Slicing someone open and fixing their insides takes some intense concentration and planning. These surgeons reveal what it really takes to pull off a big procedure.
u/TheNerdymax asks:
Surgeons of reddit that do complex surgical procedures which take 8+ hours, how do you deal with things like lunch, breaks, and restroom runs when doing a surgery?
It is well thought out
Giphy
There are several ways surgeons deal with this. Before they scrub in, they have already mentally thought out their basic timeline in these really long cases. So, how much fluid, caffeine, food and type of food gets planned.
Coffee and pee break
Giphy
I'm a liver transplant surgeon. I do more living donor than deceased donor transplants. They take longer, typically 8 to 12 hours depending on the complexity.
In most cases, there is a break at the point when the recipient liver is ready to come out but the donor liver is not. There is time for a coffee and a pee.
The extensive planning
Giphy
Well, I had a 14+ hour brain surgery a couple years ago. It was supposed to be less than 8. I was having an electronic pacemaker type of device installed in there to help control my epilepsy. My neurologist and neurosurgeon had spent more than a month planning exactly where each wire and screw was going to go. No time for breaks.
Nap time is crucial
Giphy
Level 1 trauma ICU nurse here. One of the longer surgeries for my unit was 23hrs on the table. I asked my cardiac surgeon how they are able to go for so long. He told me he started the emergent case when it arrived and at the 12hr mark relief team was in place to come in and take over. He stayed in the OR till the 16hr mark napped 4hrs then came back in.
It takes a village
Giphy
As someone who has worked in an OR here's what happens. They break scrub if they really have to piss. In large cases there are usually multiple surgeons to include residents, fellows, med students and interns.
When you are focused food is not an obstacle
Giphy
It's not that hard to go that long without food or a break when you are that focused on something.
That being said, most cases aren't that long and if they are, it's ok to break scrub to eat/drink/bathroom/breastfeeding surgeon moms will go pump
Everything before hand
Giphy
Hey. I'm a hand surgeon. For longer procedures you typically try to take care of everything beforehand. Eat, use the bathroom, make sure everything is good to go. The anesthesiologist would be in charge if I left the room, though.
Technicalities of "scrubbing out"
Giphy
Trained in pediatric CV surgery. Many long cases. The surgeons and ancillary staff would scrub out. The lead surgeon would usually only take 1 break during a long case. (usually multiple surgeons in the same case) You will never see the surgeon and the anesthesiologist taking a break at the same time though. There always has to be an MD/DO present in the O.R.
Tag team surgeons
Giphy
It's rarely a single surgeon, that's the simple answer
Especially in complex operations, there will always be a team of surgeons (often, there will be a trainee), and they will switch in and out based on the phase of the surgery.
The pros know, just do it!
Giphy
I am a General Surgeon. You just do it. 12 - 15 hour cases are common. Some of these answers are ridiculous.
The diet Dr. Pepper gets them through
Giphy
I'm a medical student, but during my surgery rotation, I worked on the hepatobiliary/transplant team which are notorious for long surgeries. There's often one attending physician, 1-3 residents at different levels of training, and a medical student for these long surgeries. I was in a Whipple procedure (very, very long), and at hour 7, the chief resident dismissed me and another resident to go to lunch, and then we came back after eating and peeing. The attending would pop in and out between this surgery and another one he was overseeing. The chief resident didn't take a single break for the entire 10 hours. Surgeons are weird, and they never pee, and they live on Uncrustable sandwiches and diet Dr. Pepper.
If it's not over, you keep going
Giphy
I have a funny story about this. Surgery was my first clinical rotation during medical school. My first case was a very complicated neck cancer which required General Surgery, Vascular, and Plastics to remove a tumor and replace the patient's esophagus with part of his intestine. We started around 8:30, and by 11:30, I was thinking about lunch, wondering where we would go eat whenever we decided to break. By 12:30, I was getting kind of hungry, hoping we would break soon. At 1:30 I was thinking, "Surely, we have to break soon", and by 2:30 the realization hit me, "Gosh, I guess these guys just don't break for lunch, f*** me." 20 years later it seems obvious to me that if the case ain't done, you keep going until it is. You can scrub out to go pee if you have to, but in my specialty, if the case is going on that long, something's not right and you're so focused on fixing what's wrong that food and water don't even cross your mind.
Everything must be considered
Giphy
In my experience, needing to blow your nose is a far bigger issue for everyone than hunger or needing to pee. Imagine spending five hours sniffing and feeling a drip on the end of your nose.
You do what you have to do
Giphy
I've been a surgical nurse for years and I've been in my fair share of 12+ hour cases. Surgeries that are this complicated quite frequently involve more than one surgeon and their assistant(s), usually a PA or NP. A lot of the time they will tag each other in/out. Some of the longest cases I circulated were cancer surgeries that involved immediate first phase reconstruction, so you'd potentially have a cancer doc and a plastics doc, sometimes a neurosurgeon, etc. Each surgeon gets their turn, so there's opportunities for breaks. And in some cases, they just do what they have to do.
Concentration makes time fly
Giphy
I'm a resident in a Department for neurosurgery. Our surgeries can last very long. If you are the surgeon time will fly because you are focused and concentrated. If you are the assistent it is sometimes very hard to stay concentrated and awake. Most of the time we use the Microscope during Brain surgery. Standing for Hours and looking in the microscope while trying to stay concentrated till the performing surgent needs your assistence can be brutally hard.
Break after 8 hours
Giphy
6-8 hours are longer cases but I wouldn't typically plan to take a break during that. Time does go very fast when you are doing the operating. On OR days I routinely go most days without eating until I'm done with everything for the day and can sit down and enjoy it.
It's all about strategy
Giphy
I frequently do long operations for complex reconstructions and time sort of passes without knowing. I typically eat a big breakfast but limit liquids other than standard small coffee.
When the surgery is a marathon and then some
Giphy
My aunt had a recurring brain tumor. Skipping excessive detail, she was 22 years past her 3rd brain surgery when it was discovered that it had returned. Her 4th brain surgery took 10-hours. I met the surgeon afterward. He looked like he had just run an Iron Man.
When you are in the zone
Giphy
I'm a veterinarian, and I do surgery a few times a month (I work with laboratory animals). For me the excitement and focus while doing surgery kind of shuts off everything else.
A sponge means break time
Giphy
Medical student here, have been in 6+ hour procedures before. It's dependent on the procedure, but in our case we hit a roadblock that required another surgeon to come and evaluate. We had 2 surgeons, so while waiting for the consult, one surgeon along with me and a resident were told to go take a quick break. They just covered the opened area with sponges (they're more like towels but are called sponges), and we broke scrub to go out quick.
It takes training
Giphy
I'm a cardiac surgeon. Routinely do operations in the 4-12hr range. I trained as a resident for 10 years after medical school to even start to practice independently. When you are a resident/fellow in a rigorous surgical field, you train your body to get used to those procedures and standing for that long.
Some surgeons are just wimps
Giphy
Surgical trainee here- I've only scrubbed in 8 hour+ a couple times- the most recent being last month (simultaneous pancreas kidney transplant), where we started at 2pm and ended at 10.30pm.
I'm pretty young (26) so it's no big deal for me, but I do respect the fact that my bosses (40-60) manage to plow through too. Throughout medical school + training you just get used to it, no scratching itches, no toilet breaks, delayed meals.
Personally I don't have lunch for physique reasons (intermittent fasting) and can not eat for more than 30+ hours and still function pretty well. This is not my medical opinion, but I think 3 meals a day is just a social construct, I don't think humans actually need to eat that regularly.
They just do whatever they want
Giphy
'm a perfusionist, which means I run the cardiopulmonary bypass machine during heart surgery. Often times, nurses and physicians have people they can call to come relieve them for a moment while they relieve themselves. Surgeons and anesthesiologists have a lot of power/clout in the operating room and can hold up the procedure for a bio break, but if a non-physician tried that it wouldn't go over well.
deprivation and candy
Giphy
Surgeon here. Two things can happen, one, Im so focused on the procedure that I dont feel hungry until im done, and if I dont take liquids during the surgery usually I dont feel like I need to pee. Im talking about a 5 to 8 hr surgery. I try to go into long surgeries well fed. All this being said, Iv had to run to the bathroom for emergencies or felt a little weak for lack of food. They can put a candy in your mouth or something easy to eat, or you can just scrub out and then scrub in again. There are usually 2 to 3 surgeons scrubed in, and not every part of the surgery is critical, so there are moments where you can leave and your team can carry on for the time your out.
This is extreme
Giphy
My old roommate is a surgical tech.
He has told me that some surgeons have catheterized for long surgeries. Don't know how common that is, but it happens.
There is a prize for self control
Giphy
Surgical subspeciality resident here - you get good at holding it and planing your hydration accordingly. I've gone 11-12 hours without pissing/drinking/eating. Food tastes delicious afterwards.
Short mental breaks are important
Giphy
Not that big a deal honestly. Over the years of training you just get used to it. Usually I use the bathroom before I start a case. Very rarely during an unusually long case I may need a break for water or a snack. A break can help with mental fatigue as well. Usually I can find a stable minute to sneak out for 5 minutes if I need it.
I'm never hungry while I operate but can be starving after I'm done.
Time stops when you have a life in your hands
Giphy
I assist in surgery. Honestly you forget about time.. A 8 hour surgery might seem long when you think about it but in reality you don't notice time passing.
When we're intoxicated, or even the slightest bit tipsy from having a little too much to drink, our immediate perspective on things is hazy.
But there's nothing like a bit of alarming news or a jarring incident to snap us out of the fog and focus on the moment.
Sometimes alcohol isn't always to blame for our impairment.
It can be a state of mind, like a perpetual numbness from being complacent in life, and all it takes is one shocking moment to rattle us back to our senses.
Curious to hear from strangers online about this type of scenario, Redditor Known_Challenge_7150 asked:
"What’s one thing that sobered you up real quick?"
These individuals were witness to shocking events that sobered them up right quick.
Bleeding Out
"Got out of a taxi and found a naked man profusely bleeding from his head crawling up the driveway in my condo. Called him an ambulance completely forgot I was absolutely wasted until 45 minutes later when I'd helped him translate and in to an amublance and stepped in my front door."
"Later a few days later learned he'd slipped in the tub and literally crawled out for help. Poor dude. He was fine but I genuinely thought he was going to die there."
– DongLaiCha
Tragic News
"At a bachelor party and we got a phone call that the groom’s father had suddenly passed."
– accountnameredacted
Bottom Of The Barrel
"I went to visit my parents back in July. I was homeless and deep into fentanyl addiction so I lost a lot of weight. My folks could see it. They knew something was up. Anyway, I spent the night and I was getting ready to leave in the morning and I looked at myself in the mirror for a good long time. I finally had enough and told them everything. They took me to detox, from there I went to rehab. Graduated in August and been living with them ever since then. I have 160 days clean and sober."
– Crotch-Monster
A reality check can be enough for some people to snap out of it.
Like Father, Like Son
"Was driving a drunk friend home, he had been on a bender again and was smart enough to call me for a lift rather than try and drive. As I helped in to his house his mother came down the stairs and said 'your as drunk as your father' and went back upstairs. I haven't seen him drunk since then, he still drinks but the thought of turning into his dad scared him out of hard drinking."
– psycospaz
Busted
"Flashing blue lights."
– FiddleOfGold
"This sobered me up just thinking about it."
– redmaple_syrup
Losing Sight
"Woke up to no sight in one eye. I had cataract surgery so just thought one of the lenses had slipped and it was an easy fix. Eye doc says nope, you had a stroke. I loved soy sauce, teriyaki sauce and salty food, which caused high blood pressure, which caused retina damage. Over six months was able to get most of my eyesight back with medication, and all back within a year. Trying to navigate life with one eye was very sobering. Started taking HBP much more seriously."
– MissHibernia
Quitting The Bottle
"Looked up someone I went to highschool with who was an awesome guy. Found out he had been dead for 3 years from alcoholism, at age 33. I made an overnight change. I hadn't started drinking that night yet, 10 months ago. Haven't touched it again since."
– omgtater
These disturbing moments were enough for Redditors to immediately come to their senses.
Unplanned House Guests
"Me and a buddy Woke up in someone’s living room, realized neither one of us knew the people, they were just nice and let 2 drunk guys sleep on their living room floor. We didn’t even say goodbye."
– Oneinsevenbillion75
Serious Health Warning
"Elevated liver enzymes."
"And the knowledge that this sh** was gonna kill me and I just couldn't orphan my family over it."
"So I opted for recovery, instead."
"Clean and sober since June 5, 2009."
– Far_Meal8674
The Joyride
"Grew up in a rural area. The little town hosted dances at the hockey arena, everyone (adults and kids) went and they overserved everyone, regardless of age. I was maybe 16 or 17 and was absolutely sh*tfaced, and jumped in the back of someone's truck with about 8 other people to go back to someone's cottage for after dance drinking. The driver (still don't know who it was) started racing one of his buddies and we whipped around small dirt roads, flying around blind corners on the wrong side of the road, going god knows how fast. It was basically a disaster waiting to happen. It was crazy scary and I was sober and thankful to be alive when we finally arrived."
– foxfood9116
The human psyche is a fascinating thing, isn't it?
How we can automatically focus on something urgent at a crucial time, even after getting buzzed from drinking too much alcohol.
But as we're in the thick of the holidays, it's a good reminder to drink responsibly and stay off the roads if you drive to your celebratory destination.
Cheers. Stay safe. And happy holidays.
We've all complained or vented about something in our lives which, in the grand scheme of things, wasn't exactly a problem, or is very easily solved.
Then there are those who complain about things that others almost hope will happen to them at some point in their lives.
These are known as "first world problems", as they are problems that pretty much only the world's one percent faces.
From having to fly business class instead of first class, or being served Roederer instead of Dom Pérignon, these complaints are often met with amusement, bewilderment, or even anger.
Redditor jennimackenzie was curious to hear the most absurd "first world problems" anyone ever complained about, leading them to ask:
"What’s the most ridiculous 'first world problem' you’ve seen people get worked up over?"
"Tale As Old As Time..."
"I once knew a mom who was legitimately devastated, to the point of tears/grief, because a doctor predicted her 8 year old daughter's final height to be around 5'2","
"Which wasn't tall enough to get cast as Belle at Disney World."
"That was the child's (and her mother's) only dream in life, apparently."
"Didn't appreciate my suggestion that she could be Minnie or Mickey."
"Lol!"
"Only a face character would do!"- TravelLovingMom
"Must Be Funny, In A Rich Man's World..."
"My boss from about a decade ago was this insanely rich dude who always went to the bank to get fresh and crisp currency."
"He'd call the bank in advance to make sure they had some on hand."
"I think he was a germaphobe."
"He had a trash can that he'd throw $1 and $5 bills in that he thought was 'dirty' and regularly just donated it vs spending it."
"I asked him why he did this and he said it was too much trouble and asked if I wanted it."
"I said f*ck yeah dumped it into my bag and when I got home it was close to $400 in singles and fives.
"Another time, he wanted to upgrade all the computers in his studio, so we went to a store and bought 10 PCs."
"They all had $150 mail in rebates and he wasn't bothered to go through the trouble of mailing them in."
"3 weeks later I received $1500 after spending a whole afternoon filling out all those goddamn forms."- azninvasion2000
Money Burn GIF by nog
Giphy
Who Wore It Better?
"When I was about 19 years old, I was at my boyfriends family BBQ."
"I was wearing this pretty floral sundress."
"His cousins girlfriend showed up in the same dress and she was SO mad that she went and changed."
"I will never understand being upset when someone is wearing the same thing as you.'
"Did you really think that your shirt you bought off the rack is going to be unique to you?"
"No."- mertsey627
Seeing Red! Or Blue In This Case...
"The blue of the balloons wasn't quite the same as the bridesmaid's sashes."
"Years ago my wife and I attended a wedding."
"It was very low key."
"The dinner was in the dining hall at the university where the couple met, cinder block walls and all."
"It was a Baptist wedding - no booze and very serious."
"The dark blue balloons attempting to liven up the hall were a slightly darker shade of blue than the sashes on the bridesmaid's dresses."
"The bride lost here sh*t and absolutely raved for nearly an hour."
"I can't remember how they finally managed to talk her down."- mechant_papa
south park wedding GIF
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See You In Court!
"Rich neighbors who end up in expensive court battles because they disagree about where a tree can be planted or whether the color of a fence fits in with the street’s 'amenity'."
'These disputes get really heated and rack up huge lawyers’ bills."
"The most pathetic part is after the judgement when they are arguing about who should pay the other party’s costs."
"Lots of affidavits filed citing the 'emotional distress' they had to endure, or painting themselves as brave warriors who were forced to take a stand to fight for 'justice'."
"Also lots of pompous litigants insisting that the judge refer to them by their 'Dr' title."
"An absolutely insane dumpster fire of entitled rich people problems."- ElectrocRaisin
It's Always People With Money Who Don't Want To Pay!
"I work in a public library."
"People will get so so mad if they have to be put on a wait list for a book."
"A popular book that just came out."
"Ok our services are not only free but so are the books."
"You’re welcome, a**holes."- Switchbladekitten
A Warm Butt Is A Happy Butt!
"My own."
"We have a bidet toilet seat (Fabulous! Everyone should have one!) and not only does it wash your bum and blow dry it, but the seat's heated!"
"It's shocking how much a heated toilet seat makes the whole process more agreeable."
"Except: We had a power outage and I went to use the toilet and the seat was cold!"
"Unacceptable!"
"This shall not stand!"
"I was really upset because it didn't feel good."
"Then I stopped and thought: This is the most first-world problem anyone's ever had."
"I was really pissed because my heiny was tepid."
"I got over it."- DeathGrover
homer simpson episode 23 GIF
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Holy Matrimony!
"Weddings are a gold mine for this question."
"People get so hyped up over their 'most important day of their life'."
"They'll destroy friendships, go into debt, and have crazy expectations."
"It's not always the couple who go crazy, either."
"Sometimes, it's the parents or another family member who feels entitled to control the wedding."
"It's just a party."
"Be considerate of guests, have plenty of food and drinks, and enjoy it."- magicrowantree
When Fast Food Isn't Fast Enough...
"Having to pull off to the side to wait for a drive-thru order to be brought out to you because your food isn't ready and there's a line building up behind you."- demanbmore
In Case You Don't Think Customer Service Employees Are Undervalued...
"I was working the return desk at a Target next to a military base so I have so many stories."
"One of my favorites was a lady who had her baby shower before revealing the gender and was livid that she had received floral newborn diapers when she’s having a boy."
"It was a huge box of super expensive, all organic diapers, that we didn’t carry and therefore could not return."
"I cannot accurately express her fury and disgust."
"How dare either suggest her boy could wear feminine diapers."
"I suggested she donate them if she didn’t want to use them and she instead threw away the entire box."
"When she left we pulled it out and threw it in our donate bin."
"There have also been multiple times where mom’s order massive toys and when we bring them out to the car they get furious that they aren’t wrapped."
"We don’t offer wrapping services."
"Here’s the thing, if you don’t want your kids to see the toys you got them for Christmas or their bit to day DON'T BRING THE CHILD WHEN YOU PICK IT UP."
'I’ve had multiple women scream and curse me out that I had ruined their kids Christmas by bringing the toys they ordered out to the car like they requested."- clever-mermaid-mae
Customer Service Waiting GIF by Juno Calypso
Giphy
Happiest Place On Earth!
"I used to work for Disney."
"That in itself should tell you everything."
"However for fun I'll give you two specific stories one form our tech department and one from my wife who worked bookings."
"I specifically worked for their call center to help with technical issues with magic band and the website."
"Suddenly got worse huh?"
"A right of passage call everyone has at least one story of is the 'Dome call'."
"Basically there is a subset of Disney Guest (TM) that believes if it rains at Walt Disney world there is someone that will push a button to encapsulate the whole of Disney property in a dome to keep out the rain."
"I'm not kidding."
"If this button is not pushed they call our tech department to angrily ask why."
"My wife worked booking."
"Pretty much everything including Bibbidi Bobbidi boutique and Pirate's league."
"These two things did roughly the same thing difference being price and theme."
"BBB was expensive did more and was focused on princesses, pirates league did a bit less and focused on mermaids and pirates."
"Lady called up my wife, and got pissed about BBB being booked up (It goes FAAAAST)."
"Karen: 'Im going to give the phone to my daughter and I want you to tell her how you are ruining her vacation by not letting her do BBB'."
"Wife proceeds to explain how pirate's league is so much cooler and how she can be a mermaid or pirate and basically gets the kid to start demanding to their parents about how they want to be a mermaid instead of a princess."- trollsong
Disney World GIF
Giphy
The horror!
Being booked into a junior suite at Disney World instead of an executive suite!
It's almost as bad as having no money for groceries, or no food to feed you children...
Said absolutely no one.
For many childhood memories are overrun by living nightmares.
Yes, children are resilient, but that doesn't mean that the things we see as babes don't follow us forever.
The horrors of the world are no stranger to the young.
Redditor -2sweetcaramel- wanted to see who was willing to share about the worst things we've seen as kids, so they asked:
"What’s the creepiest thing you saw as a kid?"
Serious Danger
"Me and my best friend would explore the drainage tunnels under the Vegas area where we grew up. These were miles long and it was always really cool down there so it was a good way to escape the heat of our scorching hot summers. We went into this one that goes under the Fiesta casino and found a camp with a bunch of homeless people."
"Mind you we are like 11 years old lol. And we just kept going like it was nothing. It wasn’t scary then but when I look back at it we could have been in some serious danger. Our parents had no idea we did this or where we were and we had no cellphones. We could have been kidnapped and never have been found."
oofboof2020
Waiting for Food
"I was at a portillos once when I was 12 and I was waiting with my little brother at a booth while my parents got our food. This guy was standing with his tray kind of watching me then after a couple of minutes he started to walk over really fast not breaking eye contact with me."
"He was 2 feet from the table and my dad came out of nowhere and scared the s**t out of him. He looked so surprised and just said he wanted to see if I’d get scared or not. He left his tray full of food near the door and left. My folks reported him but we never went to that location again since we found a better one closer to home."
nowhereboy1964
Captain Hobo to the Rescue
"When I was a pretty young teen, my friends and I were horsing around in San Francisco and started hanging out to smoke with some homeless guys. Another homeless dude came up and began aggressively trying to shake us down for anything (money, smokes, a ride, drugs- all of it) and wouldn’t take no for an answer."
"We got in over our heads and could tell this guy was now riling the other 2 guys up and they were acting like they wanted to jump us. Some grandfather-looking old homeless man appeared out of nowhere and yelled at us to get the f**k out of here- nice kids like us don’t belong down here at this hour!!"
"Captain Hobo saved our lives that night. My parents sincerely thought we were at a mall all day lol."
FartAttack911
Survival
tsunami GIF
Giphy
"I was 7 and survived the 2004 tsunami in Thailand. Witnessed the wave rise way above the already massive palm trees (approx. 40ft?) and my family and I watched/heard the wave crash into the ground from a rooftop."
faithfulpoo
These Tsunami stories are just tragic.
On the Sand
Scared The Launch GIF by CTV
Giphy
"We were a group of kids who went to swim in a local lake. And there was a dead body on the beach with their hands raised and their legs bent unnaturally that local police just took out of the same lake. I've never put my foot in these waters again."
oyloff
Be Clever
"I was walking to school and I was about 5 or 6 years old and some guy pulled up beside me in his car and asked if I would get in. He also offered me sweets to do so. I said no. The creepy bit was when he calmly said ‘clever boy’ to me, then drove off. I’ve never even told my parents or anyone else about this as it would most likely freak them out."
OstneyPiz
Bad Jokes
"Dad's side of the family pranked me by burying a fake body on our back property and had me dig it up to find valuables. Was only allowed to use a lantern for light. They stuffed old clothes with chicken bones. Sheetrock mud where the head was... Random fake jewelry as the treasures... I was like maybe 10 or 11.. I remember digging up the boot first and started gagging because it became real at that point."
Alegan239
YOU
Who Are You Reaction GIF by MOODMAN
Giphy
"Woke up to find my little brother staring at me in the dark, asking, Are you really you?"
PrettyLola2004
Siblings can really be a bunch of creepers.
No one should talk to others in the dark though.