Would you like to become an anesthetist? Or would you like to become a surgeon? Or how about becoming an oncologist, pathologist or registered professional nurse? Then pay close attention to this letter.
This was my last patient on the operating list today: a 39 year old AIDS patient with a large cancerous growth on her upper jaw.
I took some pictures of it for you guys…
Now I need to take a biopsy (remove a piece of this growth surgically). Then I need to send it to my Histopathology colleague who will examine the tissue under a microscope and then give a report on the type of growth so I can offer the patient options on the treatment.
I will probably have to send this patient to an oncologist (a cancer specialist) for chemotherapy (cancer killing medication) and radiotherapy (cancer killing radiation).
This patient is presenting a great challenge to the anesthetist. He will have to give her a general anesthetic.
The patient is very obese, and this is making the anesthetist’s job quite difficult. Adding to his problems is the cancerous growth which is extending all the way into the back of the throat. He needs to ensure that the patient receives enough Oxygen during the anesthetic.
“Maintaining the airway” is the anesthetist’s main objective, so he first takes a preview while the patient is sedated. The monitors give him information about the condition and status of the respiratory and cardio-vascular systems.
He injects some induction agent (medication that makes the patient asleep) intravenously (into the vein).
The anesthetist has to see the vocal cords and place a tube in between the vocal cords into the trachea (main windpipe) to transfer Oxygen into the patient’s lungs. Looking at the video clip above, you can see how he skillfully intubates (places the tube into the trachea).
Now the professional theater nurse will prepare the patient for the operation.
My job is to debulk (make it smaller surgically) the tumor and place some of the tissue in a special solution. That will then be sent to the pathology lab.
This is a vascular tumor (the tumor is full of blood and blood vessels) so now it is my turn to stress.
Will I be able to stop the bleeding? I have to be very, very careful with sharp instruments as this is an HIV+ AIDS patient. Even the slightest slip with a sharp instrument can have drastic consequences for me or my assisting nurse!
The operation was a success. The following morning in the ward, I meet the smiling patient, “Thanks Dr Anton! You have given me my smile back!”
Although I know that it is only temporary, I also know that for the limited time that she will be alive, I have increased her quality of life and made her feel good about herself. Isn’t this a great reason to become a doctor or surgeon?