This Surgeon's Thoughts

I got an email from a friend today with the following quote about a question that another friend had asked him.

In casual conversation ** mentioned that he was always
curious about what a surgeon thought about before an operation. Was it
just the body of the day on the table? Was it a known person who had been
researched ahead of time? Etc., etc. I can't really relate his thoughts
but he is kind of a deep thinker on things like this but would be afraid
to ask questions of a real surgeon because ** would think of them as
being so far above him.

Well, I can only answer for myself. First, a surgeon puts his pants on one leg at a time just like everyone else. So, lets just forget the caste system. If you are willing to let some person flay you open with a scalpel without questions, you aren't the sharpest tool in the shed.

With few exceptions, I never was a personal friend of a surgical patient under my care. I did, on occasion, have occasion to operate on friends or children of friends. It was usually an unpleasant emergency situation and was an added stress. I did do several operations on friends with serious and yet non-traumatic conditions, where life could be lost or, the person left incapacitated in some way. Again, these were stressful above the norm.

With an "average" operation, I did not dwell on the procedure or patient to excess. Depending on the procedure's complexity, the preparation mentally varied. I was never a "ghost" surgeon, so I always knew the patient's background from a health standpoint, considered the complications, and discussed this, as well as the risk/benefit ratio, with them. In the case of children and those without good faculties, this was done with some responsible party. Of course, with emegencies, there was often no choice. I have met a number of parents and relatives for the first time after the surgery was done, and the patient had been treated in an emergency.

With complex procedures such as intracranial and intraspinal tumors and vascular lesions, I used to try and walk myself through the operation the day before. For some years, I was a runner, and many an operation has been rehearsed in my mind as I did my morning run. It was always good to plan for contingencies. The old saying that no one likes surprises in an operating room is true. They are usually not pleasant. For many of my operating years, I had a scrub nurse that was always with me. We could discuss in detail, if needed, the procedure beforehand. That was always helpful too.

So, in a nutshell, that is it. Anyone with questions can leave me a comment, and I'll try to answer.