The theatre of life
As I write, the hard clay and ochre of iron in central
Australia’s soil spreads in every direction under my feet. The safety and
familiarity of the aluminium can that we call an aeroplane contrasts against
the harsh reality of this continent’s parched beauty. I’m flying away from
home. Flying away from a world of comfort and safety to one completely unknown.
As my fingers tap along the keyboard, sunshine warms the
over-air-conditioned environment. Like a cat, I lean into it. Sunshine hasn’t
been part of my world lately. Here, miles in the air, there is more natural
beauty visible than in the white-washed world that fills my every-day. Here,
there is more to fill the senses than the sensory deprivation that is my home.
And yet, I already miss it.
Home. The place where many sit hopeful, waiting hours
expectantly for the return of their doctor. The doctors always promise to be
back soon, an indeterminant period of time that leaves patients yearning while
those in charge of their health are pulled to and fro by the call of a pager.
The place where minutes turn to hours to days and weeks and months for those
who wait for science and guestimation to find a solution to their enigmatic
illness. Where the stay brings the accumulation of physical belongings to make
this stark environment feel a little more like the real world, yet where the
obligatory uniform of a hospital gown or hospital-issued pyjamas takes away any
attempts to be oneself. Where the stories of normal life seem like an ethereal
dream as the unchanging world swallows all traces of time.
Home. Where the near empty corridors echo with the passage
of people who have come and gone. Where lost family members search desperately
for their ill loved one, only to end up in some dead-end room, confused,
because there are no signs to find your way through these emotions. Where
light-hearted conversation and meaningless jokes are shared in the lift lobbies
as we wait eternity to find our way to another floor. Where a smile is worth
just as much as the slap-in-the-face cup of coffee that dulls the fatigue
sitting under the eyes of staff who’ve marched through the disasters of the
night.
Home. Where corporate attire is traded for blue scrubs and
booties and a hair net. Where the excitement of the surgery ahead makes my
internal music so loud that, lost in my own world, the team will find me
humming loudly as I scrub. Where the dance of sterility beats the thrill of the
D-floor any day of the week. Where the mind and the body truly connect…just
this time around it’s many minds drawn together to put another’s body back
together.
Home.
****
Where it started.
The memories of third-year full body dissection come
flooding back. The fear. The apprehension. Here is someone who used to be
alive. But they’re not anymore. Who are they now? Who were they? And where did
they go? The green sheet that drapes over them, revealing only the vague shapes
of what lies beneath. Hearts in our throats, we carefully removed the sheet and
felt the sting of formaldehyde burn our eyes and throats. Beneath the protection of the sheet lay someone. This person used to be
everything to someone else. Face down, all we could do was wonder. Who was this
body that we affectionately named Carlos?
The tutors tooled us up with scalpels. The five of us stared
at each other in desperation – no one wanted to be first to mar the smooth,
toughened skin of our charge. Shaking with nerves, I took the first slice.
Layers of skin and subcutaneous tissue slowly gave way under the pressure of
the blade. Working my way under the tissue, with a combination of blunt and scalpel-assisted
dissection, the beauty of the human body revealed itself to us. And suddenly,
we were all hooked.
A quiet thank you escaped our lips – thank you, Carlos, for being
so slim. We watched as other groups began the gruesome task of shifting buckets
of excess adipose tissue from their cadavers. Carlos, though, had beautiful
muscular definition just below his skin. The clarity of fascial compartments –
something we had all thought would be intangible – and tendon sheaths made us
pause and exclaim in wonder. We pulled on tendons and were overjoyed to see the
motion of fingers. We were incredulous that all of these bodies, living and
dead, in the room had developed from tiny little cells, and function through
the immensely complex gooey lumps inside our craniums. A quiet thank you that
we turned out okay.
As we got to know Carlos better than we’d known any body
before, we developed an acute case of X-ray vision, where passers-by became far
more than clothed individuals. They became rib cages and beating hearts with
synergistically contracting muscles moving them about this bizarre world. I’d
look down and see more than my heel-clad feet. I’d see Tom Has A Very Nasty
Diseased Foot. Tibialis Anterior. Extensor Hallicus Longus. Dorsalis Pedis,
branch of the Anterior Tibial Artery. Anterior Tibial Vein. Deep Fibular Nerve.
Extensor Digitorum Longus. Fibularis Tertius. I’d see the intrinsic muscles of
the foot and the multitude of ligaments that defied my capacity to remember
their names. I saw the bones articulating, gliding over each other with each
step. And I wondered – what does the inside of a living person really look
like?
Gowned and double gloved, I now watch my registrars and
consultants take scalpels to our patients. Our patients, who tell us fascinating
stories. The ones who become constants in the ebbs and flows of our days, and
the ones who turn up for a few days before disappearing back to their own
worlds. Who go from Mr or Mrs Whoever to a knee, hip or ankle as the many blue
drapes create a sterile zone for the only time causing pain and physical damage
is legal. The only time people will thank you for giving them scars. As the
diathermy cuts and cauterises, the soft tissues of life part to the will of the
surgeon. The nerves are identified and packaged off to the side, out of harm’s
way. The fracture begs for our attention. But it must wait until everything
else is ready. And then comes the magic of open reduction and internal
fixation. Screws and plates, hammering and pushing and pulling in a fight
between functional alignment and unbalanced muscular forces.
As the surgeons stitch the limb back together and Mr or Mrs
Whoever is slowly brought back to consciousness by the changing concoctions of
anaesthetic wonder, I can’t help but remember where this all started. From an
obsession with Netters Illustrated Anatomical Atlas and a 34th
edition of Gray’s Anatomy to time with Carlos, to the wonderful world of Henry
Gray as illuminated in The
Anatomist to the team bonding as we work to put limbs back together in
theatre.
A theatre where, just as actors, years of training go into
getting to the top. Where precision is key and where you can’t be dazzled by
the bright lights shining down upon you. A theatre where your company defines
the quality of the performance. And when it’s all over, you can’t wait to get
back on stage.
As the land beneath me has turned from clay to sand dunes,
my world has shifted. It’s time to move from surgery to medicine. From theatre
to the front lines.
But all I really want is one last dance.
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