A Special Guide To Laryngoscopy
"Look, the day's here are rough. My job is boring, my boss is a prick, the wife keeps calling and complaining, and, basically, I just have to do whatever it takes to make it through the day. If that means playing this stupid internet game and imagining I'm Michelle Pfieffer's agent and lover, then so be it. When you hit rock bottom like this, and I promise you, you will, let me know."
Fast forward five years (sigh), and I found myself yesterday reminded of these prescient words while on my anesthesia rotation. The trick to anesthesia is that the anesthesiologist does work in the beginning and end of a surgery, and spends the rest of the time reading a magazine while praying nothing bad happens. For any lowly third year medical students assigned to an anesthesia rotation, that means doing jack shit for as much as four hours at a time and resisting the urge to inject yourself with any variety of tempting narcotics when no one is looking. Granted, I've had the chance to intubate a few people just like they do on er (including one adorable seven year old - yes, they let me do that by myself, and yes, you should fear for your life if you ever go to a teaching hospital, because some schmuck medical student like me might be shoving a big metal tube down your throat while you are out cold). That's cool and all, but it doesn't make up for the massive bouts of boredom that follow.
So anyways, I was lounging in the OR during a direct laryngoscopy (a procedure where the surgeon uses a scope to visualize the larynx, vocal cords, and wind pipe, excising any suspicious tissue along the way), when the anesthesiologist recognized my boredom and suggested I walk over to the other side of the room where a television was displaying what the surgeon could visualize. What follows is a simplified description of the procedure, with visual aids. I hope you find it as entertaining as I did:
First, the surgeon sticks a scope down a person's mouth and visualizes the larynx and vocal cords (the two white bands, in case you're curious) with a camera attached to the scope, generating a picture that look like this:
Then, the surgeon wields a special laryngoscope, which may look like this:
Finally, the surgeon penetrates through the vocal cords with the scope like so:
The scope can penetrate past the cords into the trachea, often going in and out as the surgeon excises a mass or examines various parts of the trachea. Multiple times. Sometimes slowly. Sometimes faster. Slower. Faster. Faster! Fas-
Wait, what the hell are we talking about? Sorry. Anyways, at the end of the day, I couldn't help but be reminded of what that wise (and likely unemployed) coworker told me so long ago, because my mind wandered off somewhere and the last three hours of the day just miraculously flew by. What I learned is that you may not always be happy with what you are doing, but sometimes you just have to do whatever it takes to make it through the day. Now if you'll excuse me, I'm going to...umm...do some research on laryngoscopy.