Cardiothoracic Surgery. Suturing. What Else?

So, I was in an angiogram surgery today. Should I become a doctor in future, and have medical students standing in to observe my surgery, I swear I shall explain every step to them. Quiet surgeons who do not say anything while I stand there staring at the screen, trying to decipher which artery is blocked are Most Certainly Not Helping My Career At All. Anyway, considering I did not know what was going on as they stuffed in wire after wire up the poor man's radial artery(at the wrist) while trying to find the blocked artery at the heart(which they obviously know where it is but I don't) left me a lot of time to day dream. Which lead me to think of the first cardio surgery I saw.

***

It was a sunny day. Well, it really was. I could see it out of the window.
It was a CABG surgery. A coronary artery bypass graft surgery. That is when your heart arteries are all blocked with gunk(stop eating all those char kuey teow and nasi lemak) and you need another artery(taken from somewhere else in your body) to replace it. The surgeon sawed through the middle of the chest. Spent about an hour messing about with some artery that he wanted to use. Sam and I stood and watched him slowly and painstakingly cut away all the fat around the spare artery. So boring. Still, being the very very Keen medical student, we feigned interest. Oh look! That's a bit of fat being zapped off!(they use heated tools to burn away fat. something like when we were in sec school, the pateri pen we used in KHB)
Still Sam and I stood and watched. Finally, the surgeon proceeded to the chest again. The anaesthesist, a lovely oldish man, bless him, gave us 2 stools to stand on to look over the patients head.

I didn't expect this. The surgeon cut through the first layer of whatever that is covering the heart.

We see something pulsating below.

He cuts through the pericardium - the final layer.

And audible gasp from Sam and I.

The pulsating heart. Sitting in a breathing, living person. A live heart. In all its glory.

It was a high. Like Meredith said to Dr Sheperd in Grey's Anatomy. "That was the ultimate high sir."

"Never seen a heart before?" asks surgeon. "No. Not a pulsating one, sir"

***

Oh, they've finished unblocking the blocked artery of the present patient. The surgeon starts suturing up. Which lead me to think of my first suturing lesson.

***

I mean, how difficult can sewing be?? Honestly.
Honestly?? It is. I be to my last dollar 75% of the room could not follow the hands of the lecturer as he took us slowly step by step to tie a knot with the suture material.

First, the finger here, then the 3rd finger under here and the thread over and.. and...
Everyone was lost. The lecturer just stops doing it step by step after awhile. After all, statistics show that 3/4 of us will be GPs and not surgeons so statistically, it doesn't really matter whether we can actually suture or not.

Suturing aka sewing is hard work. I think all surgeons are potential seamstresses.

***

Now everyone is packing up, the patient moved back to the CCU. The surgeon tells me there is nothing more to do and sends me home.

***

Which leads me back to my first cardio surgery. After replumbing all the blocked arteries,(yes surgeons are potential plumbers too) the surgeon inserts wires to pull the rib cage together. Sheer, brutal force. Later on, 2 holes are cut into the skin just below the rib cage. 2 tubes are inserted into the body to where the chest cavity is. For drainage as to prevent build up of fluid after the surgery. TWO HOLES INTO THE BODY. Cut by a scissors and tubes shoved in.

And I think, if these are the kind of things we have to learn, what about other courses? What do people who study engineering do? Literature? Economics? Nah.

I can put a plaster onto a broken wrist. I've learnt how to. But JUST the wrist. Who knows? Given a scissors, I can make holes too.