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Wednesday, May 23, 2007

A first lap chole in a new hospital: a surgeon’s real-life story

A new lap surgeon in a hospital that had never seen lap surgery has a case posted: lap chole. Year 1992. The management of the hospital is keen that the surgeon should feel comfortable and the procedure should be completed uneventfully, and the OR Matron is severely instructed to be cooperative.
The procedure starts. During the course of dissection, the surgeon Oh,shit!s a hole in the gall bladder. I had, long back, postulated a famous rule of laparoscopy, called Rambodoc’s 1st law of laparoscopy:
“Whenever you perforate the gall bladder during a lap chole, there are never less than 763 stones in it”.
So 546 of these madly decide to spill out of the organ, as a result of which the surgeon gets irritated with himself.
“Nurse! Get me a condom, please!”
In the early days of lap chole, a sterile condom was the preferred cheap choice to retrieve stones, appendixes, gallbladders, etc.
However, the junior nurse was perplexed and scandalized at the surgeon’s demand. She rushed out to call the matron. In the meanwhile, Rambodoc did what he does best: flush and suck, flush and suck…..
The stout matron rushes into the theater: “Doctor, what is the problem?”
“Sister, I need a condom! And fast!!”
The Matron also gets flustered. She isn’t sure what to do. She calls up the Manager and says “Rambodoc wants a condom in the OR right now! We don’t have any, what should we do?”
The Manager is cool: “Ok, sister, we will arrange for it…..”
The Matron rushes back to the theater, where our surgeon is scooping truckloads of stones from the peritoneal cavity.
“Yes, sister, did you get it?”
“Sir, we have no stock at present. I have informed the Manager, and he said he will invite a tender for the lowest quotation today itself!”
The surgeon is now infuriated: “What nonsense, sister! I want a condom NOW! Or do you want me to come outside and..?”
“Migod, no, no, Doctor!” the scandalized nurse shrieked, “ please give me two more minutes!”
Rambodoc was now truly breathing fire and dreaming evil thoughts. His surgery was a total mess now. Another 5 minutes later, the Matron and the junior nurse rush in.
“Sir, it is done!”
“Good, where is it?”
“I have asked the patient’s husband to get one pack from the pharmacy!”
“ You what?!?” Incredulity, rage and, finally, hope: “Where is it, anyways?”
A nervous Matron whispered, “Sir…. He is waiting on the phone. He wants to know whether you want the pink one with the dots, or the green one with the banana flavor?!”

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