The important lesson

         Communication is the center pillar of a successful surgical practice. Long years in medical school and hospital practice make surgeons accustomed to the blood and pus. It is easy to explain the possible complications of a disease to a medical student. But only a surgeon can understand the chance of collateral damages associated with a surgery in a difficult situation.

        Some days ago my professor was called in to gynecology operating room. They had opened a patient for a large ovarian cyst. The patient had history of four abdominal surgeries. The gynecologist made a rent in the rectum while separating the adhesions in the pelvis. There was bowel contents were released to the peritoneal cavity. Considering the nature of injury and comorbidities, my professor advised a covering colostomy after repairing the rent. Now the difficult part was to get things explained to the relatives. They will never understand how difficult it is, to operate in an abdomen with adhesions; they will never realize how easy it is, to get bowel injury while separating adhesions, even with utmost care. But my professor handled the situation very smartly. He met the relatives and explained them, that the tumor was adhered to the rectum. The options left were to leave the part of tumor or remove the tumor completely with a part of rectum, for which a covering colostomy is required. The relatives were happy to agree to do the colostomy.

         This incident is a story about my professor in medical school. He did a thyroid surgery; unfortunately the recurrent laryngeal nerve got damaged on one side. He could identify it on the table itself. He went to the relatives and explained about the patient condition. He said “I was in a difficult situation during the surgery, I had to choose between the life and voice of the patient. I asked God. He told me, life is more important than voice. So I had to do it that way. So patient may have some change in the voice, but thank Him for giving back the life.”

Medical translation: the art of medical communication

                        Although the term hemothorax and rib resection seems nothing unusual to me, a normal person who has left his connection with the subject of biology after schooldays might not understand it even after hours of explanation. That is just with medical terms, but that is the least difficult part. To understand how the operative procedure going to affect the daily routine of the patient is much more complicated. Even three years of residency is little time for the surgeon to assimilate it. But as a surgeon I cannot give the Maingot's book of surgery to the patient and ask them to read and understand about the surgery themselves. There should be an effective way of translating medical definitions and procedures to layman's language.

                     Here I would like to share some of the examples, my professor elaborates to explain things to patients and even the non surgical medical personnel. At this point I have to mention that a surgeon is very different from a physician. A doctor who has never seen or done any surgery after medical school training cannot understand or explain how real life situations are different from text book descriptions.

                   Crossing the road situation 

               A surgery with a described low risk is like crossing a road on a fine sunny day. What are the chances of getting hit by a vehicle or slipping down?

            
 Now for a surgery with a described high risk, it is like crossing the road during a stormy rainy night. The chances of getting injured is high.

             




 



 Ascending the stairs situation

                See...,  undergoing a surgery is like ascending the stairs till the third floor. I will have to do it, the patient have to do it, the attendant has to do it, the child has to do it, the eighty year old grandpa has to do it. You know, the child will run and climb, the grandpa might get breathless by the first floor. This is a simple example to show how the age can be a factor for surgical outcome.

             




    Making Rotti and curry situation

              If the attendant is a person who cooks, this is a helpful example to relate how much athey can rely on experience of surgeon.  " You must have made atleast ten thousand rottis (bread) or around five thousand dishes in life till now. But can you guarantee that the taste of the dish you are going to make will exactly be same as the taste of previous one? "
            That's the same with surgery, the surgeon might have successfully done the same surgical procedure five hundred times.But, the outcome of next surgery cannot be predicted as same as the  previous one.