TIDEPOOLS Jennifer Tsai


Surgery is a paradox. A trove of confusing stimuli. A complicated relationship. The choreography weaves routine between the macabre and the vibrant, skips brisk between magic and witchcraft. Two sides of the same coin, each equally vigorous. Lush. It owns potential, weeps promise. 

The verifiable clusterfuck conjures a confusing encounter for a green medical student: screams for attention while defying articulation. It zips skates slips across mind and tongue refusing capture. My response is incomplete, a stuttering work in progress, an unfinished study in scarlet. 

The pursuit of vulnerability is well rehearsed. Steel sings across skin to split Merlot-stained lips, opening secrets, eroding defense. The happy, triumphant sound of suction drinks in celebration, at once playful, juvenile – the declaration of a satisfied toddler finding the bottom of a juicebox. Until it is not. Until it is suddenly ominous, gurgling on error. 

Blood is much thicker than I imagined. The sticky, syrupy subject sits heavy with pigment like high-quality wall paint. It offers no weakness for light to lay claim. I have a sense that it could blind you. 

The cautery sears fat, ceases the crimson dance. Golden grease drips in glistening rings. Unnerving. It looks exactly like the sheen of oily spheres that orbit slick atop steaming bowls of red-spiced noodle soup. Sustenance. Visions of food seem disturbing in the operating room, and yet for fear of eating too much or lack of time between cases, I often stand spine strained and starving. 

In one case, the surgeon delicately combs through anatomy, seeking parathyroid glands amidst the rubble of a ruined throat. He carefully dissects the fat golden-orange pods free, tests them in his highly-trained hands. They do not collapse as he compresses, refuse to bow between his fingers — a sign he has found his treasure. He motions for a flat surface — a surrogate cutting board. Minces the delicate glands into paste with his scalpel. Asks for a new blade — sharper. He divides his harvest into four equal parts, buries each portion deep in acreage carved from the muscle of her neck. The agricultural expanse is expected to yield within the month, cherished by tendrils of tiny vessels. New roots. A transplant. Repotting of sorts. 

Another surgeon pauses his prep to note the tissue damage inflicted by a patient’s colostomy bag. The stool macerates the skin, he says. Macerate – the process of softening or soaking food in liquid. For flavor. For ease of chewing. I was introduced to the term on Food Network, watched granules of sugar and splashes of rum lick up the sides of tender strawberries. The surgeon points to the raw, red, patches of skin. Angry. Macerated? Yes. By the stool, he says.

When I was young, efforts to see my relatives were mediated by distance. We met in the middle, favoring the Hawaiian islands as our in between, the halfway point between Taiwan and Michigan. My grandfather would take me out to the tide pools every morning, hold my chubby hand as I stumbled across black lava rocks, gleefully searching, buoyed by curiosity. I was never tired of the same routine, always stopped at each crater. I found joy in the homes built from destruction. 

In the body, open cavities are irrigated. They call the saline, “juice.” “Give me some juice.” They stop suction and watch the liquid pool. Clear to the bottom, a delicate ecosystem. A home built from destruction. Only here, instead of darting shards of silver fish, slow crawling hermit crabs, snail shell swirls, this crater sleeps vessels, tissue stumps charred black by Bovey, tattered muscle, open fascia. The pool shimmers red, translucent like an unset cherry jello. Gapes to the sky, reflects the beam of the OR lights instead of a dazzling tropical sun. Evacuated. Still. 

I search for signs of life. 

Jennifer Tsai is a third year medical student interested in the intersections of race, science, and society from social medicine and narrative medicine perspectives.