Life as a medical student #19 My Shaking Hands: Suturing for the first time

The operating theatre with its bright lights, sharp steel and demanding scrub nurses is a land of mystery for most medical students. Having seen so many operations done (from far corner of the room, of course), I had never stitched up an actual person. Ironically, my first chance of sewing up an incision happened when I was at Tzu Chi Hospital in Taiwan. It was a reconstructive surgery after resection of retromolar trigone cancer. Doctor Kang and Doctor Weng had removed the anterolateral thigh (ALT) flap and was now beginning to re-connect blood vessels at the neck.

''Why don't you sew up the site on the leg where we harvested the flap?'' Doctor Weng said.

I was a bit startled, but I nodded. Looking down at the patient's leg, there was a 4-inch incision to sew up. It wasn't too deep. Probably just need a single layer of simple interrupted suture. Very quickly the nurse handed me a forceps, a needle-holder and a length of 3.0 nylon. I tried to make myself comfortable with the instruments like how I used to practice in classes, and concentrate on the incision in front of me. The first few stitches took me an eternity to put in - using the forceps my left hand grasped and everted the skin edge slightly, my right hand pronated and supinated to allow the needle to pierce the skin - I don't know why but that particular moment made my hands tremble a little. While taking a deep breath in, I imitated how the surgeons normally wrap the suture around the needle holder to form the loop, and then tie the knot. And finally cut the suture leaving a 5mm tail. That's my first knot! I looked up and exchanged glances with Doctor Weng. He seemed satisfied. With Doctor Weng continue guiding me, I began suturing with more confidence.

Slowly, but more and more smoothly.

Skin pads, banana skin, orange peels? Nothing beats suturing a live patient. I can now suture better. Really.

Life as a medical student #12 When a baby is born

As a medical student, I am blessed with chances to see and experience things other people do not get to. When I was allowed into an elective Caesarean Section for the first time, my heart pounded in excitement. I was about to witness the bringing of a new life into this world!

When I entered the room, the epidural was being administered by the anaesthesia team. Surgeons and assistants were scrubbing in, putting on sterile gowns and gloves. Doctors and nurses were moving about, readying the room for delivery. Everything was in place. Then there it was - a strong pregnant mummy sitting on a cold operating table, considering what lies before her - probably feeling scared and alone. Her partner was not allowed in the operating theater. And in these moments, she must hold onto the strong love she has for her baby. She didn't know how long she'll have to wait before she could hold her baby in her arms. She let fear washed over her, and then she let it drifted away. She must be a strong lady. All the mummy.

I made a quick silent prayer in my head for her and her baby.

And then the actual surgery happened. An incision was made in the mummy's lower abdomen by using a scalpel. A few more incisions were carefully made to separate layers of fat tissues, fascia and peritoneum underneath. After the uterus was opened, it was then time for the surgeon to reach into the uterus and pull the baby out. I could feel the atmosphere of the room became so tense that everyone in the room was holding their breaths.

I couldn't contain my excitement when I saw the tiny little baby girl out of the mother's uterus, arms flailing, lungs wailing. The room was filled with joy, everyone was delighted.

''Happy Birthday, to you, the little one. 

Welcome to this beautiful world.''

And thank you, to all the brave women who birth their children with such strength and beauty.