Thursday 28 March 2013

Surgical secrets

After recently debunking some medical myths, I thought it only fair to spill some secrets that most surgeons don't want you to know. I have to tread lightly here, because what I'm about to tell you might get my licence revoked.

Ok, there's a remote chance that maybe that could possibly be a slight exaggeration.

1) We are not interested in your life story.  I'm here to fix whatever problem you came in for, so please tell me everything about that.  But I really don't care about how your Aunt Myrtle is doing or how many cats you have. Your primary doctor may care about what vaccinations you had as a child or how often you pee at night, but I just want to get the information I need and leave your room so I can get started fixing you, so please get to the point.

2) I have no idea when breakfast is actually served.

3) I hate seeing patients in my office.  I went into surgery to fix stuff, not to sit behind a desk and do tedious paperwork while wearing a suit.  I'd much rather be fixing something or banging my head against the wall or sticking hot pokers in my eye than doing office hours.

4) There are thousands of medical conditions, and sometimes we can't remember one or haven't heard of Whatever-You-Have Syndrome since medical school.  Dr. Gregory House doesn't actually exist, so sometimes we have to google it.

5) We see you completely naked during surgery, and we talk a lot while you are asleep.  If you have stupid tattoos, we will see them.  It isn't because we don't like you, but if you have "YOLO" in big letters across your chest or "The Pleasure Zone" with an arrow pointing to your vagina (yes, I've seen these), we will talk about them.

6) Whatever embarrassing problem you think you have, we've seen it (and much worse) before.

7) We really do treat everyone the same.  Whether you're a homeless guy off the street or a CEO in an Armani suit, Ferragamo shoes, and a Rolex watch, you will get the same surgery, the same pain medicine, the same postoperative treatment, the same everything.  I don't care who you are - you are NOT getting more narcotics or any special treatment compared to the poor guy next door with the same problem no matter who you threaten to call.

8) Obesity makes surgery much more difficult in every respect.  Your risk of every possible complication is higher, and we dread operating on you because of that.

9) I have no idea how often the curtains in your hospital room get washed, but they are probably dirtier than the toilets and the floors combined.  Don't touch them.  In fact, don't even go near them.

10) For people who demand certain narcotics or tell me that you need antibiotics when I know that you don't, I wish I could give you a shot of saline and tell you it's actually medicine just to get you to shut the hell up.  I've actually fantasised MANY times about doing just that, but I'm told it's an "ethical violation" to lie to a patient like that.

Can any of you other medical types (emergency personnel, nurses, internists, emergency physicians, pharmacists, medical students, etc) think of any others I missed?  Please email them to me at and I'll do a followup.

This is top secret stuff I just divulged, so I hope you appreciate my taking this risk of revealing them..  If this update disappears and there are no more blog updates after this, that means "they" found me.


  1. Brilliant post as usual doc, made me wonder though, what is the most embarrassing thing someone has come to you with?

    1. I'm also quite curious as to what people would consider embarrassing, and maybe the least embarrassing thing that someone has been embarrassed about.

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  3. work at a pharmacy. one time a guy dropped off a script for adderall and asked me when it was last filled at my pharmacy. i told him 2 months ago and its okay to fill again now. after i ran it through his insurance, it turns out he had it fill at a different pharmacy a couple days ago. i told him that we cant fill his adderall when he returned a couple hours later and he started yelling at me, saying he didnt fill it anywhere else.
    here in texas c2's are extremely highly controlled. to say he didnt fill it anywhere else is completely bullcrap. people are stupid thinking they can trick doctors/pharmacists.

  4. Yukiko that's so true! I'm from Dallas. I see a psychiatrist who prescribes me Ritalin and Lorazepam. The CVS by my house knows me and my family and doesn't card me unless they have to write my I'D number in this book(usually for Ritalin or my dads pain medicine) but one time because of lack of inventory I filled my Lorazepam at a different CVS. It was like airport security. Guys like the one you dealt with are why there's so much more moderation.

  5. Just because you yell louder and put on a show, does NOT mean you will get seen faster, treated better, or given stronger pain medications. Your doctor/nurse can tell quite easily when someone is embellishing or completely feining pain. This drives me bonkers!

  6. What if I have a crush on my surgeon? Hes very professional with me. But I feel chemistry, what could I do? I know he cant express it...but can I? And when? I know there's the doctor, patient ethical issue?

    1. I can answer that one; in a clinical trial, the Master student & I had a crush on each other but ethical rules dictated that she choose between getting her Master & PhD (later on), or dating me.

      I don't expect much but told her she know when to contact me when she get tenure.


  7. One more thing...its post op now.Had surgery a month ago.

    1. It's not unethical for you to ask him out at this point. It is, however, unethical for him to accept.

      After 90 days (or so), the "post-operative" period is technically over. At that point, since he would no longer be your doctor, it would be relatively ok for him to accept. But that's a veeeeeeery grey area.

  8. Thanks for now feed back. I have some time. Hes a neurosurgeon. But only a few more post op visits. I'm not sure how to approach it. I thought in office would be awkward. And then I thought an eventual social media message. But I'm a one on one person...and think in person is best.
    I just don't know where else ill see him. My career isn't in medical. Also if I do it in office should I wait till last visit or before that to give him time to think. I know this isn't a dating blog lol. But I'm sure you know the Doctors view more then I and the Rules.

  9. Interesting point of view. I'd say something about patients being completely naked and about it's completely normal and not a big deal and I agree...for you it isn't,you see naked people every day,that's your job. But being a patient isn't a job and we don't live in a world where it's a norm to be naked all the time in front of strangers in your most vulnerable state. We learn to be modest when we are small kids,please keep that in mind before dismissing people's feelings about their own nudity. They may be out,it doesn't make it any easier beforehands for a patient to handle. Everyone can get it's necessary but it is not easy for all patients so... just be human about it. Don't tell patients to "get over themselves" or to "stop being immature". Telling them you don't care and that you've seen everything won't help people who're embarassed about it.

    1. Wonderful, well said, arrogant thing to say to someone I hope I never get treated by this Dr

  10. Being naked in surgery.... this is very difficult for some patients. I really wished Doctors would talk more to us about this instead of us finding out afterwards we are totally nude. Yes some of us don't realize this as other things are going on in our heads. There are patients who have been raped, drugged and raped, religious beliefs themselves and/or of their spouse or just very modest. As a woman who had things done to her by her own husband during the time of our marriage, I was suppose to trust him, how do you think I could trust you or anyone else. Do I think you would do something? Of course not, but the extreme fear tears at my soul and being this vulnerable destroyed me.
    I had to have heart surgery, thinking I would be covered except for legs and the center of chest since I was given stuff to shower twice with prior to surgery. To my surprise you are laid out naked arms streached out, completely naked and then cleaned. Your legs up in the air, legs spread apart and no covering except at the head. This was so traumatic when I saw how it was done after my surgery. Also,being at a hospital with a viewing area for students, doctors and not told about this was beyond me. No "happy shot"as they call it to calm me and seeing all the trays covered with a blanket was overwhelming also and all the people male/female who saw me in all my naked glory. Maybe if I was talked to, asked if I had any problems with it, understood this was to happen and us managed my problem by the Doctor then I wouldn't have the nightmares, and it wouldn't have caused my divorce from my new husband, my life. The Doctor may have saved my life to live, but at what cost... nightmares, life alone without my husband because I felt violated again and shut him off. So now I live a life alone, it's not a life to live. I would have opted out rather than lose everything. He still loves me and hasn't remarried, but I can't be with him because I can't be a wife to anyone. We had a great marriage, this changed it all. I've seen and still currently under a psychologist to deal with how I felt violated and the reaction that happened to me. Please take time to find these answers out from patients, we don't talk about it unless we have to. Your job may be done and you have saved us, but destroyed way more in the end. I would have had a different outcome if i was prepared and we worked a compromise, all females, maybe cleaned me while awake and covered parts as they finished with a private area, something. Also, working in the medical field myself, I've heard drs and their OR support staff nurses, surg techs so on, laugh and talk bad about patients, how they looked undressed to many of us at the hospital. Very sad some do this! Not all, but there are a few unfortunately and give others a bad name. In closing i would like to Thank you for what you do, saving lives. It takes a special person to become a doctor/ surgeon. Just one story that should have been different. Hopefully things can change to help patients with prior problems have better outcomes than I did.


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