Surgical Synergy

“Okay, on my count,” says the anesthetist.

“One. Two. Three. Lift!” – Agus feels weightless for a moment, then he’s lying supine on the operating table in OR No.12.

I take a step back to look over Agus’ scans on the large LCD screen in the corner of the room. Dr Amir Firdaus joins me, and we scroll through the MRI.

The anesthetic team works in swift silence, slipping a thin plastic tubing into the center of Agus’ spine and infuse the drugs that will keep him pain free. The anaesthesia resident runs an alcohol sponge on Agus’ inner thigh to confirm he has been properly anaesthetised. At the nod of her head, the paramedics swing into action, padding and adjusting Agus’ limbs into position.

An attendant wraps a wispy cotton pad around the patient’s thigh, then MA Muhammad Syahmi straps on the pneumatic tourniquet and checks it for leaks. Agus’ right leg is stabilised and checked, then checked again.

The scrub nurse and her circulator are huddled around the open instrument trays, laying out tools, counting swabs and sorting out sterile towels. A sharp squeak breaks through the constant ding of the oxygen monitor as the radiographer wheels in the C-arm (a portable x-ray unit).

I pass through what to me is the ‘zone of prayer’ – the scrub room where I clean my hands in silent prayer before slipping into a sterile gown and gloves. A few minutes later we are in position around Agus, who lies hidden under the drapes. We go through the final checklists that guard the patient (and us) from surgical errors.

The knife in my hand hovers over the skin of Agus’ knee, and Amir catches the anaesthetist’s eye across the sterile field barrier.

“Starting.” he says, bringing the suction tube up to meet my hands. As the blade passes through Agus’ skin, there is no blood.That part will come later. For now, time stops.


Three weeks later, Agus walks through my clinic door with a brace on his knee and a smile on his face.

“I’m good, Mr Putra. Thank you so much,” he says. As we chat, I smile back at him, but my mind wanders for a moment.

As Agus lay sedated in the operating room, an intricate dance unfolded around him that – to him- will forever remain shrouded in shadow.

Agus will never know the names of those in the small army who orchestrated the battle to repair his knee. Until today, perhaps.

Though his journey to full recovery still lies ahead, I know one thing. Without the team that made it happen, Agus would not be a happy man today.

And in truth, neither would I.

Originally written on 12 October 2020 in Sungai Buloh Hospital, Selangor

Note: Patient names have been changed to protect patient privacy.