DR. ATUL GAWANDE IS conducting a simulated thyroid removal at Brigham and Women’s Hospital. The operation is a bloody procedure. It involves about 100 instruments and dozens of surgical sponges, small gauzelike pads used for sopping up blood. Each time Gawande asks for more sponges, the nurses count them aloud before handing them over—the standard way of keeping track of equipment to make sure nothing gets left inside the patient. Later, as he’s getting ready to close, an exchange takes place that no surgeon wants to hear.
“Do you have all the sponges?” says one of the nurses.
“I count 27, so three must still be in there.”
“I don’t see any,” says the other.
“Um, keep checking.”
Gawande knows what usually comes next –a frustrating process of counting and recounting to make sure nothing gets left inside the patient. Or they might have to use an X-ray to detect one of the reflective strips on each sponge. Or do a scavenger hunt inside the open cavity, pushing the organs this way and that.
Read Full PDF Article