Nicholas Zotos | ads manager

Over the tenure of my undergraduate education, I have had the unique opportunity to shadow a variety of physicians. This included witnessing a wide range of surgical procedures. I have seen the removal of a lung tumor, a whole limb amputation and even most recently an open heart surgery — a Coronary Artery Bypass Graft (CABG). It was the first open heart surgery I was able to see. In terms of medical procedures, this shadowing experience stood out to me.

As an undergraduate, I know how rare and valuable it is to be granted access to an open-heart surgery. As an aspiring medical student, I appreciated
the significance of that moment.

A CABG is an open-heart surgery performed to improve blood flow to the heart. The procedure is done in patients with severe coronary artery disease. The steps of the surgery include the taking of a healthy blood vessel from another part of the body and grafting it onto the blocked coronary artery. The healthy blood vessel is usually taken from the arm or the leg of the patient. This new route, created by surgical intervention, allows oxygen-rich blood to bypass the narrowed or clogged section.

The operation requires full sterilization before entering the operating room. I went through a full scrubbing process which included specific clothes and meticulously washing my hands for over 5 minutes. Then I donned a head cap and mask. Even though I would not be near the sterile field during the procedure, strict adherence to protocol was non-negotiable.

The surgery was scheduled to last seven hours, but I was only able to observe the first three. In truth, three hours was more than enough time. The first couple of hours felt like a marathon. The procedure required observers to remain completely still and silent, which was a challenge. However, I was captivated during the surgery, and my curiosity and attentiveness provided me the energy to push through.

I’m almost embarrassed to admit it, but when the surgeon cracked the patient’s chest open and exposed the tissue beneath, I felt a rush of excitement. My senses were heightened and seeing the blood and internal organs of the patient spiked my adrenaline.

Up until that moment, I had only ever seen a heart in textbooks or online. Now, I was just a couple of feet away from one. Watching on one of the surgical screens, I could see it beating, pressing against the rest of the thoracic cavity. I watched as the surgeon carefully attached the graft, threading it through the coronary arteries with precision. Each movement was meticulous and deliberate, and given the room was full of students, the surgeon explained every step along the way.

After the graft was attached, the surgeon released the clamps on the aorta to allow the blood flow through the new bypass. I could feel the whole room turn eerily silent as one of the scrub nurses next to me held her breath. Everyone watched the heart, ensuring it had “pulsatility” or an indication of good flow. Then after a minute, which seemed like an hour, the surgeon said, “the graft is stable.” Everyone let out a sigh of relief. That was the climax of the procedure and the most important part. By rerouting the blood flow in the coronary artery, the physician had dramatically extended the life expectancy of the patient.

With the graft now stable, the physician continued the procedure, checking each part of circulation ensuring that it all went well. As the surgeon continued to check the hemodynamic stability of the heart, I quietly exited the room to attend the rest of my classes.

This experience was extremely moving and exciting. The surgery reminded me why I began my journey into medicine in the first place. Seeing the heart beating, the complex surgical maneuvers and the critical thinking of the entire surgical team, reaffirmed my commitment to become a physician. The patient’s life was able to be saved because of our advances in medical sciences and because of the skilled clinical staff. I hope that I can continue witnessing advanced surgeries such as this and continue to appreciate the knowledge, skills and dedication required to become a medical practitioner.

Nick Zotos can be reached at
zotosn@duq.edu.