Most Intense Case You've Ever Scrubbed?

[ctsurgeryscrubrn]

Curious what cases the group has found to be the most intense and what made them intense. Here are mine:

1) Elective Open TAAA repair - my first time scrubbing a thoracoabdominal. A high-stress, high-stakes environment for sure! Patient in his 20s that suffered from Marfan's - by far the biggest and most 'barbaric' incision I've ever seen. Things were going as planned as we started in the chest and went into the abdomen. Unfortunately, about 9 hours in, patient suffered a huge complication (MI) and he passed - just awful.

2) Veteran Team Member AAA rupture - One of our beloved OR nurses, whom many of us consider a 'second mother' suffered a AAA rupture at home on the day after a major holiday. They lost a pulse just as the chopper landed. Rode the gurney all the way into the O.R. Was able to get her clamped via thoracotomy and she made it - although she proceeded to code 3 times on the table. The neuro deficit was significant, but she has come a long way and remains a very special person to me.

3) Extrapleural Pneumonectomy - I've done several of these on mesothelioma patients. Every one is super intense. There is just something about the operative approach that takes the room to a new level. Perhaps it's the clamshell-like incision, or perhaps it's going into the unknown where you may have to abort the case, but very intense for me.

4) The Trauma Child w/ Acute Belly Pain - Poor child came in having fallen really hard on his bike. Did all the scans in the ER, and attending just felt that something didn't feel right - low bp and complaints of acute pain. Brought him up for an ex-lap - unfortunately found a massive IVC injury - so sad - perhaps the only case where I've seen the staff have to actually pull the attending from compressions. It seemed like a movie and I wish it had been just that.