Contemporary management of parastomal hernia
2 March 2023
2 November 2022
On a lovely July day, I got a text message from the tissue and organ donation coordinator from my home hospital. The message read “organ procurement tonight, would you like to join?” Since I started med school, I had always considered the idea of surgery. The immediate gratification of fixing a problem, the kinaesthetic nature of the work, and the interplay between anatomy and medicine had fascinated me from the beginning. After observing some surgeries and doing a few electives in surgical specialties, I started to wonder if surgery was really my true calling. That night in July would leave me with no doubt. Scrubs on and cap tied, the coordinator and I headed down to the OR around 11pm to meet the incoming transplant teams. As each member from the four groups walked past, I was already in awe of the skill and talent I was going to be fortunate enough to witness. Soon, the patient was brought to the room, and introductions from each team member was made. Though intimidated by introducing myself as a second year medical student in a room of fellows and attendings, the surgeons had already made me feel welcomed and part of the team. As we stopped for a moment of silence for the donor, I reflected on the true privilege I had to witness the gift of life; how selfless and altruistic the donation was. Not long after, the surgery started. As I tried to peak through the bodies, the cardiac surgeon looked over at me and said, “why don’t you go scrub in and join me up here”. The time it took me to scrub was just long enough to feel both exceedingly nervous and tremendously excited. As the heart and lungs became exposed, the team took every opportunity to get me involved. I held a heart as it beat in my hands, felt the blood flowing through the aorta, touched the lungs as they filled with air. I couldn’t help but think of the controlled chaos I was witnessing, how skilled and precise, yet tactile and artistic surgery could be. To me, there was no better way to integrate all my learning up to that point; anatomy, physiology; critical thinking and physical action. The more the night progressed, the more intrigued and involved I became. As each organ was removed, we reviewed anatomical features, post-donation care, and next steps for eventual transplant. Despite the clock showing 5 am, I’d never felt so alert. One by one, the teams left to their respective receiving centres. “Why don’t you help us close?” remarked one of the hepatobiliary transplant surgeons, one of the last of the teams to leave. As I finished the last throw of my running suture, one of the transplant fellows asked me “so, have you thought about what you’d like to do after med school?” I replied, “without a doubt, I want to be surgeon”.
Part of the charitable activity of the Society, BJS Academy is an online educational resource for current and future surgeons.
The Academy is comprised of five distinct sections: Continuing surgical education, Young BJS, Cutting edge, Scientific surgery and Surgical news. Although the majority of this is open access, additional content is available to BJS subscribers and strategic partners.