Thursday, March 06, 2008

Taking things personally

Sometimes when you send a patient for surgery, even if it's necessary, and things go wrong, you just can't help but feel partially responsible for it.
A patient had pretty severe primary hyperparathyroidism. We had put off surgery for some years because she was fearful of the knife. And she has a complicated medical history.
But this year, because things had worsened significantly, we bit the bullet and decided to go ahead with surgery. Which went well, but she suffered some nonpermanent postsurgical complications.
It was one of those things, related more to her underlying health and no fault of anyone's. And every procedure has its risks and benefits, and it's always something we weigh before deciding to proceed. In her case, clearly she needed surgery.
But still, I felt horrid most of yesterday. During a lull in clinic, I went to see her in the hospital where she was recovering. Tried to encourage her as much as I could.
You know it's not your fault, that you acted in the patient's best interest. And that you shouldn't carry burdens such as these. But deep inside you mind, you do catch yourself thinking that this would not have happened if she didn't go for surgery.
Thankfully, she's likely going to be discharged today.


Anonymous Anonymous said...

I removed a retro-oesophageal parathyroid adenoma with vertebral artery sitting on either side of it not so long ago. I actually included stroke as part of my pre-op list of potential complications. It is a great burden that we surgeons have to carry week after week, that people do not wake up unwell or paralysed as a result of our handiwork.

10:07 AM  

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