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A story about knots and surgeons - Ed Gavagan


6m read
·Nov 8, 2024

Now we wake up in the morning. You get dressed, put on your shoes; you head out into the world. Do you plan on coming back, getting undressed, going to bed, waking up, doing it again? And that anticipation, that rhythm helps give us a structure to how we organize ourselves and our lives, and it gives a measure of predictability.

Living in New York City, as I do, it’s almost as if with so many people doing so many things at the same time in such close quarters, it’s almost like life is dealing you extra hands out of that deck. You're never... It's just that juxtapositions are possible that just aren't... You don’t think they’re going to happen, and you never think you’re going to be the guy who’s walking down the street, and because you choose to go down one side or the other, the rest of your life has changed forever.

One night, I’m riding the Uptown local train. I get on, and I tend to be a little bit vigilant when I get on the subway. I'm not one of the people zoning out with headphones or a book. I get on the car, and I look, and I notice this couple, college-aged student looking kids, a guy and a girl, and they’re sitting next to each other. She’s got her leg draped over his knee, and they’re doing this little contraption, and they’re tying these knots. They’re doing it with one hand, they’re doing it left-handed and right-handed, very quickly, and then she’ll hand the thing to him, and he’ll do it.

I’ve never seen anything like this. It’s almost like they’re practicing magic tricks. At the next stop, a guy gets on the car, and he has this sort of visiting professor look to him. He’s got the overstuffed leather satchel and the rectangular file case in a laptop bag, and the tweed jacket with the leather patches. He looks at them, and then in a blink of an eye, he kneels down in front of them, and he starts to say, “Listen, here’s how you can do it. Look, if you do this,” and he takes the laces out of their hand, and instantly he starts tying these knots, and even better than they were doing it, remarkably.

It turns out they are medical students on their way to a lecture about the latest suturing techniques, and he's the guy giving the lecture. So he starts to tell them, and he’s like, “No, this is very important here. You know, when you’re needing these knots, it’s going to be... You know, everything is going to be happening at the same time. It’s going to be... You’re going to have all this information coming at you. There are going to be organs getting in the way; it’s going to be slippery, and it’s just very important that you be able to do these beyond second nature—each hand, left hand, right hand. You have to be able to do them without seeing your fingers.”

At that moment, when I heard that, I just got catapulted out of the subway car into a night when I had been getting a ride in an ambulance from the sidewalk where I had been stabbed... to the trauma room of St. Vincent’s Hospital in Manhattan.

What had happened was a gang had come in from Brooklyn; as part of an initiation for three of the members, they had to kill somebody, and I happened to be the guy walking down Bleecker Street that night. They jumped on me without a word. One of the very lucky things was when I was in Notre Dame I was on the boxing team, so I put my hands up right away, instinctively. The guy on the right had a knife with a 10-inch blade, and he went in under my elbow, and it went up and cut my inferior vena cava. If you know anything about anatomy, that's not a good thing to get cut.

Everything, of course, on the way up, and then I still have my hands up. He pulled it out; it went from my neck and sunk it in up to the hilt in my neck. I got one straight right punch and knocked the middle guy out. The other guy was still working on me, collapsing my other lung, and I managed to get, by hitting that guy, to get a minute. I ran down the street and collapsed.

The ambulance guys intubated me on the sidewalk and let the trauma room know we had an incoming. One of the side effects of having major massive blood loss is you get tunnel vision. So I remember being on the stretcher and having a little nickel-sized cone of vision, and I was moving my head around, and we got to St. Vincent’s, and we’re racing down this hallway, and I see the lights going.

It’s a peculiar effect of memories like that: they don’t really go to the usual place the memories go. They kind of have this vault where they’re stored in high def, and George Lucas did all the sound effects. So sometimes it’s remembering them, it’s like... it’s not like any other kind of memory.

I get into the trauma room, and they’re waiting for me, and the lights are there, and I’ve been able to breathe a little more now because the blood that had been filling up my lungs is kind of gone into the stretcher, and I said, “Is there anything I can do to help?” The nurse kind of had a hysterical laugh, and I’m turning my head trying to see everybody, and I had this weird memory of being in college and raising money for the flood victims of Bangladesh.

Then I look over, and my anesthesiologist is clamping the mask on me, and I think he looks Bangladeshi, and I just have those two facts, and I just think this could work somehow. And then I go out, and they work on me for the rest of the night. I needed about 40 units of blood to keep me there while they did their work, and the surgeon took out about a third of my intestines, my cecum—organs I didn’t know that I had.

He later told me one of the last things he did while he was in there was to remove my appendix for me, which I thought was great, you know, just a little tidy thing there at the end. I came to in the morning out of anesthetic. He had let them know that he wanted to be there, and he had given me about a two percent chance of living, so he was there when I woke up.

Waking up was like breaking through the ice into a frozen lake of pain. It was that and developing, and there was only one spot that didn’t hurt worse than anything I’d ever felt, and it was my instep. He was holding the arch of my foot and rubbing the instep with his thumb. I looked up, and he’s like, “Good to see you.”

I was trying to remember what had happened and trying to get my head around everything, and the pain was just overwhelming. He said, “You know, we didn’t cut your hair. I thought you might have gotten strength from your hair like Samson, and you’re going to need all the strength you can get.” In those days, my hair was down to my waist. I drove a motorcycle; I was unmarried; I owned a bar, so those were different times.

But I had three days of life support, and everybody was expecting due to just the massive amount of what they had to do that I wasn’t going to make it. So it was three days of everybody who was either waiting for me to die or poop. When I finally pooped, then that somehow, surgically speaking, that’s like you crossed some good line.

On that day, the surgeon came in and whipped the sheet off of me. He had three or four friends with him, and he does that, and they all look, and there was no infection, and there they bend over me, and they’re poking and prodding, and they’re like, “There’s no hematomas! Look at the color!” And they’re talking amongst themselves, and I’m like this restored automobile that he’s just going, “Yeah, I did that.”

It was just, um, it was amazing because these guys are high-fiving him over how good I turned out, you know, and it’s my zipper. I still got the staples in and everything. Later on, when I got out and the flashbacks and the nightmares were giving me a hard time, I went back to him and I was sort of asking him, you know, “What am I going to do?”

I think kind of as a surgeon, he basically said, “Kid, I saved your life. Now you can do whatever you want. You know, you got to get on with that. It's like I gave you a new car, and you’re complaining about not finding parking. Just go out and, you know, do your best, but you’re alive. That’s what it’s about.”

Then I hear, “Bing bong,” and the subway doors are closing, and my stop is next. I look at these kids, and I think to myself, I’m going to lift my shirt up and show... and then I think, “No, this is a New York City subway; that’s going to lead to other things.” So I just think they got their lecture to go to. I step off and I’m standing on the platform, and I feel my index finger in the first scar that I ever got from my umbilical cord. Then around that, which is traced the last scar that I got from my surgeon, I think that that chance encounter with those kids on the street, with their knives, led me to my surgical team, and their training and their skill, and always a little bit of luck pushed back against chaos. Very lucky to be here.

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