47 Secrets Surgeons Are Keeping Away From You

• THREE DIFFERENT PATHOLOGISTS WITH THREE DIFFERENT ANSWERS

‘I got very upset on hearing that. Now I never rely on just one pathology exam. If your doctor finds something, ask him to send your slides to a nationally recognized reference lab—not just one or two slides but the whole lot—and get a second interpretation.’ —Bert Vorstman, MD, a prostate cancer specialist in Coral Springs, Florida

• SO OFTEN THE RISKS ON LEGAL CONSENT FORMS AREN’T THE THINGS WE WORRY ABOUT

‘Or, there may be one complication we’re really concerned about. If you truly want to understand the dangers, ask your surgeon, ‘What is the risk that gives you the most pause?’’ —Kevin B. Jones, MD, author of What Doctors Cannot Tell You: Clarity, Confidence and Uncertainty in Medicine

• IN MEDICINE, YOU CAN GET A DUI, GO TO JAIL FOR A COUPLE OF HOURS, AND WALK OUT AT 7 A.M. THE NEXT MORNING AND DO A SURGERY

‘You can be accused of sexual misconduct and drug and alcohol abuse in one state and pop over to the next one and get a license. Some state medical boards don’t even thoroughly research your background; they argue that the less-than-$10 fee to access national data is too expensive.’ —Marty Makary, MD

• SURGEONS WHO DON’T HAVE SELF-CONTROL

‘When things don’t go our way in the operating room, we can have outbursts. Some of us curse, some throw instruments, others have tantrums.’ —Paul Ruggieri, MD, author of Confessions of a Surgeon: The Good, the Bad, and the Complicated … Life Behind the O.R. Doors

• MISTAKES ARE MORE COMMON THAN YOU THINK

‘But most of them don’t actually hurt people. I work with residents, and I don’t let them do anything that I can’t fix if they screw it up. If there’s an error that I fix that I’m sure won’t affect the patient at all, I’m not going to say anything about it. That would accomplish nothing except to stress out the patient.’ —An orthopedic surgeon

• SOME PROBLEMS JUST DON’T FIX WELL WITH SURGERY, LIKE MANY CASES OF BACK PAIN

‘My advice? Grin and bear it. Some surgeons vehemently disagree. They say, ‘Oh, you have a degenerative disk, and that must be the culprit. Let’s fix it.’ But many people have a degenerative disk with no pain. There isn’t a lot of evidence that we’re helping very many people.’ —Kevin B. Jones, MD

• ASK ABOUT NONSURGICAL OPTIONS

‘Surgeons are busy, and they like to operate. A professor from my residency would say, ‘There is nothing more dangerous than a surgeon with an open operating room and a mortgage to pay.’’ —Kevin B. Jones, MD

• TALK TO YOUR DOCTOR ABOUT DONATING YOUR BLOOD BEFORE AN ELECTIVE SURGERY

‘Banked blood is a foreign substance, like an organ, and your body can potentially react adversely. If you can use your own blood or blood from your family, there’s less chance of those reactions.’ —Kathy Magliato, MD, cardiothoracic surgeon at Saint John’s Health Center in Santa Monica, California

• RESIDENTS MUST LEARN HOW TO OPERATE, AND IT’S REQUIRED THAT AN ATTENDING PHYSICIAN BE ‘PRESENT’

But ‘present’ doesn’t mean he has to be in the operating room scrubbed in. At an academic institution, ask whether your surgeon will be actively participating in the surgery or just checking in every hour.’ —Ezriel ‘Ed’ Kornel, MD

• IT’S INTERESTING HEARING WHAT PEOPLE SAY WHEN YOU’RE GIVING THEM ANESTHESIA

‘I once had a guy who was a horse trainer who started going on about how this one horse was a sure thing to win. One of the nurses collected money from everyone in the operating room and bet on the horse. It came in second place. The smart people bet the horse to place, but some had bet the horse to win, so half the staff was happy, and the other was upset. He woke up and had no idea what kind of ruckus he’d caused.’—Michael Salzhauer, MD, a plastic surgeon in Miami, Florida

• INTESTINAL OPERATION ON SOMEONE WHO HAD BEEN STABBED

‘As I was running my hand along the bowel, I came upon something and said, ‘What the heck is this?’ It felt like a condom. Then all of a sudden, it wiggled! I dropped it, shocked. The guy had worms.’ —Sid Schwab, MD, a retired general surgeon in Everett, Washington

• WORK ACCIDENTS MAY AFFECT SANITARY ASPECTS

‘During my six weeks as a surgical intern in the ER, I inadvertently stuck myself twice with contaminated needles… briefly nodded off in the middle of suturing a leg laceration, accidentally punctured a guy’s femoral artery while trying to draw some blood, and broke up a fight between the family members of a guy who’d come in with a stab wound to the abdomen. I was slugged in the head by a delirious patient in an alcoholic rage, spat upon, coughed on, vomited on, farted on, bled on, and mistaken for an orderly.’ —Paul Ruggieri, MD