Conversation among the doctors and nurses is mundane: "I had no idea they're into country music. Clamp, please." Yet they remain hypervigilant. "Yeah, they—venous return is down. Are you guys pushing?" I am a mere 18 inches away from the problem, but I'd be hard-pressed to explain what the problem is. "Something's not tight," someone calls out. "It's sucking air in," says Williams. The team recites vital signs, as Williams issues directives. "Okay, pressure's coming up...whatever you did." And then we're back: "They even went to the CMA Awards in Nashville."
So, let's review: The patient has been intubated, an incision has been made, a Swan-Ganz catheter has been threaded through her neck to her heart. We are two and a half hours in, and now she is put on cardiopulmonary bypass. Her body temperature is cooled to 32 degrees Celsius to lower her metabolic rate and protect her brain and other organs. Her heart is officially stopped. It is now up to the heart-lung machine and the perfusionists who run it to keep her blood flowing until she is ready to come off bypass. "Is it time to call Oz?" one of the nurses asks Dr. Williams, who answers, "Give me ten more minutes, then let's get him down here." Right on cue, in comes Mehmet Oz, a man who clearly commands the deep respect of all his colleagues. "Whoa," someone deadpans, "aren't you Dr. Phil?"
The energy level instantly rises. Dr. Oz is happy to see everyone, and they're happy to see him. As he examines Dr. Davies' handiwork, he wants to be sure I've been properly introduced to the family. "Luz is our charge nurse. She makes her own jewelry," he says proudly. "Luz, show Lisa your bracelet." Luz holds up a hand, as I try to make out the shape of the bracelet hidden under her bloody glove. "And we've got the A team over here," he points to Jimmy and Linda—"I mean these are the people who worked on Bill Clinton!" Before I can even ask the question, Jimmy volunteers the answer, "I'm a Republican, she's a Democrat."
Oz brags about the surgical technique Mathew Williams is pioneering: "It's a far less invasive procedure—he runs a catheter through the groin muscle to the heart." He and Williams have performed today's procedure hundreds of times together, and it shows—they know precisely when to get out of each other's way. It's a complicated tango, choreographed with finesse and subtlety. There's a good chance they could pull off the whole thing without ever saying a word to each other; the talk seems more for the chief resident's benefit, who is currently—you should pardon the technical-medical speak—tweezing at a little blob just south of an angry looking artery. "Don't grab at it, just give it a nudge," Oz deftly demonstrates. Davies gently follows his lead. "There you go, that's it. Now, you've gotta be careful right in here—you can kill someone with that valve," says Oz. Later he will tell me that "there is always a moment in every operation when someone can die." For now, as the surgeons delicately lower the new valve into position, everything goes according to plan.
What it means to be "gloved up"
We Hear You!