The Surgical Operating Room Dance

There is a dance performed in the surgical operating room suite during every operation. It doesn’t have a proper name, but is performed as part of every surgical operation because of the sterile atmosphere which must be maintained.

Maybe it’s not technically a dance, but it resembles one. The surgical team consisting of the surgeon, anesthesiologist, operating room nurse and surgical technicians have a set of steps governing their movements within the OR. The sterile field requires the team to keep their gloved hands above waist level. Anything below that is considered unsterile. The field also dictates no member of the team can directly face each other in close proximity. Therefore, when moving past another team member they must turn around 360 degrees during the maneuver…and it looks like a dance.

I learned this in 1983 while taking a one year Operating Room Technology course on my GI Bill. I had not intended to take the course when I spoke to one of the guidance counselors. I had intended to sign up in a Machinist course because I heard there was a big demand for machinists. But I was still young and naïve.

It never occurred to me the guidance counselor wasn’t really interested in my education, only in filling up classes still having vacancies. However, his spiel sounded interesting so I went for it.

Shortly afterwards I learned 120 students had signed up for the course, 60 were accepted. Of course that meant I was smarter than the other half! So I braggingly announced to my wife of my acceptance in the class. She didn’t seem too impressed. Maybe she knew something I didn’t.

Apparently she did because at midterm the class had dwindled to 30 students. At third semester there were only 15 left. Six graduated and got a job. I wasn’t one of them although I stayed for the entire course.

But the course was interesting to say the least. Our instructor’s last name was Sturgeon. Therefore the class had been nicknamed “Sturgeons’ Surgeons”, which was a source of constant hazing. At the beginning, it was procedure to weed out those with weaker intestinal fortitudes. So we were invited to view an actual operation.

We stood in awe as the surgical team quickly and proficiently set up the OR. The surgeon entered the suite with hands held above waist level and a surgical technician professionally slipped latex gloves on them. The operation began. This particular operation involved the patients’ shaved skull. The surgeon was handed an electric drill, much like one found in any ordinary toolbox, but constructed entirely of stainless surgical steel.

The drilling began and the sight and smell of burning bone caused me to become a little lightheaded, but I remained standing. However 3 other students immediately fainted and hit the floor. Three down 57 more to go.

There were lighter moments I remember. The instructor would sometimes entertain us with a joke such as this old surgical chestnut. In medical terminology, “hemo” means blood and “stat” refers to immediately. Basically, a student is assisting in an operation and the surgeon loudly demands a hemostat clamp. The student rushes off to find some plasma. However, the course was taken seriously.

But as students, mistakes were bound to occur. For example, while preparing the OR for surgery a large, obese patient was wheeled in and placed on the operating table. Not realizing the patient had not yet been put under anesthesia a student entered and gawked at the huge person on the table. The student laughed loudly and quipped “Where did they find this whale”? The figure on the table sat up and looked at the offending party who promptly dropped the tray of sterile instruments. That incident immediately set the procedure back about 5 minutes. Another one down and 56 more to go.

With such occurrences, is it any wonder why malpractice insurance is so high?