Wednesday, November 9, 2011

Life Changers: the surgeons of Light versus the surgeons of Dark

Today I saw the difference between good surgeons and bad surgeons played out in front of me. I also saw the power of negative thinking work to the detriment of a son, to the extent it was, as he called it, 'a life changer'.

In the morning was the gastroenterologist of Light. His patient's anesthesia was rocky. There was a strong gag reflex in a very large patient. He was not judging. He let me intervene. He ended the case quickly. We wrapped up with a discussion of how we could handle that clinical situation better in the future. On the next similar patient, we did as planned, and it went well.

During a delay, he told jokes. Everything was positive, appreciated, open, and calm.

The other gastroenterologist I worked with was of the same ilk. Older, kind, and very intellectual.

Then, like night and day, once back in the operating room suite, I saw Tom Jones in Indian culture: same accent, same hair, same build. He had the reputation of being mean. He was new. It was my first time with him. I was direct and professional. It turns out he has been fired at several places. So he comes to ours.

We are a haven for the surgeon who has been kicked out of his hospital! We have those that have made the paper for malpractice, several. I find that often they are actually nice, and many times, good at what they do.

Tom 'Raj' Jones took over an hour to put in a portacath. Everything was negative. And so it did manifest.
I was struck at how the patient--anxious pancreatic CA--matched up with the surgeon perfectly. Are they each other's lesson? Dr. Jones was nice with me. I am a Reiki Master! LOL. But with my colleague he was insulting and blaming his ineptitude on anesthesia.

What was next? A Patient who had coded in her last surgery. I tried my best to figure out what it was that caused it. Luckily, I manifested myself into another case, and someone else took this 'gem' for me.

So--with the surgeon I like, podiatrist Dr. Raza, who cusses and swears bilingually as he operates, the one with a false eye, I so may add...I enjoy working with him. It's easy. Monitored anesthesia care. Quick case. Go home.

No so fast--the doctor-patient-parent triad was phenomenal. The mother actually told the wife of the patient (who for some reason was not there) that the adult son was going to 'lose his foot'. He was insulted. Well, guess what? Dr. Raza, whom the scrub tech Viva said was so bad she 'would not let Raza give her a pedicure', screwed up. Not only was the foot more gangrenous, a transmetatarsal amp was indicated. But Raza couldn't do it because it was not on the consent. Raza asked for saw, Viva said no. Viva had nursing come into the room. So it was a debridement only, on an awake patient, who is an extreme sports enthusiast hearing about losing a foot.

Very strange day.

Thoughts are things. I have to go.