The year was 1996. My wife had graduated from Medical School a few years earlier, and she was in her second year of residency at a large university medical center.
The time was about 1:45 in the morning. And we were Wrestling the Anaconda.
Ok, I need to back up a little bit. My wife did her residency in Pathology. She studied in both Anatomic and Clinical Pathology – but this particular year was strictly clinical work. Although most people think that pathologists primarily perform autopsies (which is the “Anatomic” branch of the specialty), the majority of pathologists are actually on the “Clinical” side of the business. Clinical pathologists run all the hospital lab functions – blood banks, specimen analysis, frozen sections, lab tests, etc. During surgery for example, if a doctor is removing a cancerous cyst, they will send the specimen to the lab to have the margins checked. The pathologist needs to analyze the lump, diagnose it while the patient is still under anesthesia, and make sure that the surgeon has cut into “clean” tissue all the way around. If not, the surgeon needs to cut a little more.
Most of these specimens are pretty small – typically a few millimeters up to a few centimeters. But not the Anaconda. That was different.
Years earlier, I had done some work as a lab tech so I was experienced enough to help out in the lab and was able to finagle a “volunteer” work badge – it wasn’t hard to get, they were always glad to have more volunteers. When my wife was on call for the night shift, I would occasionally come to the hospital and help prepare slides, set up the microscopes, monitor equipment, log test results, anything I could do to help out.
My wife was supposed to be off work at 11:00 on that fateful night. But she called and said there was an emergency – a patient was just going in to surgery, and they needed a pathologist to stand by for a diagnosis and margin check. Routine stuff, it happened all the time. I wasn’t doing anything that night, so I asked if she wanted me to come down and keep her company, maybe help out when the specimen came in. I didn’t need to be at work early the next morning, so it was no problem for me.
But I wasn’t expecting to be Wrestling the Anaconda.
I got to the hospital a little after 11:30, changed into some scrubs, and while we were waiting for the specimen, I organized some supplies and helped her catch up on some paperwork.
As was often the case, especially with unscheduled emergency surgeries, she had no indication of what the surgery was for. The pathologists are expected to wait for the specimen to arrive, whatever it is, and then diagnose it as quickly as possible to send word back to the surgeon.
It was taking a while, so we waited. We did get about fifteen minutes notice from the OR that the specimen was on its way. About time too – it was getting late, and I wanted to go home.
Finally, at 1:30, it came. And boy, were we surprised!
Now, most specimens are pretty small, as I said. They typically arrive in a little specimen jar, not much bigger than a Dixie cup. But this one came in a bucket. Not just any bucket – a big 5 gallon bucket – and it stank. Oh my, what a smell. The entire lab was suddenly engulfed in a cloud of noxious gas reminiscent of eating durian fruit in a crowded Singapore market. Worse.
The patient had an obstructed bowel, and never went to see a doctor about it. He probably hadn’t gone poop for over a month, and eventually he got so backed up that his colon ruptured. It split right open, dumping raw sewage into his abdomen. Without immediate surgery to remove his large intestines, he would have died from sepsis. The Anaconda was in the bucket, staring at us. Taunting us. Daring us to touch it.
Did I mention the smell?
So our job was to keep from puking, while we wrestled the six foot length of fetid, shit filled, slippery, limp, and rather unwieldy length of bowel out of the bucket, into the sink to rinse it off, and onto a table so my wife could check the head and tail to make sure there was living tissue at each end. 99% of it was dead necrotic tissue that had been sitting in this poor guys gut for who knows how long before it ruptured. We really needed eight hands, maybe ten, but we only had four. It struggled back. We had to stretch it out straight, but it didn’t want to cooperate. We’d pick up one end, and the other end would go sliding off the table onto the floor. We had to work quickly, but carefully to make sure we didn’t rip the specimen any more than it already was, so it could be examined properly.
Typically, the pathologist can get an answer back to the surgeon very quickly – sometimes in just a few minutes. You don’t want the patient to be under anesthesia any longer than necessary. But we were Wrestling the Anaconda, and it was a slow, painful, stinky battle. Anyway, the surgeon was probably still busy with the abdominal cleanup, taking out the rest of the shit that didn’t make it into the bucket.
It turned out that the surgeon had done a good job, the margins were clean, and word was sent back that they could attach the loose ends, and close up the patient.
A few hours later, we were still cleaning up the lab, finding splatters of feces which had flown all over the place or dripped onto our shoes, and I couldn’t help but think that the next time I want to Wrestle an Anaconda, I’m going to go to Brazil. A fresh one straight out of the Amazon would probably be more pleasant.
There are some parts of the human body that I guess I’d rather were kept right where they belong.