Ok so I was asked if anyhting interesting happened on my night shifts. to be fair, nothing really. It was alittle like waiting for the storm to arrive, but nothing did.
However I did learn one thing.
When NOT TO OPERATE!
I was asked by a surgical reg to go and assess a lady that they wanted to do a laparotomy on. These are the details:
- 92 years old
- admitted under medics 4 days earlier with abdo pain
- treated as an UTI
- now becoming hypotensive, tachycardic and tachypnoeic
- deteriorating conditions at home
- minimal function
I assessed this lady and was extremely concerned that she would not survive any operation! But the surgeons still wanted to operate :O My boss was in and even came to see this lady herself. We spoke to ITU and decided that she would have 100% mortality if we anaesthetised her. In fact she had 100% mortality in the next few hours/days anyway. She would not leave the hospital. We spoke to her family and informed them of this, they were happy to leave it in our hands as they realised how sick she was. The operation was cancelled.
I found out from the medical team that this lady passed away 5 hours later.
So the lesson to be learnt is:
A good surgeon knows when to operate.
A great surgeon knows when not to.