And up through the chest came a bubblin' crude...

So, I'm not doin a whole lot this month as far as responsibilities go, but I am getting to see some pretty cool surgeries and traumas. One of the craziest things was last Friday. Now, first a little background on the patient: He is a 60 something year old AA male that by some stroke of bad luck developed fungal mediastinitis after an aortic valve replacement. And does anyone know how to treat cocci when it surrounds a heart? Well my friends, of course you have to do a radical sternectomy and leave his entire chest cavity opened up to drain...and so that awe struck interns, nurses, and janitors alike can stroll by his room peering at his beating heart while shooting "So, how's it goin?" in his direction. Nothing like talking to a patient while watching his lungs inflate!

So then you might be asking yourself; "But what next? No one could live forever like that!" To which I would reply; "Well, no one can live forever anyway, silly, but yes something MUST be done!" So that is where I, okay I mean the surgeons I'm with, enter the picture. This pt needed some closure of the chest wall, and what better way then to remove his omentum (and while we're down in the abdomen, go ahead and remove his bad 'ol spleen) and place it (the omentum...not the spleen...what kind of crazy wacked out surgery do you think we were trying to do) up in in the thorax, to cover the heart and lungs, in preparation to add a skin graft on top of that, in the coming months.

Now, don't get me wrong, it was a pretty sweet (4 1/2 hr long) surgery. But the best part was before we even scrubbed in. So we walked into the OR (we being me, a PGY4 Mayo Sx resident, a scrub tech, some chick, and the surgeons) to see the pt getting his anesthesia. As soon as he's under, the doc pulls the wound vac off of the heart to expose everything even more, and we all just stood there with our jaws on the floor, no one knowing exactly what to do or say. Then the surgeon says to us residents, "See, I've gotta get you used to this sort of thing so you can be confident next time." I told him this is EXACTLY why I chose FP, and that I hope I am NEVER in charge of a pt like this.

Then the scrub tech started prepping the pt with chlorhexadine, by scrubbing the entire pelvis, abdomen, chest, and neck. Well, naturally, some of the soapy stuff leaked down into the guy's 16 inch hole in his chest (don't really know if that's healthy or not, but I bet it kills fungus). SO, the guys heart is still beating, and his lungs still inflating, and so slowly the soap inside his chest started to lather! It wasn't long until soap bubbles were floating out of this guys chest and flying around the room! No lie! It was awesome. Everyone there admitted they had never seen anything like it. Made it well worth standing up for the next 3 hours performing tasks that Jeremy's youngest son could do equally well. You might notice that at the beginning I said this was a 4 1/2 Sx, but I only had to stand for 3....that's because I couldn't take it anymore and asked to leave. Is that wrong?