I will never understand some surgeons’ fascination with the pancreas. What happened to them in childhood that made them yearn for the approval of such a shallow organ? One of my colleague’s eyes light up like a Christmas tree at the mere mention of a pancreas. Me… I’m a stomach girl. Give me a good, solid, forgiving organ like the stomach any day over a sensitive, highly emotional, diva of an organ like the pancreas. You can’t even talk behind a pancreas’ back without inflaming it! And never go to bed mad at a pancreas or else it will start withholding insulin from you. In the end, it will only drive you to drink … which will make the pancreas even angrier, causing it to eat itself up inside.
The stomach, on the other hand, is a marvelous organ. You can beat it up, and it will still come back to you wagging its tail. You can: poke a hole in it, bypass it, drag it out of the chest, drag it up into the chest (disguised as an esophagus), wrap it around itself, resect it, leave it as a remnant, or use it as a conduit to access other organs … like the inflamed ego of the pancreas, otherwise known as a pseudocyst. I wasn’t always a stomach girl. I have to admit that I was “pancreas curious” back in the wild carefree days of my surgical residency. That turned out to be just a phase I was going through. This phase ended abruptly when I crossed paths with a certain pancreas (which will remain nameless) during my final days of residency.
Up until that point, I had managed to avoid the residency curse of having a maneuver named after me. For example: after a resident named “Smith” lost a guide wire in the heart while placing a central line, that became known as “The Smith Maneuver”. Most residents leave a legacy that lives on in their name, which they would much sooner forget. I was in my final rotation, and feeling pretty good about myself for avoiding the creation of a “Deol Maneuver”. Even better was the fact that I was in the middle of a Whipple procedure that was going… just swimmingly. It was going so well, in fact, that I decided to pull a prank on my attending (who had started whistling while he worked since we were progressing at warp speed). I had my finger between the pancreatic neck and the SMV while I oversewed the pancreatic stump. I decided to pretend that I had caught my glove with a stitch and had sewn myself to the pancreas. The look in my attending’s eyes when I announced that I was stuck? ….. Fantastic. The look in my eyes when I realized that I actually was stuck? …. Priceless.
Unfortunately for me, I was not cut loose until the hospital photographer was called in to take my mug shot for posterity’s sake. In an attempt to save face, I hastily claimed to be part of a pancreas activist organization known as the “Pancreas Huggers”. We went around tying ourselves to pancreatic stumps in protest of the senseless pancreatic beheadings that took place on the hepatobiliary service. This act of stupidity bought me a one-way ticket to the wall of fame, forever immortalized as the “Deol Maneuver”. I have never forgiven that pancreas for turning on me like that. at was the end of my fascination with this turncoat of an organ. The stomach is a much more intelligent organ anyway……
The differences between a pancreas lover and a stomach lover are much like the differences between a cat lover and a dog lover. A dog (stomach) lover has a relationship built on mutual respect and adoration. The cat (pancreas) lover has an adrenaline-filled relationship with an animal (organ) that can be purring one minute, and then slash you with its razor sharp claw the next. he dog (stomach) seems to recognize that its sole purpose is to bring you pleasure, and it will go through Hell and back just to make you happy. Whereas the cat (pancreas) will take a message and get back to you.
I am happy to say that I have been pancreas-free for over 10 years now. I have a good, healthy relationship with the stomach and I would never go back. But, every now and then, when I see someone like my colleague salivate over a CT scan showing pancreatic road rage, I feel some unidentifiable emotion, which just may be … pancreas envy.
What's your take? E-mail firstname.lastname@example.org
Dr. Deol is a self-employed, board-certified general surgeon.