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Stressed Surgeons Gone Bad
When cases go south, do your docs go down the rabbit hole with them?
E
very surgeon and scrub nurse has
been there. A seemingly straight-
forward case commences smooth-
ly, only to turn into a hellish nightmare in
seconds: the stubborn bleeder, the rotator
cuff tear the size of Brooklyn or the two-
part fracture that becomes the four-part
fracture after failed reduction attempts. In
times of surgical strife, surgeons may
morph into one of several dysfunctional
patterns:
• Blame game. Many surgeons have the
blame game as their default option when
under duress. The bleeder is everybody
else's fault: the nurse for not picking the
appropriate instruments, anesthesia for
not keeping the BP down or yours for not
telling the patient to stop aspirin.
Emotions are contagious, and a few nega-
tive accusations can drag the entire OR
culture into a large abyss.
• Panic attack. Some surgeons morph
into panic mode and enter into a convulsive state of hurried and some-
times illogical motions, feeling that if they move fast enough, the solu-
tion will somehow appear. But hurried and uncalculated motions
invariably exacerbate the problem. The 6-inch incision is now double
the size with no bleeder in sight. The humerus resembles popcorn after
the desperate strong-arm attempt to reduce the fracture.
Cutting Remarks
John D. Kelly IV, MD
Ironically, some of
the most brilliant
and gifted who
wield a knife also
often carry the
most psychological
baggage.
