Standing behind Dr. Vivek Kushwaha as he concentrates on his work, a nurse ambles up to give me some bad news.
“Don’t stand too close. We don’t want to take any risks with infection,” he says, speaking through a mask of white cloth.
Although this is intended to be a polite warning, he has no idea how pleased I am to keep a little distance. That’s because the task Dr. Kushwaha is performing is spinal surgery.
It is 7:41 a.m. in Operating Room No. 33 at Memorial Hermann Hospital. In front of us lay a motionless woman in her early 50s. Carved into the skin of her back is a four-inch-long hole, an incision that’s been stretched open until it’s about the size of a pack of cards. That’s the portal that Dr. Kushwaha will use for 150 minutes of surgery that is delicate, and at times, almost brutal because of the sheer force required to extract bits of metal that have been drilled into human bone.
He is removing surgical screws that were put in about 6 years ago, but they no longer keep two of the patient’s vertebrae fused and motionless. The vertebrae slip in and out of place, scraping and grinding like they did before. They have to go.
When they’ve been wrenched loose, the doctor will do some work on the compressed nerves that run through her spine. Then he’ll put in new hardware to stop the slipping and hopefully offer relief from crippling pain.
Obviously, working on this part of the body is a tricky business. It is the bone that holds the body together, that makes it possible for humans to stand erect and walk on two feet. It is the nerves that snake the length of the backbone and work like the body’s internal computer network.
You might think surgery like this would be all lasers and microscopes, but you’d be very wrong. The process resembles mechanical repair work to fix a very, very complicated machine. There is noisy hammering, and some of the screwdrivers are nearly two-feet tall. Old screws are re-plopped into surgical trays, and when they come to rest, you can see that each is about an inch long. The surgeon’s tools are big, heavy and made of gleaming steel. They look like you could build a ship with them.
No patient in their right mind would choose to be here unless there were no other options.
“By the time the patient gets in here,” an attending doctor tells me, motioning to the big operating room that surrounds us, “they are in so much pain, they are begging us to do the work.”
Prior to the surgery, I have never seen the patient before. I don’t know her name, and I am certain it’s better this way. A patient is naked and unconscious when they’re prepared for this surgery. After I walk into the OR, she is strapped tightly to the gurney and gradually disappears under layers and layers of blue and green sheeting. Everything is concealed except ground zero, the skin directly above the damaged vertebrae. Even her eyelids are taped shut.
So much anesthesia is needed, some of her body’s functions literally shut down. A big machine is used to control her breathing and her heart rate, which would otherwise halt.
When Dr. Kushwaha enters the room, he programs a portable iPod that starts off with a few selections by a British band called The Cure. None of the medical staff seem mindful of the irony. To them, they’re nice tunes to hear at the office.
Kushwaha is a youthful man. He wears Nike tennis shoes as he works. But the other doctors make sure I understand he is tops in his field. If I ever need some hardware in my spine, I suppose I am going to have to look him up— or jump off a bridge.
As the iPod skips through a little reggae, a little hip hop, the old screws come out and new ones go in. Bone material from a cadaver—it looks like a fresh dish of parmesan cheese—is packed into the vertebrae along with a growth hormone that will regenerate the damaged bone.
From death, new life will stir down in the depths of her spine. It seems miraculous, but Kushwaha declines to describe it quite the same way.
“Was this especially complicated?” he responds with a look of surprise. “This is the seventh one I’ve done this week. It’s pretty routine.”
Editor’s Note: Many Houstonians will recognize Greg Hassell from the Houston Chronicle, where he wrote a marketing column for nearly 10 years. But Greg is not all business, as we found he also likes to have a little fun and adventure. The Buzz is going to try to accommodate Greg’s inquisitive nature and allow him to share his experiences with you each month. Let’s just hope curiosity doesn’t kill this cat.