"Surgery Consult the Good and the Bad"

Seeing specialists is not something new for me and during these consultations often a resident plays a part in the work up. I have no issue with this, as everyone needs to learn and there is always a professional there to support the resident and ensure safe care.

I did, however, find an issue with a surgical resident I saw before my most recent surgery.

For over 15 years I had dealt with abdominal pain, that has been diagnosed from constipation to gastropareses. Then about 3 years ago the crushing pain came back and none of my management techniques relieved the pain.

My new family doctor decided it was time to repeat the abdominal ultrasound and this time many small gallstones were found. Yeah there was a cause for the pain, and a surgical consult was submitted. It was almost two years before my name came up for a surgical consult. Which was good as the pain had become almost daily.

I arrived at the appointment on time, though breathless, as the hospital signage leaves something to be desired. I don't have the answers as to how to improve it but there must be someone out there could make it better or at the very least less clutter.

After completing the medical history form a surgical resident came in to go over it with me. This did not surprise me, what did, was the way the resident made me feel about my medical/health history answers. As I mentioned I have a long history of dealing with abdominal pain and other health issues. So remember every detail is not straightforward. I recall that at one point they asked me about something I wrote down, I realized I had missed a detail and their response to me about the missing detail left me feeling like what I did was intentional and that they were going to get to the truth one way or another.

I know people are poor historian, I have taken a few different types of medical histories in my varied career. I also know people respond best to prompts to help not demean them. This resident needs to do some refresher on the best way to get people to work with them not against them.

Then they asked if I knew anything about the gallbladder and I replied yes, they then proceeded to draw me a crude picture of the biliary system to show me what the surgeon might do, then went on to say given my BMI I was not a good candidate for surgery.

Yes I know I need to lose weight and yes the extra weight might impact surgery but their comment left me feeling like I was not good enough to have the surgery. That maybe I will just have to live with the pain. I can say I am glad they were not the surgeon cause at that moment I felt I could not trust them.

The surgeon then arrived, did a brief recap and actually filled in physicians’ names I could not recall. They did mention how my extra weight could mean they might not be able to use a laparoscopic method to remove the gallbladder and if that happened my recover would be longer. But not that the surgery was never an option.

When the surgeon asked the resident about my lung and heart status, they said they did not listen to either, which is true, they had not. The surgeon’s expression was unreadable, but they did remind the resident you can’t do surgery on a person unless you know the status of their heart and lungs. I must admit, I did feel a little glee when the surgeon noted what I felt was an oversite. I wonder if the reason was the resident was so focused on my weight and not being a surgical candidate, they didn’t consider the surgeon might still do the surgery, just not laparoscopically.

My hope is this resident will learn how they interact with the person in the room impacts the cooperation and recovery for that person. When you put on blinders you limit options and dismiss the person in front of you, who has come to you for help and care.

In the end, my gallbladder was removed laparoscopically and my recovery was uneventful.