We ALL have our stories …
There was a moment when I heard the words “a Zero pressure- and v-fib is INCOMPATIBLE WITH LIFE !”
And she was right. She meant it. She meant it every single moment that you were dedicated to a pump run. I would see her at the end of a 2-3 day case load, worn out but dedicated to a cause significantly greater than a paycheck.
I actually didn’t hear them, those words of peremptory doom. It was like a slow motion whoosh. I was focused on the patient, trying to pull them from the edge of somewhere, but it started a chain of responsibility. This patient didn’t make it- and I was 3/4 of the way through my clinical rotation as a perfusionist in Detroit, Michigan. Colleen told me there was nothing more I could have done to change the outcome of that day. But I never forgot it.
It was definitely a “Don’t go into the light” moment…
To top it off- I was an ex Navy Corpsman, surgical first assist, had a bucket load of experience, and basically no fear. I was too illiterate about perfusion to be scared. But God that moment rocked my world. All I can say is that yeah, what I saw on the monitor was a lot of squiggly looking diamonds.
The disarray on the radar (monitor) was scary that day. Colleen emphasized that so significantly- that even now I still twitch. To her credit, the fact that she didn’t take over the case was the real deal as far as preparing someone to handle what we handle.
And topping it off, I really wasn’t used to leaving patients in the OR.
Flat Line = Deer + Headlights
She was the one that picked me up, reminded me that I wasn’t a scrub tech anymore (my incessant need to come forward and tie up gowns). She nailed me on self confidence- taught me that every “connection: I made for the first time, was the last time I should question myself. (I still double check- but it was a concept never lost).
Self confidence that you did it right the first time, that was the take home message to me. Your connections were solid, your knowledge of the patient’s history was uncorrupted by leniency in terms of effort, any surprises down the road weren’t predicated on lack of diligence.
I don’t remember much of that particular case, except it was like being wrapped up in a cascade of very rough water, like surfing and getting shot out of the tube right before it crashes down, just in time.
I so respect that segment of my life. It was a moment of manifest fear, that distinct moment when you experience the 5% of terror you hear people talking about in the profession. That 5 % is huge when you become a party to it. As an uninvited guest I can tell you It’s an intimidating number when encountered unexpectedly (which is pretty much every single time that it rears it’s ugly head). Unexpected but certainly not ignored.
Colleen had an amazing work ethic. I would see her at the end of the day- so solid. She might have been tired- but she was always solid. I would have trusted her with my life at any time.
I was very lucky to have people like Colleen, George, and Sandy taking their time to make sure that I could be trusted behind a pump.
And being behind that pump- is a Man-up situation every single case.
We all have those sort of stories.
George was way beyond cool. He exhaled perfusion- by just sitting there. Had it down cold.
I would still be intimidated if I pumped a case with him watching. He let me pump on day 1 in my clinical rotations in Detroit. That was pretty much the same as riding a motorcycle without handle bars, not knowing how or when to switch the gears. At least I knew where the brakes were- but without those handle bars- pretty useless information for me to process. It was a lot of screens and knobs and I was as clueless as clueless can be.
Even though I was a total idiot about pretty much anything that was perfusion, I did mange to answer a question he thought I would be ill prepared for- because it was relatively exotic.
It was the P50 question-
27.5 is what I seemed to to come up with. A total save. Why for the love of god, had I somehow chosen to remember that particular number? I guess it was destiny. I was just grateful he didn’t pursue it further- thus exposing the soft underbelly of the reptile. I understood the concept, but when grilled before a case, was typically myopic. Was it a concept I really needed to focus on? Maybe so. At that particular moment, it was a great answer.
I figured it out later.
Well it wasn’t a question about planes – now was it ?
He also watched me pump the worst case in my life.
What made things worse was that it was a “competency” case.
He didn’t say much after the case. That spoke louder to me than any sort of screaming. I had been sucked into a vortex of poor timing and indecision for the greater part of that case. There was no denying that. I think I hit a wall, as Colleen so assuredly told me after the fact, and now it was time to either step back up to the plate, or allow total failure to envelope me.
The next day- my stock was definitely down. The boss of bosses had reared his head- was coming in to watch me pump a case, and at least I had the guts to go up to him directly and ask him if it was more than a “competency” ?
Well he wasn’t really all that straight forward about it, told me no- and then I did what was necessary. A pretty much perfect pump run. Probably a good thing to do at the time. Birds of prey were circling.
I always called her by her last name. Kept reminding me of the band, The Allen Parsons Project.
Sandy was a machine. She dressed like she pumped- crisp. A beautiful- drop dead gorgeous lady (sort of like a perfusion stepford-wife), and smart as a whip.
When she pumped a case, she was a mechanic. Every move choreographed. She didn’t care much for students like me. Couldn’t understand half the things I said (I had come directly from “Cali” ) talked like a surfer dude, had a tendency to say once too often… “I knew that”.
As we navigated our road together, Sandy and I… well, she made sure that I knew- that I really didn’t “know ALL that”.
There was a cross, I had engaged it, and I was hanging from it. But seeing as how I had built it, I had no one else to blame but moi’.
There was a method to her and it’s name was safety, and the game as a result was safety by repetition. Same setup every time, same number of clamps, pretty much the same everything which led to the same outcomes, an undamaged patient. She liked her comfort zone, and made a good nest in that regard.
Well you can’t argue with success, and you were certainly going to lose, if you tried arguing with her.
I just hit 20 + years in this profession, and I still respect the game…
This isn’t the place for me to say thank you to anybody. But I think my patients would, if they could, say thank you to you guys.
And you deserve it.