I complain about the state of U.S. health care a lot. It’s not driven by quality. It’s expensive. It’s corporatized. It undervalues and commoditizes clinical workers. It’s too controlled by insurance companies. It’s riddled with racial, educational, and socio-economic disparities. I could, and often do, go on and on. But the other night, I was called in to do a bilateral lung transplant for an exquisitely ill, but rather young woman. Her OR time was coordinated by her surgeon, the OR scheduler, and my anesthesiologist colleague. Upon her arrival to the OR, she was immediately pounced on (in the most benevolent way) by a team of circulating nurses, surgical assistants, anesthesia techs, and scrub techs to get her moved over to the operating room table and hooked up to monitors. Another anesthesiologist colleague (who was simultaneously covering the rest of the hospital) and I worked in concert to swiftly and safely anesthetize her and put invasive lines in, while the surgical PA obtained groin access for potential crash ECMO (which fortunately was not needed). Over the course of a near 11-hour surgery, this patient continued to be cared for by myself, the surgeon, his surgical PA, two surgical technologists, two circulating nurses, two perfusionists, and multiple ancillary staff. Because the transplant crossed the hours of two different nursing shifts, the nurses and technologists were appropriately relieved and replaced. I calculated that over the course of this patient’s transplant, there were no fewer than 15 medical professionals whose sole focus was on her care. It dawned on me, what a beautiful thing that was. What other industry, where else in the world, do so many humans work together for the betterment of another? This is true in various ways in health care, but I believe it is exemplified to the highest level in the operating room. When I was a resident, an attending once told me, that anywhere in the hospital outside of the operating room, by definition, is a step-down unit. This phrase rang especially true that night. Maybe the operating room is inefficient. It’s undoubtedly expensive. And maybe it’s not the best way our health care dollars should be spent. But at that moment, it felt perfectly worth every penny. Source
