I know a lot more about surgery than I’ve ever wanted to know. My day job, while still in education, is rooted now in a medical school, a totally different ball game than the one I’m used to. I’ve learned that within medical school there are six different areas of medicine that students train through. We call these areas ‘clerkships’ at my job, and my responsibilities day to day involve the management of one of those clerkships: surgery. My physician counterpart is a Colorectal Surgeon; I chat with Vascular surgeons and Urologists, organize rotations through Orthopedic Surgery for interested students. I meet with the surgeons and the students over Teams in between their Clinics or Procedures— sometimes they barely have time to take their bloodied scrubs off before jumping on the call with me.
Their ability to transition from the operating room to administrative tasks always takes me aback. Much has been said of surgeons: their god complexes, their lack of warmth, their clinical precision. Since accepting this position I’ve thought often of Scrubs and the different personalities we see depicted in the surgery department at Sacred Heart. There’s Christopher Turk, JD’s bestie, who seems to have transitioned his sports-loving identity into a surgery-loving one. He makes a positive case for surgeons being jocks of medicine. Alongside him is the idiot Todd, always clad in flame-patterned scrub caps and talking about boobs. I imagine he plays Metallica in the operating room and air guitars with his scalpel while a patient’s chest cavity lies open. And then there’s Kim Briggs, a Urologist at Sacred Heart. She stands out amongst the other surgeons because 1. she’s a woman and 2. she delivers patient care that is much warmer than any other surgeon around. Urology is one of the most competitive fields to match into after completing medical school, mostly because of the work life balance the field offers (you’re not getting that in most surgery fields— see you in the OR at 6AM!). I’ve learned to always be impressed at Urologist’s existence.
As I’ve gotten more comfortable in my job, I’ve been included in longer and broader discussions with surgeons. So much still goes over my head— I do not get approximately 80% of the inside jokes about suturing and other nasty surgeon shit— but I find myself so curious about the act of performing surgery. About what actually happens in the surgeon’s mind as they make their cuts, incisions, staples. Many surgeons have warm-up workouts or stretch routines; some have a specific meal they like to eat before operating; a few let different nurses or sub interns choose the music that’s played and others prefer one song of their choosing on repeat. I am endlessly fascinated by their ability to hold a person’s vital organs in their hands at 3PM and then turn around and hold their child’s hand by 7PM.
And, too, with these conversations I am realizing that I’ve had more experience with surgery than most at my age. At thirteen I basically lived at the Cleveland Clinic for months while my grandmother received a lung transplant. My grandmother went through two 12-hour transplant surgeries because the first transplanted lung did not settle in her body. The surgeons called the lung ‘rejected,’ a sad ending to a lengthy procedure. Any organ transplant is, obviously, a major surgery, but lung transplants are especially complex because of the high rate of infection in lungs. ‘Rejection’ is by far most common in lung transplants; and, too, lungs are tricky after they’ve been harvested from a donor. They run the risk of infection and they are quite fragile and easy to ruin within the harvest process. Most annoyingly, I’d think for surgeons, is that lungs can simply… stop working, even after a successful harvest. Collapsed lungs are very common, which makes the wait time for those in need of a transplant exceptionally long. After the second transplanted lung took, my grandmother lived life mostly as normal, except for when complications arose from the inorganic organ.
After about six years post-op my grandmother began to hospitalized annually. Once, one of the millions of medications she had to take daily for her lung caused a huge blockage in her stomach/colon and the surgery they had to perform required them to hang her upside down to avoid fluid build-up. It became normal for me to see her in an ICU bed, intubated. I can’t tell you the number of hours I’ve spent in Cleveland Clinic eating Subway, can’t tell you how often I prepared myself for her to die. A hospital can be a portal to another world: suddenly what mattered before ceases to exist, and the only thing that has any significance is the person whose life essence is in question. On some days I was grateful for all that time in the Clinic— I got to witness my grandfather’s unyielding devotion to my grandmother, got to spend forced time with my brother when we otherwise wouldn’t have chosen to be together. The nurses became friends and my grandmother would flirt with any doctor she deemed cute enough (which was most of them).
Typically people live 4-5 years with a transplanted lung. My grandmother wanted to get the transplant in order to live long enough to see my brother and me graduate high school; instead, her lung lasted almost twelve years, seeing us through college, my brother’s marriage, and almost long enough to meet her first great-grandbaby. What eventually killed her was not her lung but her other organs giving out. The medication for the lung eventually rotted out her kidneys, requiring 8-hour days in dialysis or a difficult kidney surgery, neither of which my grandmother was willing to do. I do not blame her. She was so fucking sick of what had become her homeostasis: never really feeling strong or right in her body, maybe getting close to feeling something akin to OK, and then something happening that reduced her, again and again, to nothingness. Toward the end her skin was so thin from her medications that it would tear like paper; bruises dotted her, large and ugly freckles; sometimes her ankles would swell so big she couldn’t walk. She was so uncomfortable and so often she was in deep, deep pain. Her pain isolated her from us. I think a lot about how alone those in chronic pain are because of my grandmother, how they live in a world separate from everyone else’s. There is no way to convey the true experience of pain in the body.
In high school I discovered a lump on my left breast. I remember feeling it first as a sophomore, not long before I got my driver’s license— it felt like a hard ball just under the skin. Stupidly I told no one, somehow embarrassed? (this is such a specific form of teen girl delulu embarrassment that I feel so far from it but also tenderly close). But then the lump grew— it became visible when I laid horizontally and put my left arm over my head. I told my parents, all in one panicked breath, saying I think these things just go away (lol I was and am so so dumb). I was quickly shuffled to a doctor who quickly referred me to an Oncology Surgeon. I remember meeting that surgeon because it was soooooooo god damn embarrassing— I was in a small Clinic room with my dad and this young, low-key hot surgeon, and I had to take my shirt off. Expose my left tit like some cow ready for milking.
Anyway. The surgeon told us there was no real definitive way to tell if the lumps (there were two not just one) were cancerous until the surgery. The imaging he did wasn’t conclusive; we’d need to remove the lump and do a biopsy. I was instantly terrified and partially convinced I had breast cancer. Suddenly the world of football games and student government felt like a planet I’d never orbit again. I had a lumpectomy my senior year of high school, 17 years old. The lumps did come back benign. I wore a hideous bra for six months that looked like something the LDS church might’ve designed (thank you to my friends Megan and Caitlyn for helping me change clothes that year). The surgery gave me astonishing pain and I am struck now by how little of that pain I am able to transcribe. My chest, shoulders, arms, were so, so sore for so long. I don’t even have photos of that god-forsaken bra. I spent years denying the lump’s presence and then months thinking I’d die from it. And all I have left of that anguish is a small, barely-there scar on the outer rim of my left nipple.
In late 2016, I was faced with a new kind of pain. I was living in Jacksonville, Florida and getting such bad sinus headaches that I maxed out my sick leave at my new job. My primary care doctor prescribed behind-the-counter Mucinex and a Netty Pot but nothing alleviated the pain. We did an allergy panel and discovered that I was allergic to literally so much of Florida, a fact that would have been helpful for preventative services but useless for reactive ones. I flew to Ireland in November 2016 for vacation and thought, as we descended into Dublin, that my head was going to explode. It felt similar to the sensation of your ears begging to be popped but it was all-consuming. It took everything in me not to scream out in pain— I drove my two pointer fingers into my temples and locked and unlocked my jaw, tears streaming down my face. I remember a thought flashing across my vision like ‘if I had a knife I’d stab it through my head.’ I’d experience that astonishing pain on every flight I took in 2016-2017, and sometimes even now I experience whisps it.
My doctor began prescribing steroid shots to help me cope day to day as we worked to find out how to release my pain. The shots were also painful, delivered in my ass cheek, but they offered such relief I could not believe it. I flew on days after my steroid shot, convinced of my own strength and ability. When the steroids wore off, though, I couldn’t stand to look at a screen, not for work, not for pleasure. I couldn’t read. My head felt weighed down with lead, and when I laid down I swore I felt water sloshing against my skull. Eventually I was referred to a Otorhinolaryngologist (head and neck surgeon) who immediately did X-Rays on my sinuses.
Here is an x-ray of a ‘normal’ sinus (spooky!):
(the circles are your eye sockets, the dark parts are your sinuses)
And here are examples of chronic sinusitis (chronic sinusitis hive rise up!!!!) x-rays:
The first picture is the back view, which shows you how insanely full the head sinus is. That was me!!!!!!
My two frontal sinuses (located directly above your eyebrows) were so full of mucous and viscera that they were stuck, not draining properly. My ethmoid sinuses (located along the nose) were doing what they could to drain but fluid had been trapped in my head sinus for so long that it appeared stuck, unbudging. The ENT who eventually performed surgery on me told me that the endless Mucinex I was taking probably exasperated the issue. If you’ve ever had a sinus headache, you know the pressurized pain that I’m talking about here— now imagine that nonstop for months. Imagine cabinized air pressure alongside the pressure inside your skull. It fucking SUCKED. There were days where I could do nothing but lie on my living room floor and moan for relief. Within that haze of pain I talked to my grandmother with a new understanding of how much she’d been through.
There are a few surgical options for sinuses. A common one is called a Balloon Sinuplasty, a procedure that doesn’t require anesthesia and is relatively painless. A tool is inserted through your nostrils into your sinus and a literal balloon on the end of the tool is inflated, pushing the fluid down and out through your nose.
Unfortunately my sinus issues required a more intensive solution so I had what’s known as a FESS surgery (Functional Endoscopic Sinus Surgery). I acted brave, having already gone through a surgery and anesthesia, but I was frightened. I was relatively alone in Jacksonville and had to rely on my roommate and friend Alyssa (I OWE HER MY LIFE!!!) along with my new not-even-boyfriend yet Hans. The pain I’d been experiencing had taken me to deep and dark places in my mental health and I was very scared the surgery wouldn’t work, that I’d have to deal with this pain forever. What happens in a FESS surgery is literal body horror disguised as a ‘minimally evasive procedure’: they stick an endoscopy up your nostrils and then insert whirring tools to demolish any cartilage, tissue, bone that is blocking the sinus. In my case my septum had to be manually deviated. The last hour of the surgery involves the surgeon packing the nostrils with material to absorb left-over debris.
On the morning of the surgery Alyssa and I sat waiting for the surgery to begin. My veins, always difficult to find, proved impossible and the nurses/anesthesiologist had to go in through my hand. It sucked and my nails looked good so I did take a photo:
I remember that the surgeon was running late on other cases. I remember the waiting. And I remember, too, not being fully out as I was wheeled into the operating room. I remember the surgical team buckling something across my chest, close to my neck (this is common and is done to protect you— your body might jerk and fuck up a surgeon’s hand!). I remember the metallic coldness of everything, I remember the tools laid out, the people in the room joking about music that was playing. And then I faded out into nothingness.
Me post sinus surgery looking gorgeous!
I have always been the kind of person who flinches when gore is shown on screen. In high school biology I puked instead of dissecting a frog. When Game of Thrones took over my life I watched with a pillow against my chest, hands ready to fling the fabric up to shield my eyes from whichever brutality was being depicted. In college my friend Trent tried getting me to play Resident Evil and I screamed at the thought— I did not believe myself capable of watching human viscera blast across my screen, even if it was highly dramatized and, obviously, fake. And while that’s still mostly true (I am so sorry but Titane scarred me in only bad ways), I fucking LOVE Resident Evil now. It has become one of my favorite game series because of how well-thought-out its puzzles and level design are. I am almost happy to deal with the gore because the puzzles are just that great.
And after that sinus surgery I kind of had to… get over it. The squeamishness. For months pieces of cartilage or tissue or I-don’t-really-know-what fell from my wounded nose in streams of blood and guts. I became familiar with the scent of my own viscera (remarkably different from period blood, btw). It was like I’d somehow been endowed with new wisdom, like I’d gone to some Godly kingdom of pain and returned not stronger necessarily but markedly different.
Hans, my new boyfriend, had to make sure I didn’t fall asleep while 100% horizontal. He was responsible for propping my head up at a 90 degree angle and making sure I took my pain meds. He also helped change my gross bloodied bandages and brought me soup. I think I tried downplaying the pain with him but he saw through it, knew I needed him. Thankfully, fucking THANKFULLY, the surgery provided relief almost instantaneously. There was obviously the soreness and the pain post-operation, but my head felt lighter. A lightness I’d forgotten.
I’ve been thinking about all of this body-related stuff because of my new job and also because of my own efforts at embodiment. Recently I got my first hot yoga membership, something I’ve always avoided because #scared of anything that is physically too much and also #scared of punishing my body via overly harsh gym regimens, which has been something I’m known to do to myself. But I am really, really enjoying the challenge of hot yoga! Especially yin yoga in the heat. Sweating that way feels cleansing and I know that’s not an original thought but it really fucking is!!!! And challenging myself to do flow sets in the heat is another kind of cleanse— I love the way my body feels lengthened and flexed days after a power class.
In a recent yin class that was especially powerful for me, the instructor kept asking us to envision a door when poses got too challenging. She called it the doorway to sensation.
I’m knocking on that door, praying I’ll never again be disconnected from it.
Here’s a fun treat for you. I don’t even know who this video was for and what I was intending to communicate!!!!!!! Girl…
I loved reading a lil more about your new job and how you’ve related to it but how have we not talked about how we both had a titty lumpectomy and chronic sinusitis LOLOL
Pain is so human yet so difficult to convey! Thank you for sharing these experiences ❤️🩹