One afternoon, in the first few years of my practice in the operating room, a spine surgeon asked me to tidy up the room in the middle of a major case.

Some spine surgeries require two or more stages. In this case, after the implantation of vertebral spacers, the patient would be repositioned from a side-lying position to a prone position so that decompression and posterior hardware implantation could be completed. The transition requires a great deal of work. Drapes come down, dressings are applied, and an anesthetized patient must be carefully moved. Many hands are needed and much care must be taken.

All of this work takes place in the aftermath of surgery. Anyone who has seen an operating room at the end of a procedure understands the challenge. There may be spills and splashes, wires, dropped instruments, packaging, and equipment arranged for the demands of the first stage of the case.

When the second surgery was underway, the surgeon asked me, as the circulator in charge of the room, to get the OR put back together.

Becoming aware of the environment of care.

At the time, I did not fully understand why he cared about this. But he understood something that I did not.

In those early years, I […]