It hit me.
The unexplainable roulette wheel of acute appendicitis respects no one.
And this time, it was my number that came up.
Around 3pm a week ago I started feeling a little pressure in my tummy. Just general discomfort, nothing big. After dinner we took our two year old for a walk around the neighborhood, and by the time we headed back home it was becoming uncomfortable to walk. At 10pm I noticed my lower right abdomen was a little tender to the touch, and I told my wife I might need to head to the ER at some point in the night.
A few hours later I was sauntering into the Emergency Room, freshly showered, with my book bag and clean clothes -- you know, just in case. A few hours later I was admitted with diagnosed acute appendicitis, my surgery scheduled for the following morning.
Afraid, Not?
Was I afraid? Well in once sense, the worse part of the whole affair were the two needle pricks - one to start my IV, the other to take my labs at 4am. I remember these things because I HATE needles. They give me the heebie jeebies. I'm of the firm belief that metal has no place digging around in my veins, regardless of the length or gauge.
Be that as it may, I'd be lying if I said I didn't think about the countless things that could and do go wrong in "routine surgeries." I had a vivid flashback to the first da-Vinci robotic surgery I saw in 2009, as the surgeon was obviously doing one of his first solo runs on the fancy new machine for a prostatectomy, leading to no shortage of accidental snips and challenging cauterizations along the way. I'll never forget the doctor telling the circulating nurse to call the patient's wife after they closed to tell her, "The surgery went great." That's when I learned that surgeons take their Shakespeare seriously, taking to heart the maxim that "all's well that ends well."
So, there I was, sitting in a hospital bed in the middle of the night thinking about how all the nice nurses here were telling me that they do these procedures "laparoscopically these days, which is much safer." Meanwhile, I was fighting back visions of nicks in surgical insulation that may cause internal burns to my organs, or be the spark necessary for a surgical fire. I was thinking about how the shafts on laparoscopic Maryland dissectors can pull away from the distal tip and form the perfect breeding ground for biofilm. I was remembering all the pictures I've seen of first generation laparoscopic graspers taken apart on repair vans to reveal how impossible it really is to keep those particular models clean.
Trusting the Process(ing)
But, like every other patient in the world, I was helpless to change anything. While I may have known enough to worry about the quality of my surgical instruments, I was still a patient. I had never been in this facility, never seen its Sterile Processing department, never met its manager, and had no idea where they landed on the spectrum of broken --> beautiful, from seriously flawed --> superbly flawless. Did these technicians care about their profession? Did they believe in their daily mission to #FightDirty? Or were they Snap-chatting in Prep/Pack when they should have been inspecting my aspirating needle?
Ultimately, I was confronted with only one choice -- trust the process. I had to hope and believe that this Sterile Processing team had it together, that they were committed to being weapons of mass microbial destruction, every instrument, every time. The trays they would use for my procedure would have already been through the entire process and were now (hopefully) sitting on a case cart in some hallway with my name on it. My name. All those instruments were going inside my body, with the purpose of healing and not hurting. I had to trust that this would be the case.
One Shining Moment
As they rolled me out of Pre-Op toward to OR, the nurse put a shot of something in my IV to "relax" me, and in about 60 seconds I was out, to wake up again on the other side of all the surgical fun. As far as I know and can tell, the surgery at least "ended well." The pain is gone, along with the inflamed but not ruptured appendix, and all three incisions look to be healing well. I can't help but feel grateful for the prayers of my friends, the grace of God, and the skill of the entire team of caregivers from the basement to the OR who had a hand in this example of excellent surgical care.
But the other major takeaway from this experience has to do with what I've called elsewhere our Sterile Processing Moment. The brewing synergy in our industry of an appreciation for the power of data to drive smarter decisions, networking and education to create more critical thinking technicians, and product innovations to solve the systemic problems that have dogged us for decades -- are all coming together at once to break down generations of Sterile Processing thinking and perspectives on what's best, possible, and sustainable. The old is passing away, behold the new is here.
If you are reading this article, the monumental power of social media networking has already reached out and touched you. You are already playing a part in this sterile processing moment. With networking comes insight, with insight comes perspective, and with perspective comes the courage to change. And changed minds are changing the world.
So, on behalf of patients everywhere -- moms, dads, brothers, sisters, babies, and grandparents -- I want to thank you. Where the chaos of oversights and infection could have reigned, you seized your moment, our moment, and chose to #FightDirty in order to heal the world.
You are the future of an industry and the great hope of safe surgery across the globe.