You're busy charting a case. Across the room you hear the slight sound of a vendor tearing the plastic from a knee implant box. You stand up, walk over to the rep and stretch out your hand to take the implant out of the box. Yes, you are Pavlov's dog, conditioned to respond to the sounds of surgery. Some make us drool. Others make us foam at the mouth.

• Tones. The pulse oximeter beeps along and I don't even notice it anymore. That is, until that tone starts to plummet. Then my ears perk up like a German Shepherd's and I'm all up under anesthesia's axilla wanting to know what the crap is going on and how to make it stop.
• Fire alarms. Causes a guttural growl in me. I know. We have to do scheduled fire alarm tests to comply with all the regulatory bosses. But really, the alarm goes off now and, like everyone else, I barely do a quick sideways glance while trying to locate where, in heaven's name, is this patient's urethra. The noise is annoying enough, but now I have strobe lights blinding me and I'm having to give it a Hail Mary on the Foley and hope for the best.
• Cautery alarms. I know they're for patient safety, but cautery alarms make me foam at the mouth and utter bad words under my breath. I'll do anything to keep the alarm from going off and hearing Dr. Dread say "Fix it, fix it, fix it!" Change the units, change the pads, change sights (both thighs and both calves). Remove hair better than a spa wax job. Wash body parts like it's Saturday night in the Ozark Mountains. I'll even use good ol' rubbing alcohol with a 10-minute dry time so oil never again comes to the surface of that section of skin.

• Ringing OR phones. My blood pressure rises when someone calling an OR lets the phone ring and ring and ring. If no one answers after 5 rings, hang up. Take it to the bank we're putting our patient above a phone call. If the call is that important, give a message to the surgery's front desk and ask someone to please deliver it. If someone in scrubs is sitting around, maybe they can get up off their buttock-imprinted chair and walk their backside to that room and deliver that important message.
• Fluid suction sound. Ever notice that the sound of a fluid suction device causes you to suck the air out of the room? Yes, you're holding your breath during the whole case and you just didn't know it. Want to know how you know? At the end of the case when you turn the system off and the sucking sound stops, you exhale that breath you've been holding and it feels so good.
• Your name on the overhead page. Hearing your name called out over the department to report somewhere triggers a mild panic attack. What have I done now? What wonderful little case are they giving me this time? Seriously: How often have you been called to report somewhere and it was good news? OSM