A conversation between a surgeon and
his patient the day before his surgery.
Doctor: Make sure you get a good
nights sleep!
Patient: Speak more clearly doc –
your mumbling.
Doctor: How long will you sleep
tonight?
Patient: It is not me you should worry
about doc. You are already having trouble speaking and it’s only
nine-thirty in the morning. I think the issue is how much sleep will
you get tonight?
Doctor: That is not your concern.
Patient: I think it is doc, I am the
person you will be opening up tomorrow and you are already half
asleep. I think it is time to ask for another surgeon, one that will
be rested for the surgery.
Doctor: You need this surgery now.
You cannot let this go for another doctor.
Patient: Doctor, unless you bring in
another surgeon, you will be in trouble. I hope your liability
insurance is paid up to date.
Doctor: I will see you at 10:00 AM
tomorrow.
Patient: Not unless you have another
surgeon doing the operation. I will not let a doctor that is this
sleep deprived operate on me. So what is it going to be? Another
surgeon or do I find another surgeon on my own?
Doctor: Have it your way – but don't
expect me to give you a referral.
This is not what you want to have
happen under any circumstance, but it did and to an individual I
know. He was indeed lucky as the next day; the surgeon lost a
patient because he was sleep deprived. Whether it would have
happened to him, he does not care as he did locate another surgeon
and had the surgery a week later. This time it was at the Mayo
Clinic in Rochester. The surgery was successful and he is recovering
quite well. There was a minor adjustment the surgeon had to take
during the operation, but he said he had encountered this before and
it was not life threatening.
This is a good lesson for anyone. Yes,
the patient can always be very anxious before surgery and get very
little sleep. This is not good for the patient, but is
understandable. It is not understandable for a surgeon to be that
way, yet this happens all too frequently. If this was a teaching
hospital, we could expect interns to be overtired, but for a surgeon in a non-teaching hospital, this is unconscionable.
The study that got me started can be
read here. It describes some of the effects of sleep deprivation,
but cannot be relied on, as there were many parts of the study that
caused no problems. I do understand the inability to actually follow
practicing surgeons, as a study does not want to be responsible for
actual harm. So all the study was done on simulators.
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