When you have limited option and you have to choose one, very sure you will find your hands shaking before choosing one. Same here…. Being a surgeon I am scared with intra-op and post-op complications. I have never come across hardware problems. Orthopedic infections being my nightmares, I always pray before holding knife with my right hand and try to stick with in the principles of sterility. But today is different, I am to operate the old lady of 80’s tomorrow and I am sweating now onwards. The frail lady with difficult fracture and preoperative morbidity including bad chest condition will rob my sleep today. The rare blood group and no blood stock in blood bank, what more is needed to warn my life much before she complicates in the theatre. And his grandson whose eyes are always searching for our faults to point out. What a deadly combination? Had I been a private practioner, I would have said sorry much earlier to them. But medical college you have to accept it and being a tertiory center where you will refer them? She is getting delayed, there is no blood, she can complicate in the ward anytime and her grandson finds us guilty for all nonsense reasons. This is the sorry state of the affairs where you find some people are born headless. Politely I can label him as one of them. Else he should be at least thankful to the hospital for keeping her better than she was.
Earlier I thought I would not be touching this case. But now the matter is different..things have already been decided I will be going to the theater tomorrow. But now I have to and I am scared if something wrong happens, relatives will make an issue out of it. Who knows? they may shout for compensation. This has become the usual trend in Nepal once the patient dies they invariably destroys the hospital property and ask for compensation. How bad the matter is taking shape. If so who will come forward to operate the patients. Because every surgery carries, some rate or mortality be it from anesthesia or surgical point of view. How and when people will understand this? Thank god, the patient who died last time immediately after induction realized the matter that, this is a known complication and they accepted despite the fact some people tried to make an issue to raise our name.
I have to operate upon her tomorrow. I was reading for it since evening and how it can be done smoothly with minimal errors and with best possible outcome. Cannot say about outcome, but one thing sure with minimal blood loss I can do it and can fix it with the implant available with us. My plan is MIS and will convert into liberal incision if I find I am struggling to fix it. Any way I can only plan what happens, happens for best and I have no control over it. Only I can do is the informed consent with maximization of mortality rate to save my skin if something happens during and after surgery. Still my mind says we need to wait for few days for her general condition to improve. But what one can do if anaesthesist says he is ready. I am little confused and praying my god for helping me in such tough situation. As always please God take me out of it smoothly as if I was not entered in this problem either. God bless my patients, bless me too.