Ed Gavagan: A story about knots and surgeons

You know, we wake up in the morning, you get dressed, put on your shoes, you head out into the world. 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 gives it 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, there's just, 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 is changed forever.

And one night, I'm riding the uptown local train. I get on. 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. And 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, and she's got her leg draped over his knee, and they're doing -- they have this little contraption, and they're tying these knots, and 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.

And 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 and a laptop bag and the tweed jacket with the leather patches, and — (Laughter) — he looks at them, and then in a blink of an eye, he kneels down in front of them, and he starts to say, "You know, 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. And 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. (Laughter)

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's 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's 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." And 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, and what had happened was a gang had come in from Brooklyn. As part of an initiation for three of their members, they had to kill somebody, and I happened to be the guy walking down Bleecker Street that night, and they jumped on me without a word. One of the very lucky things, when I was at 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, and everything, of course, on the way up, and then — I still had my hands up — he pulled it out and went for my neck, and sunk it in up to the hilt in my neck, and 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, by hitting that guy, to get a minute. I ran down the street and collapsed, and the ambulance guys intubated me on the sidewalk and let the trauma room know they had an incoming.

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

And I get into the trauma room, and they're waiting for me, and the lights are there, and I'd been able to breathe a little more now, because the blood has left, had been filling up my lungs and I was having a very hard time breathing, but now it's kind of gone into the stretcher. And I said, "Is there anything I can do to help?" and — (Laughter) — 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, raising money for the flood victims of Bangladesh, and then I look over and my anesthesiologist is clamping the mask on me, and I think, "He looks Bangladeshi," — (Laughter) — and I just have those two facts, and I just think, "This could work somehow." (Laughter)

And then I go out, and they work on me for the rest of the night, and 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, and 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. (Laughter) And 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, and it was, waking up was like breaking through the ice into a frozen lake of pain. It was that enveloping, and there was only one spot that didn't hurt worse than anything I'd ever felt, and it was my instep, and he was holding the arch of my foot and rubbing the instep with his thumb.

And I looked up, and he's like, "Good to see you," and I was trying to remember what had happened and trying to get my head around everything, and the pain was just overwhelming, and 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." And 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. (Laughter)

But I had three days of life support, and everybody was expecting, due to just the massive amount of what they had had to do that I wasn't going to make it, so it was three days of everybody was either waiting for me to die or poop, and — (Laughter) — when I finally pooped, then that somehow, surgically speaking, that's like you crossed some good line, and, um — (Laughter) — 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 they bend over me and they're poking and prodding, and they're like, "There's no hematomas, blah blah, 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." (Laughter) And it was just, it was amazing, because these guys are high-fiving him over how good I turned out, you know? (Laughter) And it's my zipper, and I've still got the staples in and everything.

And 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 gonna do? And I think, kind of, as a surgeon, he basically said, "Kid, I saved your life. Like, now you can do whatever you want, like, you gotta get on with that. It's like I gave you a new car and you're complaining about not finding parking. Like, just, go out, and, you know, do your best. But you're alive. That's what it's about."

And then I hear, "Bing-bong," and the subway doors are closing, and my stop is next, and I look at these kids, and I go, I think to myself, "I'm going to lift my shirt up and show them," — (Laughter) — and then I think, "No, this is the New York City subway, that's going to lead to other things." (Laughter)

And so I just think, they got their lecture to go to. I step off, I'm standing on the platform, and I feel my index finger in the first scar that I ever got, from my umbilical cord, and then around that, is traced the last scar that I got from my surgeon, and 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.

Thank you. (Applause) (Applause) Thank you. Very lucky to be here. Thank you. (Applause)