RESPIRATORY I

The hospital was warm as we marched down the corridor that supposedly led to the rooms where bronchoscopy was to take place this afternoon.  We walked for what felt like miles beneath a white ceiling, surrounding on either side by flawless white walls that stood on a white floor, as though we were suspended in a disorientating, ethereal haze.  The corridor meandered left, then right, then left again, on multiple occasions.  It was through the fifth set of restricted access double doors that we bumped into a nurse, the navy scrubs a sharp contrast to the bright, colourless backdrop of the corridor.

“Excuse me, you don’t by any chance know where the bronchoscopy rooms are, do you?” I enquired.

After checking our ID badges, she gestured towards yet another set of white double doors, although thankfully these were to be the last.  Our keycards had certainly seen more than their fair share of action for one day.

Through the doors it was Dr Lee, a registrar, who directed us towards the changing rooms to don scrubs.

Tying the surgical caps around our heads we entered the bronchoscopy suite, ABBA playing loudly from a set of speakers that were nestled away in the corner of the room.  An elderly consultant with a round, welcoming face greeted us and instructed that we follow the patients through the whole process including their assessment before the procedure.

As I sat in the side-room observing first Tom and then Dr Lee fail to place a cannula on multiple occasions I began to grow impatient.  The patient however, lived up to their title and remained perfectly willing for them to continue their attempts.  Tony was his name, and he was lovely.  The sort that would ask for a plaster having had their leg severed and apologise for being an inconvenience.

Happily it was not long before the cannula was in place and it was time for the bronchoscopy to begin.  As the camera passed down the throat of the patient he began coughing violently in a desperate attempt to clear the large quantities of sputum being produced by his pulmonary tree, as well as the bronchoscope itself.  Within seconds the epiglottis became clearly visible on the screen as the sound of ‘Waterloo’ filled the air.  It was at this point that the camera paused momentarily.

Eventually the frantic coughing and spluttering subsided as Tony regained control of his breathing and it was during this short reprieve that Dr Lee suddenly jerked the camera, attempting to force through the epiglottis, to batter down the gates and advance deeper into the network of airways within the thorax.  The coughing restarted instantly.  Dr Lee paused once more as within the next few seconds Tony choked uncontrollably, turning ever redder in the face from the effort of trying in vain to clear his airway, drowning in his own saliva that was now streaked across his face.  His eyes watered and his throat gargled a horrible, wet cry for mercy.

Once again, it only took a short while for Tony to regain control of his cough reflex and then once again, it was time to attempt to breach the gates.  The camera jerked, and so did Tony as he repeatedly struggled to expel the device that was invading his lungs.  Dr Lee paused, waiting for the couching bout to pass.

This routine continued several more times, through ‘Mamma Mia’ and ‘S.O.S.’ and it was somewhere around the fifth occasion that I noticed something.  They began subtly, but as Tony continued to choke and wretch, as the gates refused to be broken down, the concerned looks that Dr Lee was firing in the direction of the consultant became more and more frequent.  I observed for a number of seconds, before all of a sudden their meaning became blindingly clear.  What this registrar was displaying was nothing other than the international ‘Shit-I’m-Out-Of-My-Depth’ face.  That expression of concern confined completely to the eyes, a sign all too familiar to every medical student.  A physical embodiment of someone desperately trying to remain calm whilst having great difficulty doing just that.

These looks continued for several minutes and it was just as ‘Slipping Through My Fingers’ sang from the speakers that the consultant relieved Dr Lee of the camera, passing the gates and entering the trachea on the first attempt.  A rather sheepish Dr Lee continued on the journey towards the area of lung that required a biopsy.

All the while Tony coughed and spluttered.  All the while ABBA dominated the room.  He never complained once.

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