hanging on with just a few ligaments and tissue. Above that was his abdomen, also open and exposed with a mess of body parts hanging out. A fifth year medical student leaned in and whispered to me, “if he survives, he’ll be paralyzed for the rest of his life.”
It was then that my brain began functioning and I looked around the room. The surgeons were scrubbed in, but none of them were working. They were waiting for the child to be relatively stabilized before they began fixing him. Four anesthesiologists were yelling about needing more blood, with an ever growing pile of used transfusion bags sitting next to them. The room was sweltering hot because the sudden massive blood loss had caused his body to go into shock, decreasing his core temperature. I began sweating. This kid was going to die before the surgeons could even get to him.
And all of a sudden the team moved in. Four of them, all attacking different parts of the body, stitching and cutting, communicating to each other and the scrub nurses with tension filled, stern voices. I was handed a camera and told to take pictures.
After a frantic hour of work, the surgeons had finished stuffing organs back into place and he was closed up to the best of their ability. The anesthesiologists prepared to transport him to the ICU, the surgeons scrubbed out, and the nurses began cleaning up the mess of blood and various items strewn around the room.
I returned the camera and walked backed to the now peaceful neurosurgical theater where they too were just beginning to close. It was there that I sat down, stared straight forward, and on a loop replayed everything that had just happened in my head. That’s what being hit by a truck looks like.
It played like a Grey’s Anatomy scene, but it felt nothing like it. It felt sweaty and scary, ambiguous and anxious. It was a life or death situation that the surgeons and anesthesiologists and nurses and everyone in that room had a part in. That feeling, that goal of being able to do what they do, whether it is quiet and uneventful or full of excitement and uncertainty, has me more hooked than Grey’s Anatomy ever will.
