Operation Theater
Operation Theater during the 19th Century

In the mornings when I arrive at the operation theaters, I see a list of different surgeries happening that day. There may be a cholecystectomy in one room, or a knee replacement surgery in another, a thyroidectomy happening now, or a brain biopsy scheduled in a few hours. If I hadn’t seen a particular surgery before, I can decide to scrub in and see it. Almost all the surgeons I have met in the operation theaters thus far have been very nice and welcoming in having a medical student walk in to see them work.

In my experience these past two months so far, the name “operation theater” lives up quite to its name. Going to the surgical theater is a lot like going to a movie theater and picking out which show to see. As I don’t watch a lot of movies nowadays, coming to the operation theater is my way of seeing something new and intriguing on my surgery rotation. Should I first see the long epic drama of the femoral-popliteal bypass graft or the short but graphic action blockbuster of the below knee amputation? Or perhaps I’m in the mood for a mystery flick: the exploratory laparotomy.

Old Operating Theatre Museum in London. Photo by Mike Peel.
Old Operation Theatre Museum in London. Photo by Mike Peel.

It’s no accident that in the UK, what we Americans call the “operation room” is what the British call the “operation theatre.” Historically in the 19th century, surgeries in England were performed on a stage surrounded by an audience of spectators who were curious to watch. This was before the development of modern sterilization techniques, anaesthesia, or even sterile surgical gloves, and the surgeons of the day would perform the procedures in their street clothes with just a white apron to shield them from blood stains. They would have to work quickly and swiftly to minimize the duration of pain on patients who are often fully awake. Although all of this dramatic showmanship and spectator seating have since been done away with with the development of modern standards of hygiene and privacy, the term “theater” still lingers today in the UK in reference to the “operation room.”  Today, if you come to London for clinical rotations, you can still visit some of the world’s oldest surviving operation theaters, now converted into museums.

I’m grateful to be doing my surgery rotation in the UK, one of the historical centers of surgery. Several of the major players in the history of modern surgery were British, like Joseph Lister, who pioneered the use of antiseptics in surgery in the mid 1800s, or Lawson Tait, often considered the father of gynecological surgery. At Queen’s Hospital, the hours have been reasonable and curriculum very flexible, and most attendings like teaching students. You could easily walk into a surgical theater, ask if you could observe or follow the doctor, and most doctors would be more than happy to have you observe and participate. Because of this, I’ve seen quite a variety of surgeries in diverse specialties, such as ortho/trauma, gyne, ENT, GI, vascular, and neurosurgery. I’ve also spent time in anaesthesiology, seeing the “other side” of the patient during surgery, as well as a day in the endoscopy clinic because I hadn’t had the chance to see one before in my previous rotations. The educational opportunities abound here. Being a student here is like being handed a special ticket (which I have to say we do pay a lot for) for unlimited showings at a movie theater. It’s up to us as to how to make use of that ticket.