Dr. Ruggieri goes on to say…
Like poker players and their cards, surgeons are sometimes only as good as the patients they are dealt. Obesity, excessive scar tissue from a previous surgery in the same area, disease that is more advanced than anticipated–any one of these physiological conditions creates more work and a more difficult environment for the surgeon.
Even before the surgery begins, underlying or chronic conditions such as a history of hypertension, cardiac disease or lung disease put patients at risk for complications. Today, based on your medical history, surgeons can usually analyze, quite accurately, your risk of complications (or death) before setting foot in the operating room. All you have to do is ask.
I had no idea how bad Mr. Baker’s colon disease would be until I opened him up and looked inside. It was a mess. If I were playing poker and this man’s anatomy were the hand dealt, it would be time to fold.
“That is one of the ugliest pieces of colon I’ve ever seen.” I grabbed the scrub nurse‘s hand. “See, touch that thing. Look how inflamed it is.” When given the chance, scrub nurses love to touch organs in the operating room. “OK, don’t poke it too hard, it will start to bleed again.” Her hand drew back onto the instrument stand. I was in for a long night.
Tonight, the diseased colon on the menu was angry, cursing and taunting me: “Good luck, Mr. Big-Time Surgeon, trying to remove me.” Surgeons frequently have conversations with the body parts or organs they are trying to remove. We also have conversations with ourselves; it’s a way to blow off steam while our minds scramble to deal with the unexpected.
“By the time you are done with me, your back muscles are going to be in a heap of pain,” the colon went on. “Looking forward to that drive home in your new Porsche? Well, too bad. It’s going to have to wait. You better take your time or I’ll come back to haunt you in a few days.” I could hear the colon laughing at me. I was crying inside.
“Nurse, hand me a curved scissors.” Finally, I was granted a little success in freeing up one end of the colon. But that was short-lived. More bleeding. I hate this. And I had cut myself. I stared at my finger. “Nurse, I need a new glove.” The outer skin under my glove was breached, but not deeply.
“Almost got you,” the colon said. I could not shut the thing up. “How do you know I don’t have hepatitis or H.I.V.?”
Just great, I thought. Now I have something else to worry about.
“You’re going to earn your fee tonight, Dr. Surgeon.” The colon kept talking. “I hope you’re not in this business for the money, like the last guy who operated on me. Between what Medicare pays you, the phone calls in the middle of the night and the time you spend guiding my recovery, I figure you will make about $200 an hour for this operation. How does that grab you?”
Should have gone for my M.B.A., I mumbled to myself. Big mistake going into medicine, never mind surgery. If I could only go back and do it over again.
The colon’s rant continued: “Wait, subtract what it costs you in overhead to bill for this operation (double that if the claim gets rejected), plus malpractice costs for the day, and we are now at $150 an hour. And how could I leave out the biggest expense of all? The price of the mental stress from worrying about me after the surgery (and double that if there’s a complication). Now, I figure you’re under $100 an hour. Plumbers make more than that just to step inside your house. I bet they sleep well at night. Just remember, Dr. Surgeon, nobody put a gun to your head. You chose this profession.”
I could swear that the thing was laughing at me. “Forget about keeping those dinner reservations tonight. You and me, we’re going for breakfast once this is over.”
A lot to mull over.
Is it refreshing to learn that doctors are, after all, only human? Or is it better to continue foolishly believing that they are beneficent super-heroes?
Does the surgeon have a breaking point? What happens if it’s in the midst of an operation? Is there a back-up doc who’s a principal…or merely an under-study not good enough for cast A?
Has a surgeon ever quit in the middle of an operation…leaving to become a plumber instead? Maybe plumbers should operate? Both deal in…nuts and bolts…pipes…rotor-rooting…plungers. Probably make the same money. Could be interchangeable…you think?
Makes me think I’d better brush up on my medical books…and get past self-diagnosing. Never know. I might be called on to take over for the doc…and self-operate. Sheesh!!! As if i don’t have enough to do…lying there, worrying. And i’m scheduled for a dual procedure the end of the week…an endoscopy/colonoscopy.
I’d better start cramming…big time!…which shall it be?