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I was about to sit down for a warm pre-dinner snack of daal, rice, and tilapia when my phone buzzed insistently from the tabletop. I stood there for a moment, staring at the screen, until I processed the words, “meet me in 30 min.” I wolfed down my dinner, stuffed my ID badge and white coat into my laptop bag, and dashed out the door into the freezing evening weather.

When I arrived at the hospital, I was sweating profusely into my jacket. I met my research advisor in her office, and she led me into a new world – one of windowless hallways, where there were no lost visitors or rambunctious first-year medical students to penetrate the silence. There were only faceless doctors and nurses, solemn and solitary as they headed toward their mission.

In the operating room, I watched as the anesthesiologists placed their monitors on the patient. Just before the patient went to sleep, he mumbled, “What time is it?”

I looked back at the clock. It was 9:33 PM.

When the patient could no longer open his eyes at the doctor’s request, the surgery began.

I continued to watch as the surgeons marked the operating area with black ink. They began with a single incision that pierced his skin and the membranes that held his muscles together. Then they split apart his sternum, and delved into his chest…

A heart transplant. Not just any open-heart surgery, but a heart transplant. A wave of wonder swelled and burst inside of me. I instinctively felt for my own heartbeat, searching for its warmth underneath my scrub top and jacket. The organ that pumps life throughout our body – the one organ that seems to cradle our very soul – would be taken out from the depths of this man’s chest and replaced with a new one. And I was worried about passing my hematology exam.

Through the night, I peered over the curtain as the surgeons freed fibrotic tissue from around the diseased heart, like sculptors chiseling away, ever so slowly, at a block of marble. I held my breath as the entire heart came into view. I had never seen anything more beautiful than that heart, beating away in plain sight from the depths of this man who lay before me, a man who had been speaking to us just a couple of hours ago.

How different surgery was from dissection in the cadaver lab. The silence, save for the steady whirring of the machines and the occasional announcement about the arrival time of the donor organ, was in stark contrast to the incessant chatter and narrowly-dodged bone saws characteristic of first-year anatomy. This operating room felt like a temple of prayer in comparison.

At one point, I looked back at the heart to find that it had stopped beating. The surgeons were diverting the blood flow to a cardiopulmonary bypass machine – a massive glass contraption that took in deep purple, deoxygenated blood from the patient’s chest and returned tomato-red, oxygenated blood through a tube into the chest cavity.

Nearly three hours after the surgery began, the new heart arrived by helicopter. The surgeons continued to carve away inside the patient’s chest- until one surgeon reached both of his hands into the cavity, and in one fluid movement, scooped out the entire heart. There was now a gaping hole in the patient’s chest – empty except for a deep pool of bright red blood. I went around to the other side of the operating table to gaze at the severed heart.

With slender blue threads, the surgeons soon began to sew the valves of the donor heart into the patient’s chest cavity. That was when I decided to leave. It was 1:00 AM.

One day later, I still I wish I had stayed for the entire surgery.

See also The Operating Room, Third-Year Edition

heart netters

Since the night of the heart transplant, I’ve had the opportunity to hold numerous human hearts in my hands and casually describe all of their external and internal structures.