Friday, August 28, 2009

Always be prepared

Operating is easy...if you are well prepared in advance. The MOST important part of the surgery involves not the OR but the stuff that happens in my office.

The history taking. Physical exam. Labs and imaging. Discussing options including nonsurgical management. Surgery is more than "Me operate and fix problem." Despite what the internists think, we do sometimes need to use our brain. Sometimes I have to talk someone OUT of having surgery if I think I can't help.

Take today - I knew that it would be a difficult case and booked the OR accordingly. Asked for the most experienced assist. Contemplated where to enter the abdomen. Put my bovie far away from my hands. Had in the room (but unopened) possible needed instruments and other things. One of the general surgeons was laughing at me - he knew of the patient and thought I was a might touched to consider operating on her.

Good prep work creates good luck, and the case went smoothly. Hopefully, she'll feel better.

1 comment:

Grumpy, M.D. said...

I only refer to 2 neurosurgeons, both of whom reject more cases than they accept. I think that's a good quality.