a difficult case, a lesson from the British
Thursday, April 25, 2013 at 8:15PM Yesterday I had a challenging case. A middle-age woman with mitral insufficiency. We couldn't determine exactly what the problem with the mitral valve was. I tried to repair it twice, and it still leaked. So I replaced it. You can't keep the heart stopped indefinitley while you puzzle over an anatomic conundrum. At her age, we couldn't be satisfied with a less than perfect result. The mechanical valve will last the rest of her life, but she will need to take Coumadin. She's doing fine.
But I bring this up as a way to talk about the conduct of a dificult operation. Any surgeon, no matter how accomplshed, will have a tough case from time to time. What I have learned over the years is that how you handle this is how you define yourself as a surgeon. One of my first partners told me that he "slows down all of his movements". It was a simple statement, but valuable advice. All of us tend to get anxious and jittery in stressful circumstances. This is expecially true when a life is at stake and the clock is running. I might have a tendency to hurry my movements and yell at my help, but I've learned better. I make my movements slow and deliberate. I consciously appreciate my good helpers. I keep the operating room and myself calm. I've learned, over many years, then the more I try to hurry, the more slower I get.
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"Drink your tea slowly and reverently, as if it is the axis on which the world earth revolves- slowly, evenly, without rushing toward the future; live the actual moment. Only this moment is life."
- Thich Nhat Hanh