Editor’s Note: Incredible tragedy struck the storyteller’s family. The experience served to shape a future surgeon who would extend empathy and thoughtful care to a multitude of her own patients and families.
“Time doesn’t exist in the operating room for the surgeon because they are in their ‘zone.’ It’s important to remember that there is a family waiting outside.”
I decided I wanted to be an orthopaedic surgeon at age nine. Both of my younger brothers developed Legg-Calve-Perthes Disease and required orthopaedic care. Their orthopaedist was fantastic. The problem was that we did not live in the United States and that was where I wanted to receive my education.
To move toward this goal, at age 16, I moved to the US to live with relatives. I wanted immersion in English and an American education to prepare me for my aspirational career.
I graduated from high school in the United States. My family came to celebrate with me. By then, they had decided to move permanently to the US. My father, who was a 44-year-old mechanical engineer, had developed symptomatic aortic stenosis. Our thought was that he would benefit more from having the necessary surgery in the US rather than staying in our home country.
His chosen American surgeon told us pre-operatively that my father was young and basically healthy, so he wanted to perform a “new” less invasive procedure which would be easier on him. He and the family agreed. My had father delayed his surgery until after my high school graduation. We took cherished photos of the family together during the celebration.
On the day of his procedure, my father appeared to have a “premonition” as evidenced by the way he spoke to us as we gathered that morning. He told us to always “follow our dreams” and to live life to the fullest. It was like he knew “something was coming.”
The surgery was predicted to take around three hours. At one point, a person who may have been the perfusionist, came to the waiting room and called for us. He had blood on his shoes and literally shouted saying “We have a problem.” We were stunned and don’t remember many of the details.
Then, for five hours there was no further word. We made inquiries and a cardiologist was sent in to see us. He said he was “unsure” about my father’s status.
Another hour later, the surgeon came out and told us that my father was alive but would need a “heart transplant”. This would necessitate transfer to another hospital within the city. He was quite nonchalant about the situation as he spoke with us.
My father was taken back into the OR three more times that day in an attempt to control excessive bleeding. “I left my country for the best. That was not what we were getting.”
The hospital transfer occurred. My father spent three weeks in the ICU at the new hospital. After three weeks, he died of multi-organ failure. During his stay, my mother and I never left the intensive care unit. We slept in the lounge. The Director of the ICU was personally attentive to our needs. I was age 18 when my father died.
My father and I had hoped that as a mechanical engineer and an orthopaedic surgeon team, we would devise new systems to deal more effectively with patient’s orthopaedic problems as my career progressed. That was not to be.
After his passing, we were told by one of his physicians, to “get an autopsy and a lawyer.”
By report, his femoral artery had been perforated as had his heart which was associated with the perfuse bleeding he experienced. Three hours of the surgical records ended up “missing” and his heart “disappeared” from the Medical Examiner’s office.
As we later found out, his surgeon had been sued multiple times for surgical malpractice. We never heard a word from him.
We put our trust in a country respected for its medical care but chose the wrong surgeon. Despite this experience, I remained firm in my intention to become an orthopaedist and knew that I would conduct my practice differently.
Here are the principles I follow when caring for patients:
- I explain everything, meaning the surgery itself and any complications that could occur.
- I never overestimate the simplicity of surgery.
- I address the entire family and ask, “who is who?” Each member is part of the patient’s life.
- I am attentive to speaking at their level with consideration for intellect, language, and cultural abilities.
- I seek to keep my “humanity” despite pressures to see many patients, staying on schedule, etc.
- Despite feeling like “time doesn’t exist in the OR,” I am sure to send an update to the patients’ families each hour while they are waiting for their loved ones’ cases to be completed.
- I fight the system if I feel it is shortchanging the patients.
- My job is to show up as “my best” even when it’s difficult.
- I seek perfection but always have a plan if things don’t go as I had hoped.
- If there is a complication, I communicate with the patient and family about it. I tell them about risks pre-op, so nothing comes as a surprise. I say I’m sorry and I stick with the patient and their family.
- My father stays with me when I am operating. He was a very calm person, and I feel his presence when I need it.
- I try to plan my work so that I do not lose my “aura” or “essence.”
- I will provide thoughtful, empathetic and ethical care. If the system I am working in does not allow it, I will find one that does.
