As the morning fracture clinic came to an end, my planned escape out of the department and towards a bacon sandwich was intercepted by one of the consultants.
“What do you have planned for this afternoon?” he asked.
I’d planned to spend some time in a quiet corner of the library with a pile of urology books, writing up a case report that I had been sitting on for a week and a half. It seemed imprudent to say that, though. I said that I’d had nothing particular planned and asked what I might be able to go to.
“The registrar is doing the trauma list and he’s looking for an assistant. Do you know how to suture?”
No. Well, not exactly. In any case, definitely not on a real person. The only time I’d ever really sutured anything was a block of foam in the clinical skills lab, almost a year earlier, badly. Besides, I didn’t know what the registrar had had in mind when he’d said that he was looking for an assistant but my guess was that it hadn’t been a medical student whose participation in surgery thus far had been limited to retracting things and cutting the ends of bits of thread.
My confession of utter incompetence didn’t deter him too terribly much and he pointed me in the general direction of ortho theatre before letting me run off to get that bacon sandwich. And a little while later, having fed and caffeinated myself and grabbed a few minutes to bend my hands into vaguely unnatural contortions while watching suturing videos on YouTube, I took myself off to theatre and learned that, just as I had feared, I was the one and only surgical assistant.
There is arguably nothing too terribly technical for a first assistant to do on fracture repairs.
“Have you ever used power tools?” the surgeon asked casually as I held the leg and he dissected out the bone.
“Yes,” I said, and then added doubtfully: “In a shed, though.”
As a little girl, I spent a lot of time in my grandad’s shed. I liked wearing dungarees and sawing things and hitting things with a hammer. I liked that the grown-ups weren’t allowed to come in – my grandfather didn’t count, not having ever seemed like a proper qualified sort of grown-up. I grew up around power tools and then snubbed a GCSE in sewing or cooking to take one in electric drills and soldering irons. But you assume that the tools they’ll use on real people are different from the ones you used on wood and metal.
It’s not that different. The toolbox is a bit bigger and a lot more sterile, that’s all.
“OK, so take the drill,” he said.
I looked skeptical.
“You want to make a hole in that space there at right angles to the plate. Just remember that there are two cortices, so you’ll want it to give way twice before you pull back.” I pointed my drill bit at the exposed bone. As I started to push down on the power, he said, “Oh, and try not to drill through to the table.”
Painstakingly, I drilled a hole into the distal tibia and tried not to think about hearing the rattle of metal on metal.
“Now, take the screwdriver,” he said, and helped me fit a minature screw into the equally minature hole I’d made. I was reminded strongly of lying flat on my back with my head inside a half-constructed flatpack cupboard while trying to read a set of instructions that might as well have been written in Elvish. The first screw slotted in. I handed the screwdriver over and hoped that that might be me, but that was a pipe dream and I took the drill back and repeated the whole process, still not convinced that the whole thing wasn’t about to fall very very apart.
And with my palms sweating nervously under two layers of latex, the tibia came slowly back together
“Can you get a pair of forceps and a staple gun for Elizabeth?” asked the registrar, as he stripped out of his gloves. A marvellous invention, the staple gun. I didn’t have to suture anything. Hats off to the gentleman from Poughkeepsie.
The suturing might have been less frightening.