Tuesday, April 08, 2008


You shouldn't hold in your farts. Because then they'll end up traveling up through your spine and into your brain, and that's where you get all your shitty ideas.
I heard that someplace, can't remember where, but it makes me laugh every time I think of it.

The problem with being a surgeon is that you don't get to take a break in the middle of an operation. Once you start, you're committed to the operation until the job is done. Just as you wouldn't leave a toddler alone in a room full of knives, you can't leave a person with their guts all hanging out on the table while you go take a 15-minute break. There's no autopilot. There's no second string relief. It's just you.

My mental preflight checklist includes "to do" items like greeting the family, answering last minute questions, reviewing the chart and diagnostic films, but most importantly, a trip to the men's room.

Because every operation is semi-unpredictable and can easily turn into an 8-hour disaster, I make sure to pee before every case. It's hard to concentrate on the matter at hand if my brain is more concerned about peeing my pants instead of saving the person's life laying in front of me. There's always a way to get to a "stopping point" during an operation and pause for a bit while you do a mad dash to the bathroom, but that brings on a whole new level of anxiety.

While there's a bit of physical relief, I'm plagued by mental torture as the whole time I'm in the bathroom I'm envisioning every conceivable nightmare happening back in the operating room while I'm out: Cardiac arrest. Bleeding. Contamination.

Because of this, I just tend to hold it.

Peeing before an operation helps, but I've had my share of 8+ hour operations and by that time I usually have to pee again. But over the years I've been able to train my bladder and have become quite adept at being able to go without peeing for extended periods of time... except when I'm on a road trip.

For some reason, my bladder must shrink in size exponentially when I'm in a sitting position. I actually drink less coffee (and all liquids) when I'm driving than when I'm working in the hospital, yet it's a snowy day in Aruba when I can go more than a few hours without having to pull off the highway.

The oddest thing is that it bugs me so much when I have to pull over and stop. It must be a guy thing. It's always an internal struggle in my brain: "I've got to pee" vs. "We're making such good time"

"Making good time." I don't even know what that means. It's not like pulling off to a rest area for 10 minutes to pee will ruin anything, but my brain sure makes a big deal about it.

Bladder: Hey boss, we've got to pee.

Brain: What? No way, you peed before we left the house. [looks at odometer] Besides, it's only been 110 miles. Hold it for a bit longer.

Bladder: [dejected] okay...

30 minutes later...

Bladder: Hey man, we've got to go.

Brain: Look, we'll need to stop and get gas in about 150 miles or so. You can go then.

Bladder: [whimper] okay...

20 minutes later

Bladder: Are we there yet?

Brain: No.

Bladder: Are we close? Cuz we've got to go. It's getting pretty tight down here.

Brain: Can you hold it a bit longer?

Bladder: We really need to go.

Brain: Just hold it. We're making great time. I don't want to stop now. We'll be there soon.

Bladder: No we need to stop.

Brain: [ignores Bladder]

Bladder: We're going to start pushing the panic buttons.

Brain: ...

Bladder: Hey... we're not joking.

Brain: ...

Bladder: Hey!

Brain: ...

Bladder: Hey... Hey... Hey... Hey...

Usually at this point Nathalie looks over at me and asks, "Are you OK?"

Me: [flushed and sweating] Yeah, I need to pee.