Then comes the whirring sound of an electric saw. I make an unscheduled exit to the hallway for a breath of fresh air and a reassessment of my determination to continue with this assignment. There is a snipping of scissors and more cauterizing. The vein being taken from the thigh will be used for the bypass grafts. This is to be a quadruple coronary arterial bypass operation-in other words, surgery to bypass obstructions in four arteries that feed the patient’s heart muscle. Nelson is making an incision in the left leg to locate a vein that will be removed. The senior resident, in one deft stroke, makes a foot-long incision the length of the sternum, following quickly with a cauterizing tool that seals off the numerous small vessels that have begun to bleed into the wound. Having taken their positions, they begin their work with an alacrity that is somewhat chilling to a newcomer. I stand slightly apart from them, an observer, scrubbed and wearing sanitized clothing. Nelson joins seven other members of the surgical team in the room: the senior resident in surgery a surgical nurse an anesthesiologist a heart-lung machine specialist a computer specialist and two other nurses, one of whom is in charge of the operating room. On the operating table under a bright light and surrounded by a jungle of glittering equipment is a sixty-year-old man being covered with special green drapes that leave a long, rectangular opening squarely over the middle of his chest and another opening over his left leg.ĭr.