Thursday, 21 September 2017

The Theatre


Today I had an operation on my finger.  Let's not get too carried away with the seriousness of the operation, it was something very simple and the length of the operation itself was measured in minutes rather than hours.  It was only the second time I've ever had an operation; the previous one was to remove all my wisdom teeth and was done under a general anaesthetic.

And so today I was just having a local - more on that in a minute - which gave me an opportunity I may never get again - the chance to actually see inside an operating theatre and talk to the surgeon whilst he's poking around inside my finger.

My contact with the medical professional has been thankfully quite sporadic throughout my life.  That's not due to any stereotypical male reluctance to go and see a doctor but simply due to good fortune meaning that serious medical conditions have thus far eluded me.  It was the first time I'd had those arrows drawn on in marker that you see on the TV when the surgeon is reminding himself which bit to chop away at...

I was amazed, for instance, that temperature isn't taken by sticking a thermometer in your mouth anymore.  Only hours after marvelling at such wonderful devices did I Google to find that mercury medical thermometers have been unavailable to buy in the UK for eight years.

The last time I went into an operating theatre I was unconscious, but this time I just walked in and plonked myself down on the bed in the middle under the lights.  I stuck my arm out on the little board at the side for the purpose and turned my head so I could watch what the surgeon was doing.  It's amazing how many people have had a physical reaction at the thought that I'd watch what he was doing whilst he was cutting into my finger and poking around inside, but it was an opportunity I wasn't going to miss.

The second thing, after the thermometer, to astound me were the LED lights which despite being three feet above me, were so powerful that I could feel the heat on my hand where they were directed.  I was surprised that LEDs could do that.

Just before starting, the surgeon said to me - "Right, this first bit is going to be the worst part of your day by a mile".  Then he gave me the local anaesthetic injections into the base of my finger.   Usually, whenever you get an injection, the doctor will say "you'll just feel a small scratch".  This has irritated me for years now, as I've had quite a few injections and blood tests done, so they could say "this will feel like a needle going in" and I'd know exactly what to expect.  But it was noteworthy that this time around he didn't say that; he explicitly told me it was going to hurt. A lot.

I'd had previous experience of this when, a few years ago, I'd had a series of steroid injections into my elbow after a bout of tennis elbow.  I asked the GP before he did it - "will this hurt?".  His reply: "Do you want the truth or do you want me to tell you it won't hurt?".

That first steroid injection made my arm feel like it was on fire, but was still nothing compared with the pain of having anaesthetic injected deep at the base of my finger.   I'm sure it doesn't compare with childbirth - the usual benchmark of just how painful things can get - but it sure wasn't pleasant.  But once my wincing at the initial pain had subsided, the surgeon then said - "now your finger will feel like it's going to explode." and he was right.

I find anaesthetic quite intriguing.  I've had local anaesthetic before for dental work (nowhere near as painful as this) but never had an entire finger numbed.  There was something rather surreal about watching him cut open the side of my finger and poke about inside whilst not being able to feel anything at all.  It made it feel like it wasn't my finger, in some strange sense.   Once the surgery was over, and before the anaesthetic had worn off, I tried a few experiments.

Don't worry, I didn't try stabbing myself or anything.  The most interesting was to rest four fingers from that hand on the table.  Although all four fingers were on the table, the lack of feeling from my ring finger made it feel like it wasn't on the table; even if I looked directly at my hand, my brain was telling me that my ring finger was lifted on the table.  It just goes to show that our sense of where parts of our body are in relation to each other relies as much on exteroception as it does on proprioception.

Today brought into focus that fact that I know very little about biology and anatomy in comparison with my knowledge of say physics or chemistry.  The surgeon simply pulled the two sides of the wound together and effectively tied them together.  Remarkably quickly, they'll stick themselves together and within weeks, there'll be relatively little sign that the skin had ever been rent apart.  I have genuinely no idea how that process works at all.  I know there's something to do with collagen being laid down as a framework on which cells are then placed, but how does the body "know" that there's work to be done?  How does it know the skin needs repair at that point?

The evolutionary advantages of self-healing are so obvious that it's no surprise that such a complex process exists, but what were the evolutionary steps on the way?  The ability to completely repair a hole in the skin wouldn't have popped out of nowhere in a (metaphorical) instant.

I didn't feel I could ask the surgeon that, but beforehand he did ask me whether I would rather he describe what he's doing, or whether I'd rather not know.  Of course I wanted to know.  It was like having my own documentary about the inside of the end of a finger.  Except it was the most personal documentary in the world because I was the only one watching and it was my finger. How cool is that?

You'd think it'd be hard to relax then there's a man prodding about in your finger with metal things, but actually I found it relaxing enough to even attempt some humour...

"I've put a dressing on your finger, but it's not very well attached so if it falls off when you get back to your room, ask the nurse for another one"


"I presume you mean the dressing not the finger..?"


The reply was a dead pan "Yes. That is correct"


At least he said it with a smile ;-)