The Cut.


(Very groggy, in High Dependency on the day of my surgery)

I am awoken by a very young nurse. 
It’s early. Before morning Obs even. It’s still dark.
It must be about half past five, I think to myself as I try to shake the sleep from my head. I know the young nurse is here to prepare me for surgery. 
I’m not ready. 
I try to tell her I haven’t spoken to the surgeon, that I don’t feel confident going for surgery without talking to at least one person who will be in the operating theatre, but as I do so I am overcome with emotion. Without even realising I am soon sobbing on the poor nurse’s shoulder. 
‘I completely understand how you feel. I’ve had surgery myself and I wouldn’t have felt comfortable if I hadn’t spoken to the surgeon beforehand. I’ll go and see if I can find out what’s happening. It will be ok. We can’t do anything to you without your consent.’
She’s lovely. Really sympathetic and caring and I feel a bit guilty for emoting on her as she goes off to find out when the surgeon will be here.
‘Are you alright, dear?’
I hear Gloria’s voice from behind my curtain.
I say that I am. That its all been very stressful and it just got a bit much for a moment there.
‘Well, we’re rooting for you, dear.’
Gloria’s kind words make me feel tearful again and I’m still quietly crying when the Sister comes in to talk to me.
‘I’ve spoken to the surgical team. They will be on the ward at 7am and I’ve told them they must come to speak to you first. In the meantime, have your antiseptic shower, get yourself ready. They are keen to get you done today. I’m sure you’ll feel better once you’ve spoken to them.’
The Sister has a way of making me feel compelled to obey her. A bit like a school teacher or a police officer. I wipe my face then head to the bathroom, clutching my chest drain in one hand and the antiseptic wash in the other. 
I am only just out of the bathroom and still a bit wet, when the Registrar arrives with the surgery consent form.
He’s very blasé. He informs me they do at least one of these surgeries a week and they are really quite routine. He tells me matter of factly there is a 20% chance they will have to convert my minimally invasive surgery into open chest surgery but they will only do so in this in an emergency and it would be to save my life. He then tells me this particular surgery carries a 1% risk of death. 
I’m trying to keep up with what he’s saying but he is talking very quickly and my mind hasn’t really moved on from ‘1% risk of death’. I calculate to myself – one of these surgeries a week with a 1% risk of death… That’s at least one person every two years who doesn’t wake up again from this operation…
‘Do you have any questions?’
I haven’t heard anything he’s said after ‘risk of death’.
Feebly I ask him how many incisions there will be and where they will be?
‘That’s up to the surgeon.’
Suddenly I find my confidence. I tell him it’s important to me that I have an idea of where and how I’m to be cut and I ask him to fetch the surgeon. He looks a little surprised, but reluctantly agrees when I refuse to sign the consent form.
I sit on my bed and wait. 
I don’t know what I imagine the surgeon to be like. I’ve been waiting to meet him for so many days. He’s been spoken about with such reverence by the junior doctors. I’m half expecting a ‘Jesus’ like figure to float in and heal me just by laying his hands on me…
It’s a bit of a disappointment when a short, not very impressive, slightly flustered man in his early forties arrives and shakes hands with me. 
‘I understand you have some questions for me?’ Says the Mediocre Messiah. 
I ask how many incisions he is planning to make and where they will be?
‘Hopefully just the two, possibly three… Have you seen your CAT scan?’
I say I have but I can’t really remember it.
‘Come with me a moment.’
I lift up my chest drain and follow him to the nurse station where he opens up a laptop and retrieves images of my poor broken lung.
‘You can see here you have a bulla in right at the apex of your lung, up in your shoulder. It’s adhered to the chest wall and I don’t want to say for certain I can definitely reach that with two incisions, I might need a third…’
While he is speaking I remember Dr Drippy and Mr Member of Parliament talking about two bullae and a cyst. I ask where the second bulla is and what he thinks of the cyst?
‘They told you that? Based on this CAT scan?’
I nod.
‘Hmmm… There is no second bulla and there doesn’t appear to be a cyst. I’m not sure why they would have told you that… I’ll have a thorough look when we do the operation but based on these images you just have one fairly small bulla and that’s what’s causing your problem.’
We walk back to the ward and he pulls the curtain round.
‘The incisions will be here…’
He places his fingers on my side where my chest drain is already in place.
‘And here…’
Then moves them further down to about where my bra elastic usually sits.
‘And if we need a third it would either be under your breast or here…’
He touches my back just below my left shoulder blade.
I ask if he can use my existing chest drain wound as one of the incisions?
‘If it’s in the right place, perhaps. If not I’ll have to make a fresh one…’
I must look anxious because he hesitates then says ‘I’ll do my very best to keep the incisions to a minimum. I can’t promise anything but I will do my best.’
I do believe him.
He then explains the procedure to me. The bulla will be cut out and the lung stapled, then part of the pleura will be removed to cause inflammation and ‘stick’ my lung to my chest wall. 
I sign the consent form and the Mediocre Messiah shuffles off.
I do actually feel better. That’s all I wanted, just a few minutes with the man who’ll be wielding the knife. Now that I have spoken to him I feel much calmer.
When the porter arrives to take me down I’m a little taken a back that I’m to be transported on a flat bed. I haven’t been moved like that since that first night in the Royal London. I try to get a sense of where I am in the building as I’m wheeled through corridor after corridor, lights strobing above me.
Eventually I arrive at ‘Theatre Two’. 
I’m wheeled into a preparation room and a friendly scrubs nurse begins attaching wires and needles to me. She asks if I’m cold. I say I am and she lays a foil blanket over me which seems to be attached to a hair dryer as soon hot air is blasting through it and warming me up.
Two anaesthetists come in and introduce themselves to me. I can see a huge syringe full of what looks like clear jelly being removed from its packaging.
I hear the older anaesthetist telling the scrub nurse off for preparing me on the same trolley I came down on.
‘We’ll have to lift her once we’re in there.’
I see the clear jelly syringe again as its passed over my head.
I’m full of dread now. Deep unease. I’m waiting to be told to start counting down from ten, like they do in medical dramas on the telly. I’m still waiting when I suddenly feel really woozy….
I can hear voices. My eyes are closed but I can hear voices.
I open my eyes. It’s very bright. Dazzling. I can see a female nurse standing over me…
Then it hits me.
I try to breathe but it feels like there is a wall on my chest. I start to panic and try to clutch at my chest.
‘I know you must be in a lot of pain but we are giving you something for that right now. It will work very quickly, I promise.’
The nurse is smiling kindly and now I can see there are actually two of them.
I feel like I’m being crushed under a vice. 
Suddenly I can see the surgeon standing over me. He still has his scrubs on. He’s smiling.
‘It went very well. Only that one bulla. The lung came up straight away. Just the two incisions. Managed to hide the top one in your existing wound.’
I try to say thank you, as I speak I realise my mouth is unbelievably dry and my top lip is swollen.
I ask for water.
The recovery nurses help me sip some water and tell me I’m doing really well.
The porters arrive to take me to High Dependency. I look down as they hook my chest drain onto the side of my bed and I realise it’s a completely different drain. It’s much bigger than my old one. The tube is much fatter and its full of the same bloody mixture that filled Edna’s back on the ward. It’s also in a different place. It’s protruding from lower down my side. The original wound is now sealed with a bandage. Now that I’m aware of this new drain, it begins to intensely throb and spasm intermittently (almost as if my body is attempting to ‘close’ the hole) as the porters wheel me to High Dependency.
Once I’m in High Dependency I’m hooked up to a multitude of machines and monitors. I have suckers all over my chest and an oxygen tube up my nose. 
The male nurse is asks me if I’d like a sandwich and I actually start laughing. I’ve never felt so sick in my life! The idea of eating a sandwich seems ludicrous.
‘You’d be surprised’ he smiles ‘Sometimes people are desperate to eat. Now, your hooked up to a morphine PCA.’
He presses a controller with a button in the centre into my right hand.
‘You can’t overdose on this because it’s on a timer so you just hit the button whenever you feel you need pain relief, ok? Hit it now.’
I press the button. 
I feel a flood of wooziness then suddenly I begin to retch. The nurse passes me a sick bowl. I’m overcome with sickness. Every time I retch I feel like my insides are tearing. I’m scared my lung will collapse again.
‘I can give you something for the nausea. Don’t worry about your lung, it’s fixed in place now.’
I see him reach for another syringe of jelly and inject it into my cannula. 
After a few minutes the sickness has passed. 
A female nurse comes in with two of my friends. 
‘They’ve been waiting outside for you.’
I’m so happy to see them I start to cry but then immediately stop as even gentle tears produce a ripping pain in my chest.
They sit with me for two hours and although I’m in absolute agony I feel so much better that they are here. 
Once they have gone and I am alone I start to take in my surroundings. There are four beds in the unit. There is a very young girl next to me. She is crying and moaning and keeps vomiting. She looks almost childlike, her tiny frame hardly making an impression on the white sheets of her bed. She can’t be much more than twenty. 
There is a curtain partition separating us from the other side of the unit. I can’t see who is there but I can periodically hear a male voice crying out and begging for methadone. The male nurse who was so kind to me firmly repeats ‘You can’t have any methadone. You are on morphine. We don’t want to give you an overdose.’
Time seems to move incredibly slowly, but eventually the staff change over and it is night time. 
I’m absolutely exhausted, but I am in searing, pulsating pain and when I close my eyes I’m overwhelmed with nausea again. I can’t imagine how I’ll ever sleep. Machines are beeping and I can hear both the young girl and the faceless man behind the curtain, moaning and retching. I’m so nauseated. I’m so sore. Bits of me hurt that I didn’t even know existed. How can I sleep? How can I sleep?
I’m still asking myself that question as my eyes droop and my head feels fuzzy. 
I do finally fall sleep.




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