Free How to Do a Liver Transplant by Kellee Slater Page B

turned brown. She continued to hurl abuse at the nursing staff about her dignity being compromised. They put her in the shower and hosed her down, all the while trying to stifle their laughter and remain professional. She recounted her horrible ordeal to me later on rounds. I, too, struggled to keep a straight face. Bless the nurses, they have to deal with some horrible stuff.

    The smell of faeces frequently pervades the room in the course of a general surgical operation. Patients can quite naturally have a bowel movement at the start or end of a case owing to the relaxing effect that anaesthesia can have on the anal sphincter. In general surgery it is usually just a minor irritation. We can’t see it under the sterile drapes and all we have to do is put up with the smell until the end of the case and then find some excuse to be out of the room when it comes time to clean up the patient. In orthopaedic operations, however, this sort of soiling can be a really serious problem.
    A patient recently told me her story of the time when she was about to undergo a hip replacement. This operation requires everything to be perfectly clean. An infected joint has disastrous consequences and must be removed immediately. As the lady was put off to sleep for her operation, her bowels discharged themselves on the operating table. Faecal matter became smeared all over the skin, exactly where the incision was to be made. The orthopaedic surgeon became hysterical at the sight of the smelly brown mess running all over his operative site.
    â€˜Cancel the surgery,’ he shrieked.
    All they could do was wake her up – sans operation – clean her up and try again another day. She told me that instead of hearing ‘Congratulations, you have a brand new hip,’ she got, ‘Well done, you did a great big poo.’ She was so embarrassed.

The call of the bile
    M y second year of surgical training saw me move to Brisbane, the subtropical capital of Queensland. Andrew and I moved yet again and he found yet another job as a flight instructor at a local airport. I was slated to work at one of the most famous surgical hospitals in Australia, the Princess Alexandra or ‘PA’. The whole point of working at the PA as a surgical trainee was to be exposed to the different specialties within general surgery or ‘super specialties’.
    The Princess Alexandra was home to world leaders in all the specialties of general surgery but none more so than the members of the Queensland Liver Transplant Service.I had already worked at the PA for six months doing relieving jobs just before I started training as a registrar and was truly intimidated at the prospect of returning there as a registrar with considerably more responsibility. I would actually have to work closely with surgeons who were considered geniuses and I was worried that they would discover how truly stupid I often felt. I found out that my first job back at the PA would be as the registrar in the transplant unit. This would be followed by six months in Hepatobiliary where, instead of transplanting the organs, the same surgeons would cut pieces from them, ridding patients of terrible cancers.
    To say that I began to hyperventilate on hearing this news would be an understatement. Of all the jobs available to a surgical trainee, these two were considered the most difficult and demanding of all general surgery rotations. The transplant rotation was often referred to as the ‘new car job’ because you worked so much overtime that after six months you could pay cash for a brand new car. I was terrified and at the same time pleased. Getting assigned to these jobs was a real honour because they were not given out to just anyone and especially not to a trainee who was thought to be struggling. Somebody, somewhere, must have thought I was doing a half decent job.
    The surgeons in the transplant unit at the PA were almost like mythical creatures. Everyone I talked to