It was the biggest room in the interventional radiology department. Two large screens hung in the center above a padded procedure table. The screens were flanked by an imposing device on a swivel that enabled it to rotate and capture various imaging angles. A patient lay in the center of the room underneath a surgical drape, gazing up at the whirling machines.
"The doctor should be here in about five minutes," one of the nurses said as she drew up the anesthetics. "Are you still doing okay?" The patient let out a hoarse and unconvincing "yes." Two other nurses busied themselves preparing the room. One arranged a table of instruments while another set up and pressurized an IV bag. It was my last semester as a nursing student, but I still felt like I was trespassing. I tried to make myself small as the team moved purposefully around me, barely identifiable beneath their layers of surgical garb.
"We used to go through the femoral artery," one of the nurses explained to me as he opened a package of sterile dressings. "But that required the patient to avoid bending at the hip for two to six hours afterward. Now we go through the radial artery, which is a shorter distance to the brain and allows the patient to move around more freely after the procedure." I heard the patient take a deep breath on the table. The nurse closest to me looked at his watch.
"He'll be here any minute now. Then we'll get you something to make you a little more relaxed," he said, acknowledging the patient's unspoken anxiety.
He went on explaining the equipment in the room to me as we waited.
"So, we'll feed the catheter up into the vessels at the base of the brain," he said, "and then we'll inject a contrast medium that will show up on the imaging. Then the software builds a digital diagram of the image, and the neurologist can examine the diagram to look for abnormalities."
He pointed to the computer screens as he spoke, showing me where each picture would appear. I recalled from the patient records that the patient was having unexplained episodes of syncope. Her physician had ordered the cerebral angiogram with the suspicion of an aneurysm.
A tall man in light blue scrubs entered the room. He was shrouded in surgical dress like the rest of us, defined only by a set of dark eyes behind a plastic face shield. His voice was deep and heavily accented as he addressed the team, launching the procedure into motion. I quietly watched them work from my allocated corner of the room. They moved effortlessly together, anticipating the needs of their coworkers as if communication were telepathic. The images began to flash across the screen as they worked. The physician carefully fed the catheter upward, gingerly adjusting with each advancement. His motions were methodical, guiding the catheter along a path he knew by heart.
He glanced up at the screen, surveying the progress on his digital road map. The patient was conscious, and he spoke to her as he worked. He explained to her what he was doing, advised her of what she might feel, and asked her to take deep breaths to aid the advancement of his tools. It felt like only moments before he had reached the occipital area of the brain. He motioned for the contrast dye, but the nurse behind him was already passing it over.
The screen lit up. Bright white fluid leaked slowly into the intricate map of vessels across the display. The dye flooded in like a drop of paint in water, dancing its way through each vein in lazy pirouettes. I felt my mouth hang open beneath my mask. The image before me was foreign yet familiar. An elaborate system of roots, a tree wrapping deep into the earth. The cerebral veins clutched the brain, enveloping it in a smoky web of outstretched limbs. I stood there humbled, recognizing the intimacy of human anatomy and nature, the seeming similarities of our blueprints.
I felt a hand on my shoulder as one of the nurses motioned for me to step out of the room. The computer had made a digital diagram of the vessels in the patient's brain. The physician was reviewing it just outside the door. He pointed out a small outpouching on one of the vessels and began detailing the different procedures available to fix it.
Is this what separates us from nature, I wondered? Our unwillingness to accept what happens naturally? Our ability and intellect to change it? The nurses reentered the room and began preparing the patient for the postoperative area. I stared at the image on the screen. It was incredibly beautiful, I thought, but also incredibly fragile.