What happens in the OR, stays in the OR

The operating room, on its best day, can easily be compared to a Mumbai local train station: too many people scampering around with only a fraction of them having a purpose (Surgeons, Anaesthetists and paramedics) and the rest are there for most tourism purposes (medical students). Nevertheless, they are all there with a common goal: to relax and have tea in between surgeries.

Other than that, the OR team also strives hard for the patients. While the surgeons do what they know best, the anaesthesiologists take care of everything else for the patient, while the paramedics assist the two in their jobs. They are the three pillars of OR. The fourth pillar of OR, just like media is for democracy, is gossip. During a surgery, given everything is going fine (and preferably the patient is under general anaesthesia), the OR team indulges in some light-hearted conversations which stay light-hearted, unless they reach the topic of politics, or surgeon gets handed the wrong instrument, whichever comes first.

There are only three occasions that the surgery team and the anaesthesia team might disagree with each other: before, during and after surgery. However, no love is lost between the two teams given they respect each other and the ultimate concern remains the patient. Of course, they bicker with each other consistently, the rally of accusations of ‘postponing the surgery’ and ‘taking too long to finish the surgery’ can go longer than a FedEx-Nadal set point. Yet, every single time just like in rom-com’s, the passionate love is back when the anaesthetist says those three magical words to the surgeon: “next case please”.

A routine OR day seems incomplete as long as you don’t see the following activities:

1. The surgical-assistant nurse shouting at medical students for going near the sterile trolley area.
2. The surgical-assistant nurse shouting at the anaesthetist to ask him/her to inject the pre-operative antibiotic on time.
3. The surgical-assistant nurse shouting at the nurse outside to ask for suture/instrument/gauze/detailed account of the daily soap episode that he or she missed.
4. The surgeon shouting at the surgical-assistant nurse for shouting too much.

The decibel level in an ObGyn OR can go even higher, the reason for which we cannot, for political reasons, state here because some of you readers may be married to an ObGyn.

Yet, make no mistake about the fact that the OT runs with the cooperation between all the teams. Patient welfare is the guiding principle, while a successful surgical outcome is a goal. There are candid conversations across the surgical screen that turn into deep friendships and in a few cases, lifelong partnerships. Of course, you can’t compare it to a ‘cafe’ or a ‘tapri’, and not every day is a day of relaxed, banter-filled conversations, but the OR is the best office as it is for the people that work there. So, yes, it is an ‘Adda’. Our ‘Adda’.

Dr Ankit Sharma

Oncoanaesthesia, IRCH, AIIMS