Friday, June 8, 2012

When things go wrong........complications as you call them!!

To err is human and to forgive is goes the saying.This is an apt saying but unfortunately,I am a doctor,I can cause error but will I get forgiveness so easily..........?May be not.It is the nature of my job.I am dealing with the most precious creation of the world ',the human life' and thus my margin of error is very limited.
Now I wish to let the ghosts of Aamir Khan and his Satyamev Jayte to get buried in it's grave ........enough of it......whether he says sorry to IMA ore not,whether the people think that all doctors are unethical,I need to rest this issue in peace for the sake of my peace.I love my profession,operating fibroids, endometriosis,polyps,removing uterus ,delivering babies and much more.I need to perform my work with full concentration or I might harm you.A pilot's job is very with so many lives but still they have an auto pilot.We have nothing like an auto surgeon.
Few days back one of our registrar's went to take a preoperative consent from a Lady for some surgery(not my patient so don't know it in great detail).The Lady's husband asked the young doctor whether she was taking this consent to cover the incompetency of the operating Gynaecologist.She was taken aback.......It is a medico legal requirement after all.
In all fairness to my patients I would say that none ........not a single patient of mine has shown any distrust towards the doctors.And I am greatful to you.
In my career spanning almost 13 years post PG,I have had my shares of complications.......not many ...........I can count them on my finger tips and in fact  remember all of them to write all the details about it.
One such incident took place around 3 years back.A lady with previous 3 caesareans and very big cysts on both ovaries presented to me.She had adenomyosis as well.Her CA 125 was elevated ( the ovarian cancer marker).She went to various hospitals and decided to get operated by me.Herself a qualified professional,her husband is also a well connected person.So we decided on removing the uterus and both ovaries,send it for frozen section to rule out any evidence of cancer and if any evidence of cancer to proceed for lymph node removal and staging.While removing I realized that her uterus was badly stuck with the bladder due to the previous caesareans.And despite my all gentleness I had inadvertently opened her bladder.My assistant Dr Deepa M,actually was quite shocked.But these things do happen when you are performing a complicated surgery.What is important is to identify it and to rectify it.I completed the whole surgery,frozen section suggested a benign condition.I repaired her bladder and post surgery informed the patient of her bladder getting accidentally opened.In post op periods her intestine took longer than normal to come out of the effect of surgery and she developed paralytic ileus.She had apparently a tendency for post op paralytic ileus,as she told me that she had a similar problem after each of her caesareans.She had Catheter in her bladder for about a week.In the meantime her ileus got better as well.3 years later she is fine with no problems at all.
When she left the hospital after about a week she left as a happy patient.But that was her who had 'forgiven' me.What would have you done.Done the same or declared me an incompetent surgeon who did a complication and covered it with the blanket of consents?Just think for a while and let me know your opinion.

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