OPINION: As a Surgeon, I Know How Vital Masks Really Are

(The Washington Post ) -
masks coronavirus
A large mask on the face of a lion statue outside the New York Public Library, earlier this month. (Reuters/Lucas Jackson)

Today, my wife returned from a visit with a friend. “She won’t wear a mask. She said it’s too uncomfortable.”

Had I been there, I would have said, as I now do when I hear people complaining about the discomforts of a mask, “Sorry, you’ll get no sympathy from me.”

As a surgeon, I spent much of my life behind a mask. Yes, it could be uncomfortable, especially during hay fever season, when I would excuse myself at the end of a three-hour operation to discreetly remove my [wet] mask and wipe my face clean.

Yes, you learn by trial and error how to pinch the wire across the bridge of your nose so that your breath doesn’t shoot out the top of the mask and fog your glasses. You wear a mask because, in the operating room, contamination is a no-no. You wear a mask because if you don’t, the most vulnerable person in the room — the patient — might get an infection because of you.

Recently, I was the patient. I underwent a simple hernia repair under local anesthetic. Being the patient, I didn’t have to wear a mask. Being a surgeon, I felt more awkward being in an operating room without a mask than being there without my pants. I asked for one, and the understanding nurse anesthetist got me one.

While members of the operating team, the physicians and scrub nurses, do not have to maintain social distance, they do have to follow agreed-upon rules limiting their movements to avoid inadvertent contamination: hands in front of you at all times, above your waist and lower than your shoulders; no exposing your back to the front of another member of the team, which results in a front-to-front, roll back-to-back, front-to-front pas de deux if two team members have to change places in mid-operation.

Although both the operating team and the operating tables are covered with sterile drapes that extend toward the floor, only the waist-high tops are considered sterile. Should equipment be found dangling over the edge, it will be removed and replaced. You do it because, in the operating room, contamination is a no-no. You do it so that the patient will not inadvertently get infected.

If someone sees someone in the operating room unconsciously break protocol, they will call it out and it will get fixed so that there is no question about contamination. No one in the room wants to risk the patient getting infected.

If your child is in the operating room, you want the surgeons, anesthesia providers, nurses and technicians to wear their masks — masks that cover their noses — and follow the rules. Those in the operating room want to as well. They want to because the constraints are inconsequential to them compared to the risks of contamination to the patient.

They wear masks and follow the rules not for themselves, but for others. You are glad they do. When you see them after the operation, you say, “Thank you.”

Clarke is an emeritus professor of surgery at Drexel University at Philadelphia and clinical director emeritus of the Pennsylvania Patient Safety Authority.