At his concert a few weeks ago, Billy Bragg commented in some dismay about the tendency for the leads on his two guitars to get tangled up together during gigs. I could have told him the name of this pernicious power, the bane of operating theatres everywhere: Malignant Spaghetti Syndrome.
I feel as if a large part of my life has been spent teasing out knots in various linear elements in my life. I’m not being philosophical or metaphorical here – I mean actual physical knots in things.
The first of these challenges I can remember is success in finally getting a comb through my curly hair at age nine. I remember the warm glow of acheivement. I was the fourth of five kids and my mum was working full time – I suspect supervision of personal grooming was way down her daily to-do list. It was one reason I was bullied in my English school, the others being: speaking funny (we’d just moved from Australia); being friends with the wrong people, including the strange girl who was good at somersaults, and Francesca Schmidt, a German; and hungrily eating everything the school matrons served up for lunch. (One game was imagining what foods I might possibly refuse to eat – a stale loaf of bread with kippers stuck in it was one particularly memorable proposition.)
Since then I’ve struggled through trying to unknot my own children’s (and dog’s) hair, leashes, necklaces, and various charging cables in my time, but the most frequent place I come across this malevolent force is at work.
Most anaesthetics these days are made up of a combination of medications that are delivered directly into a patient’s blood stream. No more drops of ether on a Schimmelbusch mask, more’s the pity!
Actually, I don’t regret those days (before my time!) for a number of reasons, including severe post op nausea and vomiting, and the tendency of some of those old agents to explode mid procedure – once memorably killing the patient and everyone in the theatre team, barring the anaesthetist who was safely in the tearoom at the time.
Anyway, things have moved on since then but giving your drugs as an intravenous infusion means many seperate lengths of tubing, all fatally attracted to each other and themselves. 90% of the time you can get your equipment ready for the next case in a matter of minutes, but sometimes, inexplicably, and usually when you’re in a hurry due to clinical urgency or a desire to get home on time, this sort of thing will happen.
The tubing is super grippy, I don’t know why. When faced with this you have no choice but to spend the next five minutes gradually unknotting it. There is a rumour that one in ten of these actually come from the factory like this, but even though it would be nice to blame someone else, I suspect this is just another conspiracy theory. This tubing is only one of the things that can get tangled up in theatre. One day operating rooms will be wireless, but this is not that day. All the monitors we attach to our patients have their own cords. Our theatre suite is less than ten years old but there are never enough power sockets for everything that needs plugging in, thanks to the proliferation of devices designed to keep a close eye on the person being operated on. The most feared culmination of all this comes when you have to deliver your patient to the intensive care unit. No matter how fabulous a job you’ve done keeping someone alive against all the odds, if your wiring is tangled up the fearsome nurses will look at you with distain. And they have very long memories.
As an aside, I don’t remember ever being taught how to unknot something? My only technique is to try to gradually tease the tangled bits apart. Is this another life lesson I’ve missed?