Rant of the Week

Surgical Error

In some kind of documentary to be shown on television in the near future, a brilliant Toronto brain surgeon comments on how discouraging his work can be when so many of his patients die. 

As discouraging as having a doctor give you an option with little real chance of a success, but a large probability of reducing your quality of life for what little time you do have left?

You know all those ads urging you-- if you are a woman-- to do a breast self-examination regularly?  Check, check, check!  Early detection will save your life!

Maybe.  But then again, maybe not.  A recent study conducted in Denmark showed that the results of therapies administered after "early" detection do not show a marked improvement over the results of therapies administered upon "late" detection.  I suppose the latter refers to a situation in which a woman never checked herself until she experienced some obvious symptoms.

A few years ago, it was de rigeur to insist on DREs for men over 40.   Digital Rectal Examinations.  Then again a similar study came to the conclusion that early detection did not improve the chances of survival for the patient, though it certainly resulted in drastic changes to the patient's quality of life.

Some people occasionally snipe at me for daring to question the wisdom of doctors.  Are you a doctor?  Then how do you know whether someone should have surgery or not?  How can you possibly make a judgement like that? 

Fine.  So let's consult a doctor.  (But first, since you are so high on "experts", what's your opinion of Global Warming?)   The trouble is, these new studies are conducted by the same "experts" that set us on the wrong path initially.  Doctors vs. Doctors.  Which ones are right?     Doctors in North America are quick to install tubes when children develop repeated ear-aches.  In Europe, they almost never insert tubes.  Doctors used to like to have pregnant mothers lie on their backs on an operating table to deliver their babies.  We now know-- from other doctors-- that that is about the worst possible position to be in to deliver a baby.  Doctors prescribed Thalidomide and removed your tonsils and maybe parts of your brain and still perform triple-bypasses.   

The vast majority of doctors probably do still believe in breast self-examinations.  But established wisdom is often wrong (you can't swim for one hour after eating?) and it gets entrenched, and it should not be surprising that it takes a few years for it to be dislodged. 

Sometimes, a radical new idea has hallmarks to it.  It "rings true".  It seems strikingly to address vacancies in the established wisdom.    But the idea that any cancer should be surgically removed or bombarded with deadly radiation has the kind of simple logic to it that you just know might not make as much sense as it seems to at first glance.  It flies in the face of something that seems more logical: do no harm.

For example, how do you explain this fact:  the professional group least likely to consent to surgical treatment is.... get ready... surgeons!

You are getting ready to travel by air for the first time.  Your best friend-- a frequent traveller-- has been urging you on.  Maybe he even sold you the airline tickets.  He escorts you the check-in desk.  Then he waves goodbye.  "Aren't you coming?"  "Are you nuts?  I never fly.   I'm taking a boat."

 

 

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