Tuesday, March 19, 2013

Opposite Ends of the Spectrum

Recently I have noticed an emerging 'pattern' in some of the surgeons I work with. Let us call it the 3D versus the 5D split. The reason I am mentioning this in the first place is not to freak you out on your healthcare situation, but to clue you in to how one job can be done with such different behavior, action, quality, and heart (or lack thereof) as to be two completely different things! If I can see a pattern like THIS at my work, I am certain with the right curiosity and interest YOU may begin to see such patterns around you.

Let us call this the 3D-5D-3D sandwich:

Dr. 3D:

  • uses an open surgical technique that I have not seen in fifteen years. I find this shocking.
  • justification for said technique is 'it is cheaper'. 'Robot costs too much in time and takes too much anesthesia risk and expense'. Never once is robot technique acknowledged as 'better'.
  • Patient has no idea how risk of loss of sexual function is double to quadruple rate of risk in robot with this open technique.
  • blood loss is predicted at '300 ml'. In the O.R. during surgery I have to resuscitate patient for a blood loss in the range of 500-750 ml! Estimated Blood Loss (EBL) in a robot case for same procedure is less than 20 ml.
  • surgeon humiliates tech over set up in front of the entire O.R. and does not stop after tech apologizes
  • When I inform surgeon patient is hypotensive due to massive blood loss, surgeon says, 'it is only 300 ml' over and over and 'look the field is dry just catch up'. I calmly say, 'I have to inform you of this because it is my job'. The assisting surgeon pauses, taking in the fact that the anesthesiologist is stating, 'Blood pressure is seventy' and suggests transfusion to the operating surgeon, who refuses to give blood. I emphasize that 'I do cardiac' and 'I can fix this', and give strong medicine to improve blood pressure short-term as I give fluids with a pressure bag to 'catch up'.
In a word, this is a dinosaur, hopefully, a going extinct before too long into the future.

The energy of this surgeon is chaotic, rushed, irritable, and unpleasant.

The worst part is: this dinosaur THINKS they are giving excellent care, at a discount, and insurance companies, especially government-sponsored programs, REALLY LIKE IT!

Dr. 5D:
  • Gets paid cash only and provides high-quality service care to the elite
  • uses as little anesthesia as needed to get the job done
  • wakes the patient up in the O.R. and actually TESTS for signs of improvement with the work. If there is none we go back in and do it again (this is a closed procedure, not an invasive one)
  • Is going to the place, internationally, where the instruments are made and is taking a course offered by the company to 'keep up'
  • Is pleasant and light, and appreciative of the team
  • Is respectful to everyone, patient, pre-op staff, spouse, the same in the O.R. as outside the O.R.
Would you believe that both of these surgeons are roughly the same age?

The energy of this surgeon is healing, calming, and Light.

Dr. 3D--the ReMix:
  • Refuses for scrub tech from earlier case to scrub in
  • Is described in the most PC way possible by the scrub as 'the kind of surgeon that has blinders on--forget about that hole in the aorta, let's work on this anastomosis here' (an anastomosis is sewing two things  together, in this case, coronary artery graft to coronary artery)
  • Says, and I quote, 'This case only took me seven minutes! Is that enough for you to get a unit?'--implying that I am paid for anesthesia time and it might not compensate me financially because he is so fast. That one felt personal, although I did not show it. (I make more than him. Way more. Like, more than triple. My job is riskier than his.)
  • Puts an extreme geriatric patient through the risk of anesthesia for this seven-minute case.
  • Sincerely thanks everyone in the team, and then goes and makes a fuss in recovery room for a long time, is very loud, and needs computer specialists to help enter orders into the computer. Clearly relishes his role as 'Captain of the Ship'.
To me, this 'sandwich' clearly shows a fork in the road of  everyday behavior which is based on the internal self-talk that we have within. Both are options, but are near incompatible. I believe at some point there will be a separation of the two realities, mind-sets, therapeutic skills, whatever you have it, down the road for all of us.

And did I forget? I gave Reiki to all of the patients too! That part goes without saying....


Reiki Doc