Friday, 10 May 2013

Measure twice, cut once

"Measure twice.  Cut once." 
This quote is actually a basic tenet of woodworking rather than surgery, but the meaning still translates to surgery (and medicine in general) very well.  When you're cutting a piece of wood, you are supposed to make a measurement, mark the piece of wood, and then recheck the measurement before powering up the tool and doing something irreversible.  If you're about to do something that you absolutely CAN'T take back, you'd better make DAMNED SURE you do it right.  So check your work, then double check it, and only then should you cut.

Though this blog seems to be mostly about my own self-glorification (not really), I'm sure it will come as a great shock to many of you that I, DocBastard, am not perfect.  No, no really, it's true.  Please try to contain your surprise.  Damn it, contain yourself!  I am actually not immune to stupid moments, and I may have erred ever-so-slightly once or twice.

(By that I mean that I have had more than my fair share of moments where I've hit myself in the head, called myself an idiot, and wished there was a big pile of dirty glass shards that I could jump into for whatever my most recent egregious fuckup was.)

So of course since this blog is dedicated to exploiting my greatness (not really), there's no way in hell that I would actually reveal any of these "epic fails" (as the kids say), right?

Wrong.

When I was still in training doing a rotation in pediatric surgery, I was given the distinct honour of informing a 6-year old boy named Thomas (not his real name) and his parents that he did not, in fact, have Crohn's Disease, which is a terrible, incurable disease where the body attacks its own digestive system.  The tests had all been done, and they were definitively normal.  Wonderful news!  I marched happily into the room and gave them the good news, much to the delight of the little boy and his parents.  The three of them cried with joy, and I got to witness the sheer happiness on their faces.

And then Thomas and his parents walked into the room.

Uh...um...oh SHIT.

I had mistakenly given the news to his roommate Isaac (also not his real name).  Sure, I had the right room, but I had not thought to double check the bed number in the room, nor had I made sure that the little boy I was talking to was actually Thomas.  I immediately looked for a pit of sand in which to bury my head, but finding none I simply apologised profusely.  I suppose they saw the look of sheer terror (and idiocy) on my face, because fortunately Isaac's parents were very understanding of my little flub.  Before I got the chance, Isaac happily told Thomas the good news, and both of them started jumping on their beds, giggling like tiny mad scientists.  I think that was a better ending than mine would have been anyway.

Ever since then, I always verify the patient's name when I enter a room.  It certainly wasn't my first mistake, nor was it my last, but it was definitely one of my worst.  I'm sure I've repressed some other momentary lapses in sanity, and as the horrid memories resurface, I'll be sure to expose some of my other sins.

And before you ask, no I've never cut off the wrong leg or removed the wrong kidney.  Shame on you for even thinking it.

EDIT: In case you're wondering, this isn't a repeat of a post from a few weeks ago.  I had written it then but hadn't posted it until a few days ago, but it was posted on the day I wrote it instead of the day I posted it.  I just deleted it and reposted it today.

11 comments:

  1. Doc, Well cutting off limbs (for whatever reason) how can doctors screw something like that up? It seems pretty hard to not get the right limb, I mean it must be written down somewhere that it's the left and not the right...
    Does that make any sense?

    ReplyDelete
    Replies
    1. It does seem ridiculous, doesn't it? And yet, it still happens.

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  2. Although its not related to this post, I have a question Doc...when someones hand is cut off how do they not die, if they can die with slashed wrists??? BTW Doc, I have been following your blog ever since it began, as well as your FML comments(your my favorite commenter) and because of you I have begun to wear my seatbelt which saved me from a life threatening accident, and I have decided to be a doctor. I am starting university in September, wish me luck! Keep writing and saving lives Doc!!!

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  3. Hi Dhaliwal!

    I'm not a doctor but I'm pretty sure that the reason you don't die during an amputation is that the doctors know what they are doing! Sounds stupid, but if you work carefully and close off/rejoin the major blood vessels (veins & arteries) after you cut them then you don't get all of their blood pouring out like it would if you slash your wrists.

    Imagine a heart transplant! You couldn't do that without a perfectly choreographed procedure for keeping the blood under control and flowing while you remove an organ that's so essential it can be seen beating after only a few weeks gestation. However, years of analysis, trial and plenty of error eventually lead to a protocols that exploit every trick and loophole we can come up with to keep people alive while they are stripped out and re-fitted in amazing ways. Only humans can do this because we are the only species who can learn from the accumulated knowledge of thousands of others. Aren't we an amazing species!

    ReplyDelete
    Replies
    1. But what if the limb is amputated without surgery??? My aunt's hand was cut off back in India by mistake and she's still alive 50 years later...what was the difference between that and slashing wrists that she was fine after one and if her wrists were cut she probably would have died :/ it always confuses me

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    2. It may be 'cause the cut was very clean and she propyl got medical help very quickly. Not to mention a lot of luck.

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    3. Severed arteries have a tendency to go into vasospasm and shut themselves off, so to speak. Most people who try to slash their wrists don't come near the radial or ulnar arteries. It's a very inefficient (and painful) way to commit suicide.

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    4. Is it true that young peoples main arteries become thin when damage to reduce the amount of blood lost?

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    5. Yes. All arteries at any age will do it to some extent unless they are heavily calcified.

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  4. Replies
    1. There was no news for him unfortunately. He was there to have his Crohn's disease treated.

      Delete

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