The Harvesters
It could be the fact that they come in the night, but I guess it has to do with their taking organs out of living bodies which makes them seem cool to me. They are called Harvesters in our hospital and they are our guests.
As a member of the Washington Regional Transplant Consortium, one must be on call to go to any area hospital in the night to harvest organs and tissue from an organ donor. I am not an employee of the WRTC, but have worked with them on a case.
It's called a "case", but in my mind, there is a living human at the end of the case. Actually, there is a living human at the beginning of the case, as well, but that issue is always up for ethical debate. An organ donor almost always has a beating heart when they are taken to an operating room, and they invariably do not when they, 0r most of their body, are taken out. The donor doesn't have viable brain waves before the harvest, and sometimes doesn't have a brain at all on the way out.
Most of the time, kidneys are the goal, but livers, hearts, corneas, skin, and bones are pretty common, too. I really don't know what else is harvested, but you can assume every part of the body can at least be learned from. When I was asked to assist the WRTC team because of a missing surgeon, I was allowed to take out the heart, since it was going to be used for teaching purposes. If it were to be used as a donor, they would not have let me near it, but since they recognized the fact that I was doing them a favor as the private hospital PA taking the place of one of their two surgeons, I was given the scalpel and told to cut.
The eerie aspect is that the team does this at night, avoiding busy daylight hours, when the hospital makes its money from the Surgical Department. It's like a secret game of poker going on in a back room, the ethics of which can be questioned by a conservative mind. The team will bring their own music, tell their own jokes, and laugh and talk to one another without a sweat of tension. Meanwhile, those of us who perform operations on people who will typically walk and talk afterwards, wonder what exactly goes on behind their closed doors.
A patient, usually from the ICU, is declared brain-dead and is wheeled into the operating room. They are stripped naked and the whole body is drenched with betadine. The anesthesiologist monitors the patient's vitals and administers anesthesia that may or may not have an effect, depending on your ethical persuasion. Then you harvest the targeted organs.
I was handed a chest saw one night after the skin was cut using the bovie. Usually a nice, sharp scalpel is used. The bovie is an electric pen that electro-cauterizes tissue. It's often used to stopped little bleeders and cut tissue within the body, but never used on skin. It burns the edges, causing an ugly and painful incision. We used the bovie on this donors skin, though, since she wasn't going to be feeling much anymore. And holy shit - the incision was literally from stem to stern. The neck down to the pubes, one long electric, burnt line. The doc had a bovie and I had one, and we just started cutting down.
When we got to the sternum, he asked me if I had ever used a chest saw. I lied and told him I have in school once. This is actually an appropriate lie in surgery, since you declare your novice status while not giving the benefactor the ability to deny your acceptance. I do it all the time. Then you can also say something like, "Now refresh my memory"
The heavy saw looked a lot like a jigsaw with the blade being contained in a sturdy bracket. The trick is to center the saw right at the top of the sternal notch (the sexy divot at the base of a womans' neck) and bite into the top of the sternum. Then, as the saw is moved down the center of the sternum, you must lift up, making the blade's bracket slide along the underside of the bone. This is done to avoid sawing through vessels and heart muscle. So I did it.
The exact words of the surgeon as he finished explaining the technique, were, "OK, go for it!" With enthusiasm, I put the saw in place, pulled the trigger and slid down the sternum. The noise of an air-powered sternal saw is pretty damn loud in the closed operating room. Imagine a heavy jig-saw in your basement. Apparently, I cut the chest a little faster than average, since the surgeon's right hand, resting on the base of the donor's chest, was jerked away from the oncoming saw as though he were avoiding a striking snake. I cut the sternum in about 2 seconds, and when I came to the end of the sternum, the sudden lack of resistance made me cut through the air another foot or two! My only experience with saws having been with either with wood or a more solid material, the cancellous tissue of human bone felt like styrofoam. The saw must have been used pretty infrequently, because it felt very, very sharp.
After saying, "OK, go for it!", the very next words out of the surgeon's mouth were, "Holy Crap!! . . . uh, ok, good job".
We then inserted a spreader, and turned the crank. This is like a reverse vice, and the ribs began to open. The gap got wider and wider, until the gap was about 6 inches apart. The ribs then break or become disclocated from the vertebral bodies in the back. It makes the sound like opening a crab. Widening even more, the patient looks like a giant clam.
He and I both began removing the heart, and after a few cuts and ties, I noticed the anesthesiologist leaving. He just turned off his machines and walked out. The heart wasn't beating anymore. I am not sure when it happened, but it freaked me out a little. It's pretty hot under the lights of surgery, with an impervious gown and mask on, but I still felt a wave of chills slide down my back and arms.
Eventually, the other surgeon arrived and I was scrubbed out, with the bragging rights of "cracking a chest". Granted, it was on a goner, but I still can say I did it. Cracking a chest is only done by trauma docs in the ER and Heart surgeons - and over-eager PA's who lie their ass off.
The transplant team removes what they need to , and icepacks everything in Igloo coolers. If there is a nice kidney or liver or heart, a helicopter is waiting on standby and stuff is run out of the room. But usually, the team quietly leaves with their coolers, leaving behind a quiet room with a corpse. Or what's left of one.
Once, cutting through an OR at night to get to L&D, I walked right in to a room with a dead body in it. A tech was wrapping things up, but on the table was a huge shell of a body, it's entire thoracic and abdominal cavity empty.
The harvestors had done their work in the night
As a member of the Washington Regional Transplant Consortium, one must be on call to go to any area hospital in the night to harvest organs and tissue from an organ donor. I am not an employee of the WRTC, but have worked with them on a case.
It's called a "case", but in my mind, there is a living human at the end of the case. Actually, there is a living human at the beginning of the case, as well, but that issue is always up for ethical debate. An organ donor almost always has a beating heart when they are taken to an operating room, and they invariably do not when they, 0r most of their body, are taken out. The donor doesn't have viable brain waves before the harvest, and sometimes doesn't have a brain at all on the way out.
Most of the time, kidneys are the goal, but livers, hearts, corneas, skin, and bones are pretty common, too. I really don't know what else is harvested, but you can assume every part of the body can at least be learned from. When I was asked to assist the WRTC team because of a missing surgeon, I was allowed to take out the heart, since it was going to be used for teaching purposes. If it were to be used as a donor, they would not have let me near it, but since they recognized the fact that I was doing them a favor as the private hospital PA taking the place of one of their two surgeons, I was given the scalpel and told to cut.
The eerie aspect is that the team does this at night, avoiding busy daylight hours, when the hospital makes its money from the Surgical Department. It's like a secret game of poker going on in a back room, the ethics of which can be questioned by a conservative mind. The team will bring their own music, tell their own jokes, and laugh and talk to one another without a sweat of tension. Meanwhile, those of us who perform operations on people who will typically walk and talk afterwards, wonder what exactly goes on behind their closed doors.
A patient, usually from the ICU, is declared brain-dead and is wheeled into the operating room. They are stripped naked and the whole body is drenched with betadine. The anesthesiologist monitors the patient's vitals and administers anesthesia that may or may not have an effect, depending on your ethical persuasion. Then you harvest the targeted organs.
I was handed a chest saw one night after the skin was cut using the bovie. Usually a nice, sharp scalpel is used. The bovie is an electric pen that electro-cauterizes tissue. It's often used to stopped little bleeders and cut tissue within the body, but never used on skin. It burns the edges, causing an ugly and painful incision. We used the bovie on this donors skin, though, since she wasn't going to be feeling much anymore. And holy shit - the incision was literally from stem to stern. The neck down to the pubes, one long electric, burnt line. The doc had a bovie and I had one, and we just started cutting down.
When we got to the sternum, he asked me if I had ever used a chest saw. I lied and told him I have in school once. This is actually an appropriate lie in surgery, since you declare your novice status while not giving the benefactor the ability to deny your acceptance. I do it all the time. Then you can also say something like, "Now refresh my memory"
The heavy saw looked a lot like a jigsaw with the blade being contained in a sturdy bracket. The trick is to center the saw right at the top of the sternal notch (the sexy divot at the base of a womans' neck) and bite into the top of the sternum. Then, as the saw is moved down the center of the sternum, you must lift up, making the blade's bracket slide along the underside of the bone. This is done to avoid sawing through vessels and heart muscle. So I did it.
The exact words of the surgeon as he finished explaining the technique, were, "OK, go for it!" With enthusiasm, I put the saw in place, pulled the trigger and slid down the sternum. The noise of an air-powered sternal saw is pretty damn loud in the closed operating room. Imagine a heavy jig-saw in your basement. Apparently, I cut the chest a little faster than average, since the surgeon's right hand, resting on the base of the donor's chest, was jerked away from the oncoming saw as though he were avoiding a striking snake. I cut the sternum in about 2 seconds, and when I came to the end of the sternum, the sudden lack of resistance made me cut through the air another foot or two! My only experience with saws having been with either with wood or a more solid material, the cancellous tissue of human bone felt like styrofoam. The saw must have been used pretty infrequently, because it felt very, very sharp.
After saying, "OK, go for it!", the very next words out of the surgeon's mouth were, "Holy Crap!! . . . uh, ok, good job".
We then inserted a spreader, and turned the crank. This is like a reverse vice, and the ribs began to open. The gap got wider and wider, until the gap was about 6 inches apart. The ribs then break or become disclocated from the vertebral bodies in the back. It makes the sound like opening a crab. Widening even more, the patient looks like a giant clam.
He and I both began removing the heart, and after a few cuts and ties, I noticed the anesthesiologist leaving. He just turned off his machines and walked out. The heart wasn't beating anymore. I am not sure when it happened, but it freaked me out a little. It's pretty hot under the lights of surgery, with an impervious gown and mask on, but I still felt a wave of chills slide down my back and arms.
Eventually, the other surgeon arrived and I was scrubbed out, with the bragging rights of "cracking a chest". Granted, it was on a goner, but I still can say I did it. Cracking a chest is only done by trauma docs in the ER and Heart surgeons - and over-eager PA's who lie their ass off.
The transplant team removes what they need to , and icepacks everything in Igloo coolers. If there is a nice kidney or liver or heart, a helicopter is waiting on standby and stuff is run out of the room. But usually, the team quietly leaves with their coolers, leaving behind a quiet room with a corpse. Or what's left of one.
Once, cutting through an OR at night to get to L&D, I walked right in to a room with a dead body in it. A tech was wrapping things up, but on the table was a huge shell of a body, it's entire thoracic and abdominal cavity empty.
The harvestors had done their work in the night
posted by All Rounder | 1:38 AM
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