A few more minutes with Andy Rooney

“I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.

But then I read what killed me: ‘serious complications following minor surgery.’

Now what the heck is that?

Nobody gets run over by a ‘serious complication.’ You don’t hear about a guy getting shot in the chest with a ‘serious complication.’ Sure, I didn’t expect to live forever (well, maybe only a little bit), but I was sorta going for passing out some Saturday night into my strip steak at that great restaurant on Broadway. Maybe nodding off in my favorite chair, dreaming of reeling in a 40-pound striper. You know, not waking up. This whole ‘death by complication’ thing is just so, I don’t know … vague and annoying.

Here’s something else that bothers me. This note I got a few days ago from a lady who says she’s a fan. She talked to a reporter at a national newspaper the other day. Asked the reporter, basically, what kind of complication ‘’did me in’? The reporter said ‘No idea what killed him. Unless someone dies unusually young, we don’t deal with the cause of death.’

Now I know reporters have lots to do. I was one myself before they started paying me to just say what I think. But I guess what this reporter means is, if I was 29 instead of 92, they mighta thought it was worth asking why I went in for minor surgery and died of ‘serious complications.’

Remember a guy named John Murtha? A Congressman. Democrat from Pennsylvania. He made it to 77, a real spring chicken next to me. We were talking about this the other day, and guess what he told me? He went in the hospital last year to get his gallbladder taken out. A tiny incision, they said. Laparascopic surgery. Only he died, too. The reason, you guessed it: ‘complications of surgery.’ The docs looked really sad about it but they wouldn’t give out any details. They said they couldn’t, because of family privacy, and federal privacy laws. But you know, people talk. Someone on the inside came out with it: ‘they hit his intestines.’

John figures it’s better that people know what happened. Maybe it’ll help docs figure out a way not to hit intestines when they do that surgery next time. Now what’s wrong with that?

I know what you’re thinking. That Andy Rooney – something’s always bugging him. Well, I guess it’s like my mom told me a zillion years ago, when she asked me at dinner if I knew anything about how the window in the garage got broken. I said no because I didn’t want to admit I’d been throwing a baseball with Tommy McNamara, and I guess my aim was really off. She looked at me with that look moms have … the one that makes you squirm and try to change the subject and finally offer to do the dishes if only she’ll stop looking at you like that. She said ‘Andy, just tell the truth.’

So … do me a favor. Something killed me. And it would be good to know what. You don’t have to squirm, or do the dishes.

Just tell folks what happened.”

Pat Mastors is founder, Patient Pod.  She is author of Design to Survive: 9 Ways an IKEA Approach Can Fix Health Care and Save Lives.

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  • Anonymous

    Thanks Pat (and Andy) for this thoughtful piece.  Realistically, it would be highly unlikely for the hospital to announce that the surgeon had – ooooops, sorry about that! – knicked the intestine during a routine procedure.  And let’s face it, any invasive  procedure on any 92-year old is fraught with possible problems. You’re so right – had Andy been “29 instead of 92″, we’d all of course want to know more, but hospitals would still be reluctant to satisfy the public’s curiosity for obvious reasons.

    • Pat Mastors

      Carolyn, of course, older people are in more fragile health,
      and yes, we all die of something! However I don’t believe it’s the public’s
      curiosity that’s at issue – it’s transparency.  It is no more
      “OK” to knick the intestines of a 92-year-old than a 29-year-old
      (unless time and gravity move our internal parts around in some unpredictable
      fashion). The more such errors are reported, the more information is available
      to those who perform the procedure, the more the process is improved, and the
      less medical harm occurs. News organizations can play a valuable role by
      routinely checking on publicly available cause of death information.
      “Sepsis” is one such COD that if aggregated could flag problematic trends with
      certain surgical procedures. Just my 2 cents.

      • Anonymous

        Agreed, 100%.

      • http://pulse.yahoo.com/_UQ52N63EO5UL7JQE7RLBOG3YRU kumud

        the alternative is to NEVER DO ANY SURGERY on a 92-yr-old, as happens in almost all other civilized countries in the  world.  But that is a slippery slope (what age is acceptable? 80? 70? no wait, over 65 is fraught with possible complications.  And what surgery is acceptable? lap chole? appy? no wait, even a skin biopsy can lead to rip-roaring sepsis with shock due to cellulitis in an immunocompromised elderly patient; not worth the risk)

        you get the point.

        and there absolutely is truth to the “time and gravity move our internal parts around in some unpredictablefashion” thing, not to mention the unforeseeable effects of prior surgery accumulating scar tissue over 6 or 7 decades etc.

        • Pat Mastors

          If that’s the case, I say please disclose these truths, to the patient, to the family, to the public, and to the medical literature upon which protocols and prognoses are established. Let’s not pretend surgery at 70, 80 or 90 is something it’s not. We patients (people) need to have realistic expectations of risks and outcomes based on facts and data. The fact that much of this is not shared with us, before or after consent forms are signed,  is unfortunate, and I think reflects an archaic mentality (e.g. patients – or the public – “can’t handle the truth”). I say, let’s all (patients, providers and payers) take a giant step toward a common acceptance of mortality, limited health care resources, and human fallibility.

      • http://drpauldorio.com Paul Dorio

        Actually, time and gravity DO move around our internal parts, as you wondered.

  • http://twitter.com/thoughtsthreads Terry Palardy

    This is so Andy Rooney … you have captured his conversational tone, his sense of humor, and his honesty. Well done!

  • http://profiles.google.com/mittmanpa David Mittman

    Great commentary. 
    Truth is people tend to over promise because things usually work out well. As someone else said, age is not particularly relevant when it comes to making the promise. I would also say that people are notified of all the complications and what you hear is “don’t tell me all those things can go wrong”. 
    At the end of the day your idea of a feedback mechanism on complications regarding age (and other variables) for both clinicians and patients has much merit and should be instituted.
    Thanks,
    Dave

  • http://profiles.google.com/mittmanpa David Mittman

    Great commentary. 
    Truth is people tend to over promise because things usually work out well. As someone else said, age is not particularly relevant when it comes to making the promise. I would also say that people are notified of all the complications and what you hear is “don’t tell me all those things can go wrong”. 
    At the end of the day your idea of a feedback mechanism on complications regarding age (and other variables) for both clinicians and patients has much merit and should be instituted.
    Thanks,
    Dave Mittman, PA

  • Anonymous

    Great piece! How many families know all too well about what can and does go wrong? Unfortunately, they tend to be  those families that were surprised by “serious complications following ANY surgery”. This subject deserves to have more attention.

    I just visited this authors website. Brilliant!
    Katherine Smith

  • DQUser

    There are three basic problems with the American medical industry.  In order of importance they are 1) money, 2) money and 3) money.   “Complications resulting from surgery” are most often the reselt of an error but how often do you hear of a hospital or surgeon admitting to a mistake.  For an example of what can happen go to this website: http://www.mayovictim.com 

  • Jacqueline McGrath

    Pat Mastors, your resurrection of Andy Rooney to make your points was ingenious. But the piece deserves broader exposure. I suggest you submit it for reprint to the AARP magazine, Readers Digest and the Saturday Evening Post.
    And why not incorporate your incisive MRSA piece and approach the producers of 60 Minutes? Go, girl!

  • http://www.facebook.com/rfdbbb Robert Bowman

    Andy was a source of inspiration. I have been reading “My War” about WWII and have new respect for the front lines, and more reasons why nations do stupid things. It helped me understand why nations have vested interests not to do revealing reports, such as the Butt Report which indicated total failure in British bombing. My US examples have been numerous failures in primary care reporting. Basic Health Access a blog or to back

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