In both my driving habits and my surgical practice, I look both ways

I noticed something different about my driving habits lately.  At a traffic light I used to accept the green as an open invitation to drive through unconcerned, confident that other drivers would see the red and do what they are supposed to do: stop.

I don’t do that anymore.  I always look to see if the road is clear, and other drivers have indeed stopped.  And then I go.  I have come to anticipate the worst of other users of the road, and I no longer take a chance, even if I am 100% within my rights to do so.

On thinking about it, the same thing has happened to my surgical practice.  I used to operate without dwelling on the negative consequences of surgery.  I’ve always known that bad things happen to patients even in the hands of good surgeons, but that didn’t stop me not giving the prospect a second thought when I was newly qualified.

Maybe it was the four year old tonsillectomy kid who had a respiratory arrest seconds after coming off the operating table, and whom I found blue and with fixed dilated pupils?  The anaesthetist and nurses were distracted with another emergency nearby at the time. (She made a complete recovery.)

Or the active, still working 80-year old who needed septal surgery to control annoying nosebleeds?  He slipped in the ward while waiting on the morning of the surgery – no one was to blame, it was a freak accident – fractured his acetabulum, and died six weeks later as a result.

I have come to see the green light of patients meeting criteria for having a surgical procedure as an opportunity to stop, look around, and think, “Why should I not be doing this operation?”  For a surgical patient can be a little like the tired, asleep, distracted, drunk, drugged driver careering towards your intersection, and both of you are going to bear the consequences.

Like young drivers I used to think I was invincible, as a young surgeon that complications happen to someone else, and I was wrong.  Maybe it was the so-nearly-a-facial-nerve-injury in my surfer patient having surgery for exostoses, or the so-nearly-an-optic-nerve-injury in my patient with terrible sinusitis, and whom I thought for a terrible hour as I finished the operation that I had blinded in one eye. (He wasn’t blind, but I was ten years older immediately afterwards.)

And so, in both my driving habits and my surgical practice, I look both ways before I put my foot down.  That attitude does not come from a textbook, nor from talking to older surgeons or colleagues.  It comes from direct experience gathered over time.

You might call it the beginning of a priceless quality for a surgeon – wisdom.

Martin Young is an otolaryngologist and founder and CEO of ConsentCare.

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  • Anonymous

    I am 69 and probably about five years ago I adopted the same procedure when I encounter a green light, I always look both ways before proceeding.  It seems the older I become, the more safety conscience I become.  Maybe it is because, after you bury a few friends because of stupid accidents one realizes that you are not invincible.

  • Michal Haran

    This is true not only in surgery, but in any other field of medicine. Also, making those decisions is more like standing in an intersection with multiple and confusing traffic lights, in which you can easily be misled by a green light which is not in your route of driving, or think the light is still red when it has turned green long ago.
    We can’t always fix the misfortunes of nature, and sometimes being overzealous about it, can cause much more harm than good. One of my (excellent) mentors told me years ago (when I was young and enthusiastic to cure all my patients)- It takes a very good physician to know when and how to treat a patient, It takes an extraordinary physician to know when to withhold treatment. 

  • Michal Haran

    This is true not only in surgery, but in any other field of medicine. Also, making those decisions is more like standing in an intersection with multiple and confusing traffic lights, in which you can easily be misled by a green light which is not in your route of driving, or think the light is still red when it has turned green long ago.
    We can’t always fix the misfortunes of nature, and sometimes being overzealous about it, can cause much more harm than good. One of my (excellent) mentors told me years ago (when I was young and enthusiastic to cure all my patients)- It takes a very good physician to know when and how to treat a patient, It takes an extraordinary physician to know when to withhold treatment. 

  • http://www.facebook.com/people/Charles-Cohn/730439597 Charles Cohn

    What you describe is a major reason that I drive a gas-guzzling fulll-size van.  On one trip a car on the other side of the interstate had a collision late at night and then caromed across the median and hit us.  No damage except for a couple of broken ribs.