Two new books are on this last task. A homes on the most majestic wildlife resident, divine footsteps surgeons in the hospital corridors, breezing past the rest of us dithering pill-pushers shortly discussed on our computers. Many surgeons can be small women these days, but somehow, they all seem to 15 feet in height.
Dr. Paul a. Ruggieri summarizes their ethos bluntly: If you are patient, "I do not exist to talk about your heartburn, of neck pain, gain of weight, fatigue, or swollen legs." This is not my job and, frankly, I am not interested. "The surgeon, said, is to operate (or sometimes more difficult to determine operating). The rest of the book belongs to the small crowd, leaning, dithering.
In General, the surgeons that meet us as memories are somewhat atypical of the species, such as the poet-philosopher Richard Selzer, or the thoughtful political guy Atul Gawande. Dr. Ruggieri, by his own description, is a regular Joe Scalpel: a student means, he is a graduate in debt in the middle of his medical school class, survived a grueling old style residency program and now works in private practice in a community hospital.
As a general surgeon, Dr. Ruggieri spends his time not probe for the location of the soul, but deeply in intestinal cuttings: "I must take several feet of your colon, sir." "It sound good next week"?
Of course, just because you are a demigod in the O.R. does not mean you are exempt from the perplexities of modern medicine, and it turns out surgeons get their share and much more. For all the immediate gratification of the calling - they can resurrect the dead with a few knife slashes and a purse-string suture - they are too condemned to a bit of dithering.
Calculation of risks and benefits of surgery in a sick patient age is only a part of it. Like everyone, surgeons are tormented by ambiguous test reports, including careful wording often forces in an unnecessary operation. Right of malpractice casts a giant shadow in their decision-making process, with statistics showing that virtually all surgeons will be named in a suit at a point in a career.
Dr. Ruggieri meditates at length on poor surgical results - some the foul the poor surgeons, some of the bad equipment, some bad luck. Human flesh is never completely reliable and a successful operation will not necessarily improve the health of the patient. Inexperience, impatience and fatigue can all undermine fundamentally competent surgeon; Dr. Ruggieri makes the interesting point that even if training programs now restricting resident work hours, a fully qualified surgeon may nevertheless have been up all night with an emergency before a full day of elective surgery, including yours.
And while the sailing smooth in the operating room is an exhilarating rush and ego - boosts, things can go wrong in an instant, leaving the surgeon "grasping blindly in a rising pool of blood."
Some statistics describing "best" hospitals for a given type of surgery are available to the public, but measures of performance for individual physicians are generally not. Ask your surgeon before your procedure, Dr. Ruggieri complication rates suggests - you will need to assume the answer is true. And if you want to know what happened while you were sleeping, track down the report of the device (although even in this document may not reflect all nests hen trip).
It must be said with some emphasis that the realistic dialogue of creation is not strong of Dr. Ruggieri, but the reader will forgive him stiff-necked paragraphs, it encloses quotation marks for the immediacy and honesty of the rest of his story. He offers anecdotes required featuring unhappy people impaled by sharp objects (including the Horn of a rhinoceros irritated), but it is at its best describing his own worst moments, muttering under his breath to a recalcitrant section of the intestine, his right eye twitches anxiety, wondering why he did not go for MBA instead.
A preoperative patient may prefer to leave the book of the Dr. Ruggieri at home until it is safely on. Elizabeth Bailey book, however, specifically to include in the suitcase of the hospital, a marketing gimmick is not a bad idea at all.
Checklists for doctors to perform have shown to reduce errors in the hospital. Ms. Bailey offers a collection of checklists for a patient finish for the same purpose. There are lists for "going" and "" during your stay,"various ways to organize the cup of unfamiliar drugs left by your bedside and articles for your escape planning and deal with your insurance." We need someone who is ill exceptionally energetic to fill everything, the book will be a boon for concerned friends and relatives, trying to rein in the chaos.
And for background reading, no one should miss introductory essay of Ms. Bailey: a producer of music videos, she was pushed in the role of patient advocate when his old father has been systematically mauled by one of the major teaching hospitals in New York. Bravo to him to turn that all too common misery for a constructive purpose.
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