u/McTendies69

Fellow OR people. I built the most accurate preference card of my career and it is for no surgeon in particular and somehow every surgeon I've ever scrubbed for.

A preview:

POSITIONING

\- Supine. He'll reposition it himself, sigh, then put it back exactly where you had it.

\- Bed height: wrong. Adjust until correct. You will not find correct.

INSTRUMENTS

\- His personal scissors, the ones with the tape on them. Never the good scissors.

\- One (1) instrument that does not exist. Nod. Hand him a Kelly. He accepts it.

PREP & DRAPE

\- ChloraPrep. Becomes a "betadine case" the moment you open the ChloraPrep.

\- Big drape goes on correct. He flips it. It was correct. Now it's also correct, but his.

TOP HINTS

\- No eye contact during the dissection.

\- "I don't need the cholangiogram" = set up the cholangiogram.

\- If he goes silent, you're open. Open the tray you already opened.

Full thing has meds, sutures, dressings, specimens, counts, and a whole scrub-tech workflow.

Full disclosure, I'm an OR nurse and I built a little tool that generates these case briefs (the real, non-satire kind), and I made this one in it as a joke. Card's in the comments if you want to read the whole thing or roast it. Just thought you'd appreciate the bit.

For any case, any service, any surgeon. You’ll know him, or her, or it.

The card they actually need. Works for a lap chole, a Whipple, an I&D, a code in the next room they wander into uninvited. One card. Every case. Every time.

## NOTES
- will convert to open; we do not speak of this)
- Scheduled time: 45 min · Block: 4 hours
- 0730 start. He arrives 0835, scrubbed and annoyed the room "isn't ready." It's been ready since 0715.
- Time-out: you run it perfectly. He answers the name check with "yep" and scrolls his phone through site verification.
- "Quick case." Three hours appear from nowhere.

## POSITIONING

- However you position it, he will reposition it himself, sigh, then put it back exactly where you had it.
- Bed height: wrong. Adjust until correct. You will not find correct.
- Whatever’s tucked, he’ll ask why it’s tucked. Whatever’s out, he’ll want it tucked.
- “This should be quick.” Open the long table. Open the second long table.

## ROOM

- 62°F for him, hypothermia for the patient. Patient wins. He does not lose gracefully.
- His playlist, loud enough to mishear the one count that matters.
- Lights off → on → “who turned the lights on.”
- A piece of equipment “just in case.” It is never just in case.

## INSTRUMENTS

- His personal scissors, the taped ones. Never the good scissors.
- A driver he’ll only call “the right one.”
- The setup is correct. He rearranges it into the identical setup and calls it better.
- One. Yes, one instrument that does not exist. Nod. Hand him a Kelly. He accepts it. “Perfect.”

## PREP & DRAPE

- Prep wide. “Why so wide.” Prep narrow. “I can’t see anything.” There is no correct border.
- Three-minute dry time. He says “that’s good” at ninety seconds. You work for the clock, not him.
- Big drape goes on correct. He flips it. It was correct. Now it’s also correct, but his.
- Bovie and suction clipped exactly where he wants them. He moves them. Asks who moved them.

## SUTURES

- Whatever you opened, he wanted the other one. Open the other one. He wanted the first.
- “The other one.” There is no other one. You open another one. He uses the first.
- Skin closure decided in real time, out loud, twice, landing on the one you didn’t open.

## SPECIMENS

- Dropped in your field, no name, no site: “you know what this is.” You don’t. You label it correctly anyway, under oath, in ink.
- “Send it fresh.” You hold the fresh cup. “Why isn’t it in formalin.” He wanted it fresh. Eleven seconds ago.
- 5:55 PM: “let’s get a frozen.” You make the call and absorb the sigh from both ends of the phone at once.
- “Don’t lose it,” said about a 3mm node, to the one person who has never lost a specimen, over the open biohazard bag.

## COUNTS

- Initial: correct.
- He adds a lap off the field “real quick.”
- “It’s not in there,” said with total certainty by the one person who cannot possibly know that. It is, statistically, often in there.
- Final: a personal journey for everyone in the room.

## CLOSURE

- Suddenly urgent. He’s narrating to the resident, dictating in his head, and asking who moved the Bovie. You did. Where he wanted it.

## DRESSING

- “Just a simple dressing.” You build simple. “Where’s the abd pad.” You add it. “Why’s it so bulky.” Because of the abd pad. The one he requested. Nine seconds ago.
- Dated, timed, initialed in ink. He looks right at it and asks when it was placed.

## UNIVERSAL HINTS

- No eye contact. Ever.
- If he goes silent, you’re open. Open the tray you already opened.
- “We definitely won’t need it” = set it up.
- “Almost done” has no relationship to time as you understand it.
- Glove size changes with his mood. 7.5 today. Probably.
- Warm irrigation. “This is cold.” It is not cold. You warmed it. It is not cold.

## POST-OP — THE REVIEW

- He’s in the hallway calling it “textbook” before the resident starts closing. You're still counting. You're always still counting.
- Sign out time. He’s already out the door.

Fellow OR people. I built the most accurate preference card of my career and it is for no surgeon in particular and somehow every surgeon I've ever scrubbed for.

A preview:

POSITIONING

\- Supine. He'll reposition it himself, sigh, then put it back exactly where you had it.

\- Bed height: wrong. Adjust until correct. You will not find correct.

INSTRUMENTS

\- His personal scissors, the ones with the tape on them. Never the good scissors.

\- One (1) instrument that does not exist. Nod. Hand him a Kelly. He accepts it.

PREP & DRAPE

\- ChloraPrep. Becomes a "betadine case" the moment you open the ChloraPrep.

\- Big drape goes on correct. He flips it. It was correct. Now it's also correct, but his.

TOP HINTS

\- No eye contact during the dissection.

\- "I don't need the cholangiogram" = set up the cholangiogram.

\- If he goes silent, you're open. Open the tray you already opened.

Full thing has meds, sutures, dressings, specimens, counts, and a whole scrub-tech workflow. Counts section nearly made me feel things.

Full disclosure since I'm not trying to be sneaky: I'm an OR nurse and I built a little tool that generates these cards (the real, non-satire kind), and I made this one in it as a joke. Card's in the comments if you want to read the whole thing or roast it. Not selling anything to anyone in here, just thought you'd appreciate the bit.