Keeping it in the family

I wouldn't let her take out my spleen

I wouldn’t let her take out my spleen

The test of whether or not you rate a colleague as any good is whether or not you would let them operate on a member of your family. This test is seldom (thankfully) applied but patients in your care sometimes ask if the surgeon who will operate on them is any good and seek your assurance, as a doctor that they know and trust, that this stranger is up to the task. This question is easily answered when it someone you do rate highly as a surgeon and is fraught with problems and stress when it is someone you would not let near your neighbour’s cat. Again, this occurs rarely as most people are good enough at most things that they do. It is good fun in fact to recommend a former boss who you think is great. The pain comes when it’s the opposite. To avoid answering this question directly one could use a generic reply “all the surgeons here are good, I’ve not heard anything to the contrary about Mr Handslikeshovels and I am sure it will go fine” If anyone recommends a colleague this half heartedly they are trying to tell you that they do not hold this person in high esteem.

A similar thing can occur with certain new and novel treatments and certain operations. A friend of mine used to regularly talk patients out of their Whipple’s the night before surgery much to his consultant’s fury. He was firmly in the “get pancreatic cancer and spend your last few months in hedonistic glory” camp, not for him months in hospital with comorbidity and misery. He is a pessimistic kind of guy and I disagree about Whipple’s as it happens and would take my chances with surgery.

The test of a new operation is would you want your family member to have it done the new and novel way if required. Quite frequently the answer is that you wouldn’t. Old ways were of course once new ways but any new technique should be applied with caution and continual audit of personal and unit results. When offered a new operation or a new procedure be sure to obtain the surgeons own results, find out their own experience and what complications they have had. You wouldn’t let just anyone do your garden or your decorating, apply the same prudence in letting someone take a knife to you.

To finish on a happy note a patient I had admitted and looked after was handed over to my colleague, the Prof, for his operation. “Is he any good this chap?” asked my patient. “I’ve known him more than 13 years. He’s the best there is” I said “He is as good as we have got and a really nice guy too”. The patient was out of his bed day 1 walking all around the hospital and was ready for home day 2. He believed the top man had done the operation, and so he had an exceptionally good experience and fast post operative recovery whilst most patients who have this operation stay 3 to 4 days.

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