Not Waving

Ministerial Meandering

Not waving…

You know that feeling - when your sense of control over a situation just slips your grasp, and you know that unless something miraculous happens in the next thirty seconds or so, you’re toast.

As a surgeon who is prepared to tell the truth about my experience, I can vouch for more than one occasion when I knew that I had lost the moment when I could save my patient on the table.  

I remember when I was training in cardio-thoracic surgery, and I was working with a senior colleague to close a congenital hole in the heart; my senior colleague, whilst not a Consultant, was nevertheless highly experienced but had discovered she had made a tear in the left atrium.  This is a very difficult area to access as it is behind the heart when one approaches from the front by splitting the sternum (breastbone).

She knew she was in deep guano and called the senior consultant, and when he put his head around the OR door, she simply said, “I’m having a death on the table.”  He came in and looked, assessed the failing physiology of the child, the look of hopelessness on the anaesthetist’s face, and said, “Yes,” and walked out.

I had a similar experience of my own later when I was in the same position my female colleague had been in.  I had received a victim of a severe car crash who arrived at the ER in ‘kit form’, and already in clinical shock.  We took him straight to the OR, placed chest tubes and I opened his abdomen to be faced with the Red Sea.  Swimming rapidly to the bottom of the sea, I found his liver and spleen in many different pieces that the Almighty had not planned for.  The spleen hit the bucket very fast, but in those early training days we still tried to suture liver lacerations together.  The loose bits joined the spleen, but I tried to restore what was left by suture and not packing - which is what we would do now.

The Red Sea had used up all his clotting factors and I knew I was losing him, so I called my boss.  It was (of course) 0430 in the morning.  I battled on until my senior arrived, and then used the same words; “I’m having a death on the table, Sir.”

My boss - not known for his surgical skill - didn’t venture further into the OR, but said simply, “I’m going to make a pot of tea,” - and left.  When my man on the table arrested, which he did fairly soon thereafter, we didn’t bother to try to resuscitate him further - his heart was empty as a stone, and I was paddling in the Red Sea.

I wish I could say that these were the only occasions when I have lost a patient in the OR - or even in the ER - but it wouldn’t be true.  I have lost them on the road side, in the desert, in tents in the jungle, and other odd places.  Trauma is a severe task-master.

But these gory and sad stories remind me of the time when Jesus’ disciples were in a similar position on the Sea of Galilee and their boat was about to sink in a raging storm.  All experienced fishermen, they had nothing left to try - they were going to drown, all of them.

But Jesus was in the back of the boat, apparently asleep.  When they called him and shouted at him above the howling wind, “Master, don’t you care if we drown?”, Jesus does not simply leave them to it; he says to the wind, “Peace, be still.”  And there was calm.

Remember, He knows when we need him, and never walks away.

Philip+