What really happens in the OR?

With all of the controversy around masks these days, people often assume that it's pretty easy for me as I wear a mask in the OR most of the day.  The truth is, I don't think it's easy for any of us to wear a mask all day.  I'm pretty used to it though.

The OR is a special place for me.  It's where I am truly in my zone.  I am happy there.  I have many memories of training, working with my father and brother, and most importantly, helping others. But yes, there are rules.

The OR is a room for sterile procedures.  Not everything in the room is "sterile", but conditions are set up for minimal contamination.  The room is vented in a certain way, there are cleaning protocols that often use bleach and require timing to keep bacteria counts to a minimal level.  The personnel wear clean scrubs, hats, shoe covers, goggles and masks.  Interestingly, these items are designed to protect the OR personnel as much as they are designed to protect the patient.

Once a surgery begins, there is a sterile field on the patient.  That means, only those in sterile gowns and gloves can touch that site.  Only other sterile instruments can touch that part of the patient.  That area is cleaned with chlorhexidine or iodine and draped off.  The rest of the OR remains non sterile but "clean."  Traffic in and out of the room in minimized once a surgery begins.  If we are placing an implant, traffic in and out of the room may even be prohibited to prevent infection.  Everything is designed to keep the patient as safe as possible from infection.

The OR can seem scary from the outside, but it can be fun.  I have to say, I owe a lot to my father and brother for teaching me how to keep an operating room pleasant and not stressful.  The surgeon is the "Captain of the ship" and sets the tone for the case.  My father set the bar pretty high for me.  He was not only a great surgeon, but was calm, kind and funny.  I think I am calm and kind but I'm still working on the funny part.  My brother was my assistant for 16 years.  He had  a great skill of keeping the OR mood happy when we were in a complex case that was very difficult.  When I worry, I get quiet.  Mike was great at taking over the conversation when I was concentrating or just lost in my work.

So for me, the OR is not scary.  It's just my place.