The holiday season brings out the child in me, and if there's one undeniable truth that children know about Christmas, it's that the toys don't run unless you've got batteries. It isn't much different in the OR. It used to be that everything ran on compressed air and muscle. But the rule of toys applies here, too: Without batteries, you've got no toys, and without toys you can't do surgery. I learned this again the hard way recently.

The power failures that be
I'd just started a traveling assignment at a hospital I'd had a good experience with a few years ago. I wanted the physicians, and 1 orthopedic surgeon in particular, to know that I remembered what they liked and that I could do the job even better now than I could last time I was there.

On the day I was scheduled to work my first case with the likeable ortho doc, I got there early and went over everything at least 3 times. I stocked the room with instruments and supplies that he'd never need because I didn't want him to wait for anything. I wanted to have it in my hand before he even thought about it. What I forgot to bring was the knowledge that you can't trust OR toys.

The trouble started with the bed. I made sure it was in position and all the attachments were within arm's reach. I would have worn a tool belt with the attachments on it if I thought it would have made me quicker. We got the patient into the room on time. Dr. Likeable arrived for the first debriefing and anesthesia put the patient to sleep. The doctor began to position the patient and the bed refused to move up or down. It was plugged in and the battery said it was charged, but the bed was dead.

We moved the patient to another bed. Moments after incision time, the doctor calls me to check the battery on his hood. Yep, it's dead. As my face reddens, I'm feeling a little too warm myself. (What happened to the North Pole ORs I'm used to?) I race to replace the battery, fumbling under his gown at the waist of his scrub pants, to avoid catching the blame for a passed-out or suffocated surgeon. There's a look of relief on his sweaty brow as the fan begins to whir again.

OR gods take out computer and saw, too
I probably don't need to mention that when I go back to the computer, it has kicked me out of the system and refuses to let me back in. I force a shutdown and reboot, asking the OR gods what else could go wrong with this case.

Never ask this question, because they'll oblige you with an answer. In this case, it is silence, which is not a good thing seeing as how Dr. Likeable was using the saw. Another battery has bitten the dust. And, of course, there's no spare in the room. By this point, I'm wondering if it would be too much to ask for the "Ghost of Christmas Future" to whisk me away to the end of this case.

Finally, though, the agony is over. With the dressing on and the drains secured, we move the patient safely back to the (working) bed for transfer to PACU. On the way out of the OR, though, I'm tempted to leave my pager there. If this room has the inexplicable ability to drain battery power, it might as well take care of that nuisance as well. May your holidays be safe and happy, your cases go smoothly and your batteries have enough charge.