As a teacher in an academic institution, I'm accustomed to frequent visitors to the OR. Medical students, therapists, athletic trainers and, Lord knows why, other surgeons frequently observe my surgeries in the spirit of learning. Teaching is a role I do take seriously, yet each visitor carries some element of risk.
- The traffic jam. There's good data indicating that frequent OR traffic increases infection risk. More people means more carriers of bacteria. Some unfortunate souls are deemed as shedders and exude more bacteria than my daughter's pet rat. When my room gets too crowded, we fasten a do not enter sign across the door (see "Crowd Control").
- The contaminator. Despite my best efforts, there is always a looming observer who saunters too close to the surgical field and touches either my gown or one of my assistants. Ouch! Yes, I have a PhD in sterility, and surgery is one discipline where it pays to have at least a little obsessive compulsive disorder. We have a saying in orthopedics: Infections are forever. Not entirely true, but close. After I politely reprimand the offender and don my sterile sleeve, I attempt to finish the case and pray I won't have a repeat offender. I then reinforce to the audience that the surgical no-fly zone is at least 3 feet away from me. If the student has bad breath, it's 6 feet.