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Adventures of a New PA

Patient Awake! For Surgery, That Is

Published December 19, 2011 8:58 AM by Timothy Loerke
Have you ever considered staying awake for your surgery? I have absolutely no desire to be awake for any moment where knives and drills are involved on my body. Back in school, I saw one surgery where the patient had to stay awake due to a heart condition. It was weird to see the dividing line of the drape where the surgeon did his business while the patient talked to the anesthesiologist.

Last week, I was about to enter the OR when I saw a sign on the door that said, "Patient Awake." I asked one of the staff what that meant, because I had never seen this sign before. I never thought it actually meant that the patient would be awake during surgery, partly because nobody told me this during pre-op. I was shocked to find out the reason this patient was staying awake. He wanted to be a PA! I went up to the patient and said, "You know, there are easier ways to watch a surgery." He said, "Yeah, I know, but I really wanted to see my own." Anyway, the surgery went fine. The patient didn't suffer anything ghastly.

What was most interesting about the surgery was not the patient or the procedure. It was the fact that the overall atmosphere of the OR changed. No music. No joking. No angry surgeons. Just polite, professional and educational talk filling the suite. The sign was on the door so that people wouldn't walk in blabbing away about this or that, or make inappropriate comments about this or that ("What is said in the OR stays in the OR"). I began to think how medicine would be different if at all times we acted like patients were awake, even when they weren't in the same room. People would be treated differently. Minds would be kept clear and sharp. The attitude would be to serve and to educate. Medicine would be totally different.

In ways, I wish every patient stayed awake, because it causes you to slow down and think before you speak. But then again, I would never wish for anyone to be awake during his or her own surgery, not even my arch nemesis. It's a novel concept to consider, but it may change the behavior of us medical professionals.

4 comments

This article on an awake patient has a little different twist, but nonetheless fascinating. I ironically just read your post and then came across this article.

http://www.guardian.co.uk/lifeandstyle/2011/dec/30/stayed-awake-during-operation-experience?CMP=twt_iph

G January 3, 2012 8:09 PM
Irving TX

New reader to your blog - LIKE IT !!!

Have been NP for 15 years, and find your blog very refreshing ...

thank you

Arlyn Duval, Family Practice - Family Nurse Practitioner, El Centro Regional Medical Center December 29, 2011 7:55 PM
El Centro CA

I have been following your column for a while now.  Just wanted to say thanks for being such an inspiration.  I have been a practicing PA-C now for about 3 months in Primary Care/ER, in a rural community.  It is crazy because I have seen a lot of myself in your posts about being a newly minted physician assistant.

Keep up the good work writing and practicing in Ortho-Surg.

Sonny T.

Sonny Talbot December 20, 2011 2:15 AM
WA

I had NO idea that this was something you could request! I just had surgery last week (open laparotomy to remove a dermoid ovarian cyst). Wonder if I could've asked to stay awake? Not sure if I'd really have wanted to, but I'm a pre-PA student and I can see how that could be really interesting. I still had a really good experience though- it's amazing how much knowledge I gained about medicine by being the patient for once. It was an interesting perspective- although not one I'm hoping to repeat anytime soon!

BTW- I love your blog! I stumbled across it a few weeks ago and have been working my way through your archives- it feels like something of a road map for what the next few years of my life will be like. You're a wonderful writer and it's so inspiring to see, step by step, how you became a PA.

Kristen December 19, 2011 12:40 PM

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