The OR Cat.

Whenever we remove tissue from someone's body in the OR, it ends up in one of three places:

• stitched back inside again
• off to pathology for testing
• the incinerator for burning

Very rarely do we remove something entirely and the stitch it back in (in fact, I can only think of grafts and organ transplants as examples). Most often, the tissue gets sent to pathology for testing, in which case, the surgeon always hands the tissue to the scrub nurse and tells them exactly what it is (ie. "Distal ileum and proximal cecum, short stitch anterior, long stitch lateral"). They know that this means they should preserve the tissue in formaldehyde and label it accordingly. Then there's the tissue we take out and don't need to analyze. That tissue also gets handed to the scrub nurse. However, it seems a bit rude to refer to a piece of someone's body as "garbage" so instead we tell the scrub nurse that it's "for the cat". I'm not really sure if this is any better. The imagery refers to a hypothetical stray cat that lives around the OR and survives off the scraps of human parts we throw out. In actual fact, this tissue gets incinerated but for some reason, the cat saying has stuck. Creepy or cute? You decide. I vote cute with a hint of creepy.

This week at Grand Rounds, however, I learned that "for the OR cat" is not just an expression. A resident did a presentation their recent trip to The Gambia, entitled, "International Surgery - A Resident's Perspective". It was a great talk, with loads of pictures. One picture was of a turkey vulture sitting in the hospital's courtyard. The resident had put a caption on the picture stating "Africa's OR Cat". And, in earnest, she reported that since no pathology was available where they worked, all specimens from 'garbage tissue' to 'specimen tissue' were simply chucked into the hospital courtyard after each case and eaten by the vultures (or, if left until after dark, the hyenas). I have to admit, this seemed to me like a remarkably efficient, low-waste system. I felt significantly less creeped out by the physical evidence of real-life scavengers than I did about some fuzzy toothsome ghost cat lurking in the hallways of my local OR.

Oddly enough, the resident didn't mention if the hand-off phrase in The Gambia was "for the OR Vulture" rather than 'the Cat'. I'm rather curious to know...