Higher Selves

As long as we are in touch with our higher selves our egos are not a threat, rather a tool in service of the spirit.

It's a rare thing in medicine, but when I find true professional, willing to talk openly about approach to problems in patient care...it can be magical. But it supposes for even an instant that all parties open their minds beyond "what's done here" and their own prejudices. I've learned so much that way. There are MANY ways to do almost everything in medicine. I can watch 5 people sew up the same wound 5 different ways. The knee has at least 8 approaches (if not more) for arthrocentesis.

Having such discussion usually happen late at night, in corners of intensive care units with like minded providers. They are insightful glimpses into the genius that is in most of us when others truly listen and open their minds to the possibilities. It's also about deferring such discussions from the presence of the patient and others so we don't feel the need to prove ourselves.

I am so surrounded by ego, and it's "my way or the highway" mentality that we often miss the point, and allow the patient to suffer in the process. But even during long, long days engulfed in 90 hour work weeks, there is still some possibility of finding our higher selves in spite of the attack of ego of others. It's better for the practitioner, better for the practice of medicine and better for the patient.

Bullshit Rules

I know the rules. The rule in surgery, your hands should never slip below your waist. Everything below the table level is considered "unsterile". Once your hands enter that area, they should never be brought back into the sterile field.

So when I lowered my hands to adjust my lead apron, hands at belly button level, technically I was in violation. I was careful to keep my hands in front and not below table level or my waist. One of my esteemed anal retentive, subversive, passive-aggressive colleagues (an oxymoron) pointed out to the entire OR my faux pas.

But in our world, it's a moot point, filled with inaccuracies and frank bullshit. We sit and stand regularly in the OR bringing our entire torsos to nipple level below the table and pop back up again...regularly, with impunity.

Some things are just bullshit. In this case, not sure if it's the rule without evidence or the colleague without discretion or sense. It's likely a commentary on more broad issues in the world of medicine, pseudo teamwork, inexplainable rule without evidence and ego than contamination.

I changed my gown and gloves without saying a word.