What the f*%k


In medicine I have frequently found myself in what I like to call ‘what the f*%k’ moments. As a medical student one finds themselves treading a gloriously thin line between remembering what it is like to know nothing and desperately trying to be the receptacle of all knowledge. The balance between having an understanding that being in the operating theatre is in fact an incredibly alien experience, whilst pretending that you’re not at all bothered by the fact that the anatomy diagrams seem to somewhat underplay the mashed and bloody flesh that your consultant is expecting you to be able to identify.   


On my first trip to the operating theatre I casually slid in along the back wall, desperately trying to appear casual in scrubs that are 3 sizes too big, trembling from the waist down as the theatre nurse throws me the stink eye. Whilst maintaining the cool façade of ‘I absolutely know what’s going on’ the voice inside my head is screaming ‘holy f*%k that’s the inside of a person, and that bloke has got his whole bloody fist in there’. None the less - a sort of addiction to the adrenaline rush associate with this terrifying experience developed and I found myself trailing the vascular surgery team, desperately hoping to see blood hit the ceiling at some point.


On my last week in vascular surgery I found what I had been so desperately looking for – a below knee amputation. A patient who had committed themselves diligently to the  art of inhaling so much tobacco that their limb no longer received oxygen. In my head I’d conceived this surgery as one of absolute finesse, a planned and meticulous dissection. I’d laid all the ground work with the team – writing ward round notes for a good 6 weeks, patiently listening to lectures about the decomposition of limbs, diligently taking blood pressures in clinic. After dropping a few hints, the team offered me the greatest of all honours – ‘yeah you can scrub if ya want’.


I walked into theatre and the registrar was really setting the mood by turning up the volume on the bose mini speaker, blasting Madonna’s ‘like a virgin’. As I stood at the sink, meticulously following the scrub instructions plastered on the wall, the adenine rose, the sweat on my nose causing my mask to slowly slip into my peripheral vision. I stood patiently at the patient’s side – who, due to other medical complications was deemed unfit for a general anaesthetic, and was therefore being operated on under spinal anaesthetic, with sedation – think drunk paraplegic.


What then came to pass can only be described as an unceremonious decapitation. I imagine you could use a chainsaw and achieve equivalent results. As the lower limb was torn to shreds in a mere minutes, blood exploding towards the ceiling, the confused patient groping me as I attempted to hold his now significantly shorter leg, while Madonnas ‘like a virgin’ wails into the chainsaw massacre to which I am bearing witness. All I can think is ‘what the f*%k’.    


Dr. Madeleine Smith