The Dorsalis Pedis Mishap

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Second to the last day ko na of paying my dues in what I call the “surgical retribution”. I was assisting Dr. Jon (a medical intern who is at the same time a licensed dentist). And it was already our last patient, our fourth one after several circumcisions. Graduation ng mga UPCM interns kaya ang naiwan ay ang PGI, si Dr. Jon. Natapos na din ng pag-assist yung mga kasama kong ICC’s.

Patient was Ms. R who has a small mass over the dorsum of the left foot. Excision was initially uneventful, especially with Dr. Jon, who I think is good enough, as it is already the second day I am assisting him. We were careful not to destroy the mass which the surgical resident, Dra. Che, diagnosed as benign tumor. Naisip na namin ng intern sa simula pa lang na hindi iyon basta lipoma o sebaceous cyst. Kaunting blunt dissection, and we’re done.

Nang biglang… may squirt of blood. Kala ko, minor lang, so we just need to clamp it with mosquito then tie with the cotton tie. Then the intern asked me to call the resident who had just finish in her operation. Ibig sabihin, it’s something that he can’t handle alone.

“Maam, may naputol pong artery,” sabi ko. She just smiled, and the nurse went to provide cotton ties. Wala akong sinabi kung sinong nakaputol, pero alam ko, sa smile ni Maam, ako yung salarin na iniisip niya.

“Maam, sorry,” sabi ni Dr. Jon. Okay pa kaming tatlo, relaxed din ang walang alam sa nangyayari na pasyente namin, kahit bumubuhos ang dugo na parang fountain.

The resident then meticulously tried to reduce the nick by tying up the vessel, twice or thrice I think. That time, I was already praying. And telling myself, I don’t want to become a surgeon. I think I can’t handle situations like this.

Dra. Che released the mosquito clamps… and boom, blood spattered, at napaiwas pa kami. That time I can already sense the change in mood of the resident, but she contained her anger/anxiety by looking away for several seconds. Napatingin na lang din ako sa intern who is clueless of what to do next.

“Bulldog vascular clamp, please,” sabi ni Dra. Che. I was already anxious deep inside, especially when the cotton tie was not successful against the nick on the artery. Nagiging clumsy na rin yung kamay ng resident, ilang beses niyang naputol yung suture.

Nang biglang… pinutol ni Dra. Che yung vessel intentionally. I was flabbergasted for a moment. Iniisip ko, was that the solution to that mishap? Kaso wala na akong maisip, unless okay lang magka-hematoma at maging anemic ang patient. Hindi na rin ako nagtanong, for the whole moment was a period of silence, and probably prayers.

The resident cut the dorsalis pedis, tie it with the cotton tie at each end, then told Dr. Jon to close the wound with simple interrupted. As the resident walked away from the room, I was thinking of what will happen to the patient’s left foot. I was convincing myself that it was the only thing we could do, because reducing the nick is close to impossibility. The gush of blood precludes the procedure the resident is trying to do.

I just hope and pray that it would not be that bad. I left before they all left. Sana pag-alis ko, na-explain din sa pasyente kung ano yung nangyari. This happened from 12 noon to around 3 pm. Hence a very late lunch.

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