A year at U of R

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Saturday, January 20, 2007

Gastric bypass

Gastric bypass and stomach stapling weren’t what first came to mind when I imagined my surgical rotation this spring. I’d imagined the rotation as a drama-filled TV miniseries filled with gunshot wounds, heart transplants, and trauma. However as I’ve learned from all of my previous rotations, the only thing that will surprise me is if I’m NOT surprised by what I learn. If gastric bypasses are one of the mainstays of the unit, I’ll make the most of it.

On my first clinical day of this rotation, I flipped through patients’ charts, familiarizing myself with the forms. I felt sadly voyeuristic as I searched curiously for how much the many gastric bypass patients weighed before surgery. I was amazed by the Body Mass Indexes of over 50 (normal is 18-25). I would have to weigh almost 300 lbs to have a BMI like that.

I tried to imagine myself at 5 feet tall, and 300 pounds. I can hardly carry a backpack that weighs 40 pounds. How would I even move if I was carrying an extra 200? I wouldn’t be jogging or biking century rides. Would I make it up the stairs to my apartment? My life would be radically different.

Part of me felt very self-righteous about NOT weighing 300 pounds. I go to the gym. I run every weekend. I don’t buy ice cream or eat Oreos. I’ve earned my weight! So why can’t these people just give up Oreos too? Think of the health care dollars it would save!

However obesity may be one of the only diseases where people point the finger at the patient. No one would blame cardiomyopathy on the heart transplant patient. But society blames obesity on the victim.

I dropped the charts back in the rack, and followed the nurse I was shadowing into the patient’s room. The patient smiled cheerfully at us from her bed, and asked us how our day was going. She was delighted to learn that I was a nursing student. Her husband sitting nearby peppered me with interested questions. The two of them held hands, and bantered with the nurse. The couple radiated warmth and good humor. They were much more concerned about making the nurses’ job easier than in their own needs and care.

I left the room smiling, imagining the patient in a few years. Maybe the couple will be running down a beach or biking down a trail together, and doing the things I take for granted. Maybe they’ll be sunbathing in Hawaii! I imagined how much their lives will improve.

A gastric bypass seemed much less like a mark of someone’s failure, and more like an opportunity for them to regain a lost life. Maybe a gastric bypass is more like a heart transplant than I had imagined.