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Team Players : They are the menders of broken hearts. Follow the doctors, nurses and technicians through heart surgery as their clockwork precision saves a man's life.

November 29, 1994|KATHLEEN DOHENY | SPECIAL TO THE TIMES

It is not quite 6:30 on a chilly Monday morning, but already Operating Room 14 at St. Joseph Medical Center in Burbank is flooded with light.

The stark, white-walled room is crammed with monitors, intravenous lines, a heart-lung machine and other expensive equipment. But oddly, it's the boombox that's secured from thieves.

On the operating table, Ed Gillespie is drowsy but still conscious as he awaits coronary bypass surgery.

In an hour, the 63-year-old retired Burbank letter carrier will be joined by an often overlooked and underappreciated group of medical workers: the surgical team.

Each day in the United States, these teams of men and women, their faces almost obscured behind masks, enter operating rooms. And when they emerge, a baby's been born, a brain tumor removed or, in the case of Ed Gillespie, a heart's been fixed.

Who are they?

This morning, 13 people--doctors, nurses, technicians and technologists--will tend to Gillespie. Despite their diverse personalities and backgrounds, they will blend into a harmonious unit over the next five hours as they work feverishly to improve the blood flow to Gillespie's heart. During the procedure, Gillespie's heart will be stilled while a heart-lung machine takes over, and blood vessels will be borrowed from other parts of his body and stitched to the coronary arteries so that clogged vessels are bypassed.

As preparations for surgery continue, the operating room is transformed into a kind of sterile stage. Team member after team member arrives, their noses and mouths covered by sterile masks. Age ranges are wide, with seniority claimed by Dr. Taro Yokoyama, the head surgeon fondly dubbed "the King of Hearts," and nurse Betsy Stocking, both 60.

Most members have worked on the St. Joe team with Yokoyama for the past four years, ever since he expanded his practice from St. Vincent Medical Center in Los Angeles.

Each team member is handpicked by Yokoyama, and competition to join is stiff. Some workers are hospital employees, others are employed by Yokoyama and still others are independent contractors.

Some are gregarious; others quiet. And proving that vanity is alive and well even when the fashion statement you're making consists of dull green scrubs and caps, the men groan that they should have shaved when a photographer asks to snap their picture; women beg off until they can find their eyeliner.

Beneath the joviality and differences lies a shared passion for what they consider a miracle. No matter how many times they go into an operating room, the results still amaze them. On this particular Monday, here's how the team managed the miracle one more time.

*

6:45 a.m. If surgery were politics, the anesthesiologist would be the advance man. Dr. James Wickham is standing at the head of the operating table, overseeing anesthesia administration. But earlier this morning, a nurse had already followed his orders to administer a sedative to Gillespie in his room on 3 North.

Soon after, Rosa Ordenes, the surgery technician assigned to wheel Gillespie to the operating room, arrived. Ordinarily she tries to make small talk, figuring conversation eases anxiety. "But he didn't talk much," says Ordenes, guessing that the sedative had already done its work.

Now the operating room is filling up as nurses and others take up their posts. Sarah Campbell, a registered nurse and clinical coordinator, sits at the foot of the operating table. Her job is to record details of the procedure and keep tabs on which supplies are used.

Sandy Wu, the scrub nurse, stands near Yokoyama, ready to provide him with instruments. Stocking, the circulating nurse, will assist Wu.

Nurses wrap Gillespie's lower body in sterile dressing, leaving the chest area exposed.

Off to the side, perfusionists Joseph Berendt and Fred Ferguson are preparing the heart-lung machine. Berendt and Ferguson have worked together for 21 1/2 years--so long, Berendt says, that "we sometimes come up with the same solutions for problems, even though we were thinking independently."

Percy Tapia, the monitoring technician, will keep an eye on the monitors displaying blood pressure and other parameters of body function.

*

7 a.m. Melissa Radley, a physician assistant (trained to perform routine services such as outpatient exams and specially trained in surgery), arrives at the sinks outside the OR to scrub up. Her job is to "harvest" one of the veins to be borrowed. "We'll take the saphenous vein from the right leg," she says. The vein lies just beneath the skin on the inside of the leg and can be removed without significantly affecting blood flow.

"Dr. Yokoyama will tell me in advance how much he needs." She guesses eight to 10 inches, but the exact amount is Yokoyama's decision. "We call him the magician," Radley says.

Like other team members, Radley openly admires Yokoyama. He understands, for one thing, that physician assistants are there to help doctors and not replace them, she says.

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