Thirty Seconds Out of Thirty Years

by Tim Hulsey, MD

A blue patient with a term pregnant belly.
A service patient- many unknowns.
A sweaty anesthesiologist at the head;
A nervous gynecologist between the knees;
Can’t intubate– can’t ventilate! WHY?!
A question for another day.
In utero blue baby desperate for air.
Doctors desperate for airway. Hand reaches for scalpel. Scalpel parts neck skin.
Blood issues forth. Scissors separate straps.
Pregnant neck is so-o-o thick! So is thyroid isthmus!
And full of blue blood supply, too.
Clamp and tie? Not today!
Isthmus is no match for sharp 10 blade
Blood fills wound. “Suction! Suction more!”
Cartilaginous rings in sight. Scalpel parts rings.
Endotracheal tube suffices for trach tube.
Easy now! Not too far in. Let the O2 flow.
Pack the wound. Better hemostasis later?
Monitor beeps. Ambu clicks. O2 sat comes up.
Doctors’ laryngospasms relax. Other sphincters, too.
OB’s hand reaches for scalpel. Scalpel parts belly skin.
Some blue blood, but some red, also!
Blood fills wound. “Suction! Suction more!”
Muscular uterus is no match for sharp 10 blade.
Easy now! Not too deep. Baby on board!
Just deep enough. Head pops out.
“Suction!” Baby’s pink, moving, crying.
Cord clamped and cut. Baby handed off.
Mother’s O2 sat… 99%– better than doctors’?
Two patients where there was one!
Both pink. Both stable. Baby crying. Doctors, too.
Sneak up on the bloody thyroid– remove packing.
Easy, now… Gently… Suction ready.
How amazing is the human body? No bleeding!
ET tube swapped leisurely for trach tube.
Reason for the longest 30 seconds in my life:
World’s largest lingual thyroid– who knew?!