I fainted the first time I saw surgery. I was a history major at the time, but I’d been thinking about nursing school, which seemed more practical than history. My aunt, an anesthesiologist, was pitching medical school instead, and she invited me to Galveston to spend a week with her in the O.R.
The random archive known as memory preserves one thing from the visit. I had entered an operating room, trailing Aunt Doris. Nervous about getting in the way, I’d followed her closely. Unexpectedly, she stepped left. Suddenly, I saw what I presumed was a patient in the center of the room on an O.R. table.
In truth what I saw was a lump covered with blue drapes. There was a leg sticking out of the blue lump, and the knee associated with that leg was impaled by something long and metal. A harpoon? A spear? I started to reason my way through this question. Then I fainted.
When I came to, I was sitting on the floor, slumped against the tile wall in a hallway outside the O.R. Doris handed me a glass of water.
“I’ll be back,” she said, and walked back into the fray.
I sat for a while, recovering and embarrassed. When my aunt popped back out of the O.R., I apologized for fainting. She maintained that it was no big deal, that lots of folks faint in the operating room. Sure, I thought, not believing a single word she said.
Somehow I made it through the week managing to stay upright. Eventually I went home still unsure about nursing or medicine. I cringed each time I thought about my nosedive in the O.R. I took a job in a city morgue to toughen myself up, and after a couple years of science courses, I ended up in medical school. A decade later I became a surgeon.
It turns out that Doris was right. Lots of students faint in the O.R., especially at the beginning of the year. We revive them, as I was revived. They’re always embarrassed, just as I was embarrassed.
It’s hard to predict who will faint and when. Some faint at the opening incision, as drops of blood form along the path of the knife. Others tolerate the blood, but grow shaky and ashen when the orthopedists break out the drills and saws.
The foul odor of infection pushes some students over the edge. For others, the sight of specific organs is the catalyst. My husband hit the deck in the neurosurgery O.R.
“It was THE BRAIN,” he explained, pointing at his head. “I was staring at the living brain, of a living human being. Then boom.”
Inexplicably, one of my classmates even fainted in dermatology clinic. The dermatologist took a tiny cookie cutter and removed a quarter-inch circle of skin. The wound was smaller than the eraser on the end of a pencil, but as he stared at it, John went down. Bang. He cut his forehead, which made a wound that was bigger than the biopsy. He was ashamed and told everyone that he’d hurt himself in a bike accident.
The science of fainting is well understood. Noxious stimuli affect the human heart. Bad news or scary sights can drive our heart rate down to 20, which means not much blood is being pumped up to our head. We lose peripheral vision and hearing. If we don’t sit down quickly, we fall down instead.
New medical students faint, I think, because the things we see are shocking. We are empathic beings. The first time we see a knife applied to human skin, we feel the sharpness of the blade. When we witness the human brain exposed, we are distressed by the diagnosis that prompted excavation of the skull.
It’s an amazing attribute of our humanity that we can faint at the misfortune of others, that seeing the blood or bone of our fellow humans can make us sweaty and swimmy-headed. Over time we learn to regulate this response, but it takes experience. We train our minds to suppress our visceral feelings of shock and horror, to fill themselves instead with anatomy and the specifics of surgical procedures. Still, I find that in the moments just before surgery, the part of me that fainted looks at the anesthetized, exposed patient and is reminded how frail we are – both the patient and myself.
As you read this, it’s July – the month when new medical students start in the O.R. Across America, students are fainting. When they wake up, they’ll be embarrassed, though they shouldn’t be.
I try to warn students that they may faint. I tell them that fainting signals their humanity and that they should feel affection for their fainting self instead of embarrassment. Certainly, they’ll never lose that self, just as I have never lost the girl who fainted long ago at a knee arthroscopy in Texas.