First Day of Ramadhan

It was a Friday and the next week shall be my last week.
I had bihun sup for sahur.

If I remember it well, the day is not like any other day I was in the department.
When I was doing venepuncture on this man that speaks English, the sound of helicopter taking off muffled our conversation.
"This is the third time today. and it's just 9 am"
I remember seeing this new man looking all unwell but I went on with the venepuncture.

I scrubbed in for an operation that I don't remember anymore and returned to Zenker.
Dr Weiskopf and a cardiologist was there and the situation didn't seem good.
"Remember this. It's myocardial infarction" she showed me the ECG.
Turned out it's of that man that was looking very fragile this morning.

It's a rather busy Friday.
And I have another operation scheduled at ~6 pm.
I asked Dr Reinisch for an hour or two break.
I went to Ariana Orient House to get some dates and drinks and whats not (where the fresh fruits and veges section almost empty), dumped everything at home and return to the empty Zenker.
I scrubbed in and went to see the operation schedule.
The digital one was down and they only have papers stuck on the board, obviously all written in German.
I got one of the scrub nurse to tell me whats going on and returned to Zenker to clarify with anyone there.
Turned out Dr Matthias was there.
I had the option to go home but since "help is highly appreciated", and the fact that I was already prepared for surgery, I opted to stay.
Turned out it's a really interesting surgery with amusing team.
And the patient is........ the man who had MI earlier that day.

We started at half past 7. I have always feel some distance from Dr Sudkamp. He is after all the obarztin, which means he's one of the high rankings. That he is always wearing the same face expression doesn't help either but surprise!surprise! he's really nice. Further explanation will ensue.
We started up very nicely. I had been in a surgery where Imi was also the scrub nurse. I had always wanted to ask where she comes from since she did the same to me. So I asked on that operation. She's from Philliphines. and the question where you are from jumped from one to another. I am Malaysian, studying in Czech Republic and interning here *insert further explanation*

When the heart is exposed, I noticed that it's bigger than the other hearts I've seen during the weeks that had passed. And yes, it's not normal.
The second surgeon harvested the leg vein and I was opposite the head surgeon who's harvesting RIMA.
I had been in quite a number of bypass operation but this one is where I learned the most.
You had to take off the clip and replace it with suture. and there's more than 12 clips on the venous graft alone. Flush the saline into the graft to see if there's any leakage. You have to repair it.
Then time by time as the graft is joined to the coronary vessel, you have to flush again to see if the anastomoses are leaked.

There's a number of other procedures done and when the second procedure was completed, the iftar time has long passed. It was not until 12 midnight that the chest is temporarily closed.
The head surgeon offered for anyone to take a break.
I stayed in my gown for quite sometime but after the explanation about the reperfusion time, which will take no less than 20 minutes, I got out of my gown and headed for the break room.
Man, everybody had finished and the break room was empty and urm, eerie but nah, the devils are supposed to be in hell.
I reached for the empty pocket. I really wanted to get something from the vending machine but my coins are all in the locker room in Zenker. Which means I have to change out of my scrub, fetched the coin and get into new scrub if I want to get them. So yeah, I broke my fast with the water from the sink.
Amazingly, I didn't feel fatigue. Ironically I was really pumped out.

I gowned in again for whatever left to be done. And whatever left to be done was really tense and the atmosphere during the second session was really tight *inside stories*. The surgery didn't show any sign that it's going to end soon. With heavy heart, I asked to go home when the clock showed 240 am. I had the permission to go anytime I want but I really want to stay until the end. I reached home just in time to perform jamak taakhir and munched something for sahur before the break of dawn.

I was up at 8 the next morning and spent the whole Saturday sleepy, and walking in the cold and rainy Stuttgart. It was really cold I just had to buy a jumper from H&M. Thanks Allah for summer sale! Oh yeah, they wrapped off the operation sometime past 4 am and the patient was sent to ICU for postop care.