I can’t tell you what my first memory is… In fact I’m not even sure I can pinpoint the age at which vivid recollection begins. Nonetheless my childhood, which in all reality is much more recent than it seems, is saturated with memories… many of which go on to make exceptional stories that continuously get circulated at family gatherings despite complaints of redundancy. For instance, no matter how old the story gets, my family can’t seem to forget the time I ran to third base instead of first after an excellent hit during my first tee-ball game. Then there are those memories that don’t have any hint of significance. You know? The ones that no one else remembers but you and they aren’t even worth the brain space. (I always wonder why we can’t have more control over our memory storing capabilities.) Anyway, many of my memories take place in the two story house sequestered between the bend of Valencia Street and the narrow stream that fed into the Gallinas River; the house with too many rooms to count in El Ancon where I slept more nights outside on the trampoline than in my bedroom, which I shared with my cousin Deidra; and in the old adobe house where my mother grew up in El Goosano, or as my step dad would say- ‘The Worm’. And many of my memories have to do with being a nerd.
I’ve always been enthusiastic for education. When I took care of my little sister and cousins, I would organize a game of school where I was the teacher and they were the students… often against their will. I won a calculator in elementary for scoring in the 99th percentile on the standardized tests and my name has been printed in the Las Vegas Optic, my hometown newspaper, for making the A honor roll countless times (my dad has stacks of papers to prove it). So as you can see, I’ve been hitting the books most of my life, and most of my life (20 years to be exact) I have known exactly what I wanted to do: become a doctor. The desire goes back so far that my sister Jelly, in her mischievous and jolly toddler form, would proudly exclaim, “My sister wants to be a pedestrian when she grows up.” What she meant was pediatrician, but she was close enough. Once again, I can’t pinpoint that ‘Aha moment’ where the child version of me made up my mind for the rest of my life, but I can tell you that I’ve never drifted away from the idea, but rather at different ages it was continuously confirmed. One memory that stands out the most is when I was at Christian Camp with other teens from El Valle Del Cristo Church, where I’ve spent more Sundays than anywhere else. We were in Mountainair, NM and I was sitting in the large chapel where evening services were held. A pastor, whose voice still permeates my soul, was speaking and inspiring the youth to make decisions based on God’s plans. I remember the exact Bible scripture he used (it’s my favorite one to this day):
“For I know the plans I have for you,” declares the Lord. “Plans to prosper you and not to harm you, plans to give you hope and future.”
By this time in the talk, I started squirming in my seat and anxiety was quickly surging through ever molecule in my body. It was at that moment I began to feel convicted. I had never thought about God’s plans for me. I had decided to become a doctor and had never once prayed about it… Just seconds after these alarming thoughts raced through my mind, the pastor in his same memorable voice began speaking. I can almost guarantee you that he was looking straight at me and every word that left his mouth was for my ears. He began to preach that we don’t always know what we want to do with our lives, but all along the way God is blessing us with talents and gifts to succeed in areas he has planned for us. He said he gives healing hands to those he wants to be doctors. In astonishment, my whole future had been completely confirmed and I was even more fired up for pursuing my goals than ever before. So I continued to be a nerd, I graduated valedictorian of my high school class and received a full ride scholarship to the University of New Mexico where I lived among honors students in the Scholars Wing of Hokona Hall. Things were falling into place and I couldn’t be happier about pursuing my goals.
Now here I am finally doing what I set out to do years ago and I continue to make memories all along the way- one of which I am about to share with you, if you chose to read on J
“What size of gloves do you use?” he asked me as he comfortably sat in front of a neatly arranged table of medical instruments, which laid atop a sky blue chux pad.
“A small,” I said.
He stared.
I stared.
“She’s about a 6… maybe a 6.5,” my attending physician chimed in, while I nodded my head in humiliation. (I thought to myself- Gosh Sevy! You’ve only be in the OR for 5 minutes and you’re already making a fool of yourself!).
A few minutes, 4 to be exact, go by while I wash my hands alongside the doctor. We scrub methodically, each finger individually paying close attention to the nails and making sure to use half of the disinfecting sponge for one extremity and the other half for the other side. Dr. T. teaches me to begin at the fingers to work my way up to the elbows and then we rinse in a very technical manner making sure the water runs down our elbows rather than allowing the water to run back onto our hands. The whole hand washing procedure is such an art; however, one that lacks flexibility and free form. It’s an art, because throughout the entire process you become one with your hands and arms. You inspect your skin with such unusual acuity it’s likely that you would notice something you had never noticed before. You intensely pay attention to the direction the water flows and you don’t take for granted every instrument that you use along the way. It’s handwashing at an all new level.
From the sink, we march with purpose to the scrub nurse, who has all of our sterile gear ready for usage. I stand patiently with my very very clean hands pointing up and away from me, being extra careful not to contaminate them with anything. At this point I already have my scrubs on, my scrub cap (which looks like a disposable hat that a cafeteria lady would wear), and my shoe covers (the extra long ones, as the incredibly friendly third year student suggested before leaving). The friendly nurse takes a freshly opened baby blue gown and holds it outstretched so I can carefully and slowly slide into it, she then opens the sterile gloves and I systematically slide each hand in… I follow the steps exactly as I am instructed making certain to avoid error, as that result in beginning the process all over again. Then the fun part- tying the gown. One of the male scrub nurses comes over and quickly velcros the top of the gown, ties the inside, and then for the last, and most fun part, he grabs the small cardboard piece (and only the small cardboard piece to avoid contamination) as he looks at me and in a goofing voice says, ‘shall we dance?’ I spin around as I’ve witnessed all the others do, so as to securely wrap the final tie around my waste, and voila! I’m all scrubbed in.
At this point I’ve already introduced myself to the patient, a quiet and obviously worried woman who can’t be much older than me. I walk around the table to watch the epidural and the anesthesiologist takes an interest in me after noticing my UNM student ID. He begins showing off and talking about each injection, he explains his routine and points out how to find the landmarks on the human body that identify where the injection should occur. He rambles on and on and I take in every tid bit of information, grateful for his nice personality and willingness to teach. He moves quickly and makes small adjustments, 5, 10 and 15 angle changes to the needle trying to approximate his exact location within the spinal column. All the while, I glance back and forth between his hands as they handle the needle so comfortably and his face. I watch his eyes and the small tilting motions of his head and I know that not only has the needle penetrated the patient, but his mind has. For a long moment he doesn’t speak and it’s obvious that he is visualizing the needle’s position within the body, as if he has some sort of superhero x-ray vision… but rather he is relying only on years of experience, almost negligible changes in pressure, and input from the patient. I watch in awe as he can accomplish such an amazing task. I am also in awe as I recognize that medical technology is so advanced, we can insert a needle into the very highly protected space surrounding the spinal cord, a space that just over a century ago was normally closed off to any outside substances. While epidurals were discovered in 1901, it wasn’t until 1942 that it was actually used for this reason… so it is a very recent advancement in the continuously evolving medical field and I can’t help but think of this same procedure and how different it will be another century down the road.
For now though, only a few minutes have passed… the patient lies down after following specific instructions, so that her position is conducive to the procedure that is about to occur, the procedure that I am about to assist with! The entire team assembles themselves with three goals in mind: 1. They must stand where they can most comfortably carry out their job. 2. They must avoid tainting the sterile field or vice versa if they are sterile they must avoid being tainted. 3. And finally they must avoid getting in another person’s way. It’s a meticulous process, but one that naturally unfolds without too much complication. I take my place to the patient’s left, where I stand at the level of her belly… and then it begins.
At first I feel as if the procedure is rushed. The doctor’s hands move quickly, but smoothly. He calls out the names of different instruments and they are very swiftly placed into his hand. His eyes almost never leave the site of the incision. His hands, in contrast, whip back and forth exchanging one tool for the next. The first incision is made with a scalpel, which only penetrates the skin. At this point, , the scalpel is returned to its place on the silver table and he uses a tool that resembles a very small torch that allows the obstetrician to make very fine cuts through the superficial fascia layers and the subcutaneous fat and also burns small arteries that have been severed, so as to seal them shut. The fat is squishy, slimy and pale yellow and the fascia is a shiny white covering that is very thin, but also very tough. He is careful to stop cutting before he encounters muscle. It’s a delicate process, but his practice allows him to proceed rather hastily. When the muscle is reached, he prepares to use his next tool: brute force. (Yes, you read that last sentence correctly.) With his two hands, he rips the woman’s muscles apart to reveal the contents of the abdomen. It seems like a harsh maneuver, but all the while the patient quietly converses with her husband on the other side of the blue curtain.
Finally, it is my time to shine… ok ok not so much shining, more like holding the bladder out of the way. So I take the special bladder holding contraption, surely there’s a scientific term, but I can’t seem to think of it. I carefully grasp the bladder and then slide it down to reveal the shiny, muscular organ that we have been working to expose: The uterus! But not just any uterus, it’s a uterus with the special contents consisting of one amniotic sac, one placenta, and one baby in the breached position. It only takes one slow command from the doctor, a quick nod of the entire team’s head, the newly introduced neonatal team’s presence, and a quick slice of the uterus, and the grayish little creature meets the outside world for the first time. The entire time I am following every command that is directed at me. One hand continues to hold the bladder out of the way, the other grabs instruments when needed and performs simple tasks quickly. My eyes though are transfixed on the small limp being that is not so gingerly placed on the mother’s belly as the umbilical cord is unwrapped from around its neck- the reason it was breached and could not turn into the normal delivery position. It’s a boy. He’s a boy and he has a quiet cry. His skin is gray like the color of the stormy sky and there are spots of white goo like clouds that dot that stormy sky. As he lies face down on his mother’s belly, the only movement in his flaccid body is the barely visible heave of his trunk as he breathes in an out. Then the neonatal team swoops up this new little baby and my eyes once again fixate on the mother, my patient. Closing up our incisions is the time consuming part. All the while, I make sure to watch the suture technique as thread is weaved in and out of each layer making sure to create a tight seal; but my mind is multi-tasking and it can’t help but fill with excitement. If I had had one ounce less of control, I would have allowed that small tear that was building up in the corner of my eye to escape, but the heat of the moment consumed my tear and it evaporated into the full room where people moved around quickly attending to their tasks. The overwhelming joy, however, could not disappear. It was still there strongly resounding through my body and I embraced every minute.
In a week full of studying, lectures and frustration, I was blessed with an opportunity to not only witness, but to assist in a procedure that allowed a new life to join a world that I live in. He was a 7 pound, 3 ounce reminder of why I am so in love with the field of medicine and why I must continue to endure this obstacle called medical school.
Somewhere in Albuquerque, a family celebrated their first Christmas with a brand new baby boy and I can’t help but send happy thoughts in their directions. Happy holidays my dear friends and family.
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