“He’ll need re-cannulating” said the aneasthetist off-handedly to no one in particular. Certainly not to me, watching and listening, and ready to pounce; like an incompetent vulture.
“Erm, do you mind if I had a go?” I squeaked, regretting the sentence merely halfway through. I was met by blank stares from the qualified team. “It’s just that, I’ve never really done one before.” For some reason I couldn’t stop talking; word vomit was just tumbling out, my brain apparently had no control over my mouth.
“What, never?” said the shocked voice of an SHO. 4th year medical student and never even done a cannula. I was truly shameful.
“Well, not technically,” I mumbled, “tried a few times but like, it didn’t work. There was blood everywhere,” stop talking Sarah. “It was a grey, you know” stop talking Sarah. “I think the pressure was off. Burst right through the vein. The second time there was just a lot of skin… But, thought it might be good now…he’s asleep you know…” I had started to trail off, I was essentially talking nonsense to myself, trying to swallow my own words out of sheer embarrassment, while simultaneously convincing myself that I was the person for the job. “I’ve done it on models before!” I offered, more optimistically. I was only met with pitied giggles from my placement partners.
“Yeah sure,” said the SHO, “you can give it a shot.”
“Great!” I muttered, unconvincingly, while trembling hands reached for gloves. As the stodgy blue rubber trapped my hands, I was trapped in performance; my audience were watching, participating like a Greek chorus, nerves and notable anticipation building. The placement partners to my left offering glances of encouragement as they edged back slightly. The anaesthetic nurse, offering quips and witticisms: “When he wakes up with a haemorrage, we can just blame the medical student!” The Greek Chorus erupted with laughter, while I chuckled out of desperation, as the spotlight shone brighter. The SHO’s on either side of me, preparing the vein, preparing the saline, preparing my stage and gently nudging me closer to the centre when suddenly the genre turned farcical.
“You’ll want to go in that vein there.”
“That one right there?”
“Yep, that one there.”
This must have only gone on for a moment, but it felt like an age. I could feel the SHO internally laughing at my incompetence.
I picked up the cannula, my main prop for the performance – my foil. Stumbling at the very first hurdle, I fumbled with the wrapping, and then, there it was; part plastic, part metal, with unlimited potential; this could be the vector wherin lives are saved – drugs administered, fluid given, life saved. Or, this could be the vector of destruction; burst vessels, blood pooling until the pressure builds and builds until an outpouring of hot sticky red liquid comes seeping out. One of the SHO’s laid down a pad under his wrist.
“Just in case. I always get blood everywhere,” she said unconvincingly.
With one final look to my partners, I knelt down to the patients’s wrist, my stage. The back of his hand was a sickly colour – slightly yellow under the cold light of the aneasthetic room, with green veins leaping forward, all with a reflective, unhealthy, artificial sheen of recent alcoholic washing. The vein looked at me, shiny, pearlescent, dimensional, almost daring me to miss.
“So right there?”
“Yep. Right there.”
“Go in at a slightly lower angle,” suggested the SHO.
“Don’t forget to pull the skin,” offered a colleage. I was being heckled. The greek chorus was now participating, as the room bounced with offers and suggestions from more experienced practitioners.
“Hold it from the wings.”
“Go in smoothly.”
“Not too quickly!”
As the tip reached the the vein, suddenly silence; my only soundtrack was the constant beeping of the heart monitors, and my own breaths, becoming ever shallower.
Friends, Doctors, Patients, lend me your wrist
I come to cannulate your vein, not to burst it.
As the tip edged ever slowly to the vein, the rest of my body became paralysed; stage fright had taken over me as I couldn’t blink, couldn’t breath, couldn’t do anything but edge the cannula ever closer. I met resistance as the skin was acting as a barrier – the antagonist to my cannula’s noble journey. With a further push forwards, the skin gave way beneath me, as I felt an offload of pressure. As I focused on the vein, eyes boring into it, out of the corner of my eye, I noticed a flash of red; I was in.
The journey wasn’t quite over yet though. “Just advance it a tiny bit.” The cannula carried forward as I gently nudged the plastic tubing, dark red blood spilling back into the tube until the journey was over, the cannula could go forward no more; I was definitely in. I breathed – anxiety and anticipation came pouring out with my breath, and I breathed in relief with a hint of pride – I daren’t look up at the audience yet. The relief and loss of adrenaline made my arms go weak; I pushed onto his wrist as I took the needle out, but still blood dripped out – as it touched the pad, the deep burgundy drops slowly seeped out, diffused at the edges, making a gradual gradient of colour; there was something oddly soothing about the stains. When compared to my first attempt at cannulation, where blood mercilessly was bursting out of the vein at the patient cried in pain, this was in some ways the same sign, but it was the sign of a job well done; the cannula was firmly in place, the patient was still asleep, and I could feel my ears heat up as I looked at my handiwork.
I finally looked up at my audience; no longer were they the cruel judgemental Greek Chorus, but an ensemble cast with words of congratulations and encouragement. I pulled off the gloves, and with that, the scene ended and the curtains dropped.