Across The Red Line: Stories From The Surgical Life

8. On the Table

8 On the Table It was a freak Friday accident, really. Another surgeon in an adjacent examining room had given a patient a mild sedative. The patient, a big, strapping 19-year-old, had become confused and combative. I heard the commotion and went to see. It looked as if he was about to fling himself out of the sixth-floor window. Careening from wall to wall, crazed, the boy struck the 60-year-old doctor. I tried to wrestle him to the ground. In time others arrived, the boy was subdued, and order restored. He was fine. I do not remember being hit myself, but I felt bruised and I had a sharp pain between my shoulder blades. It hurt. The next day, after a night of aspirin and no sleep, thinking I had strained a muscle, I called an orthopedic friend of mine. I went to his house that Saturday, and he confirmed the muscle pull and injected the muscle directly with Valium. I had not heard of this treatment before. It did not help. The next night was sleepless, too. The pain in the upper back was worse. I wondered if I would be able to work on Monday. Surgeons do not usually take time off for illness. It’s not “manly.” Given their common need to feel so vital, most surgeons show up at the hospital with the flu, broken bones and with all manner of cuts and bruises. They are not going to cave in to some mortal’s ailment! But I wondered if I could operate feeling this bad. 75 I did, but I shouldn’t have. I did a long case and that Monday night the pain was much worse. A muscle tear should be easing by now. What was wrong? Tuesday, I didn’t operate, I took it easy, I saw some patients, came home early, had a big glass of bourbon. But the pain was worse. Before going to bed, I went outside to put the top up on my wife’s convertible. Getting out of the car in the dark, I didn’t see the driver’s window was up and I hit it with my forehead. Startled, I extended my neck. Pain shot down my left arm. I was scared. Maybe I had neurological injury. Maybe it wasn’t a muscle pull. Maybe my orthopedic friend and I had the wrong diagnosis. I said nothing and went to bed, but not to sleep. Wednesday I stayed at home, but did not get any better. Thursday I went to see a neurosurgeon. I liked him immediately, in part because I wanted to. He was calm, careful, deliberate, slow to speak. I was reassured . After a physical exam he ordered some x-rays— routine views of the neck and a magnetic scan. The MRI, or magnetic resonance imaging scan, is a thing to behold. I was placed, supine, in a narrow tube, like a torpedo tube, which was surrounded by a huge machine. No part of my body protruded from the tube. My arms were pinioned by my side. I could not move them. I could not bend my knees, I could not sit up, I could not see anything but shiny tube, inches from my eyes. The technicians left the room, bolting the huge, heavy metal door behind them. And then the racket started, a loud banging noise. My nose itched and my back hurt. I had to move my legs, just bend my elbow, I had to get out. Despite the intercom, the staff could not hear me shout for rescue over the banging of the electromagnet. This must be 76 Chapter Eight what prisoners of war know. After 45 minutes of fear, panic, deep breathing, pain and more claustrophobia than I had ever imagined, a sweet young x-ray technician said she would like to get some more views, some different pictures and I said: “No!” I was so relieved to be out of that torture chamber that it was minutes before I felt the pain again. My symptoms hadn’t been helped by 45 minutes of rigidity in a tube. It was like being stuck in a sewer pipe. The radiologist didn’t look me in the eye when I had finished dressing. “I’ll send the films right over to the neurosurgeon ,” he said. Uh-oh. The neurosurgeon said, “Your neck is broken and...