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A Vital Measure: Your Surgeon’s Skill

Fri, 11/01/2013 - 9:35am
Pauline Chen, M.D.

To those of us in training, the hospital was cursed. At least when it came to a certain operation.

We dreaded being asked to scrub in at these operations because we knew we would be forced to hold patient parts until our fingers went numb and arms quivered. The surgeons hunted, stabbed and slashed their way through the procedure; and whenever their knife would go a little too far, or their knot would slip, or their stitch pull, we braced ourselves for their fury…and for the inevitable extra time it would take for them to correct their errors.

The patients, many of whom had come in to the hospital walking and talking, ended up lingering for weeks afterward with infections, open wounds and other complications.

But everything changed when a new surgeon came on board. Built like a rugby player, he shocked us first with his speed, and then his results. The once unbearable day-long slog became a morning’s work; and instead of spending weeks in the hospital, his patients went home after eight days.

In the operating room, his bear paw hands turned delicate, teasing out tissues, caressing vessels and nimbly knotting thread as fine as human hair. There was not a single wasted movement; and each step blended seamlessly with the next, giving those of us who had the fortune to observe the sense that we were watching not surgery, but a well-choreographed ballet.

“It’s like you’re just standing there holding the needle or knife,” said one friend who was lucky enough to assist the new surgeon, “and he’s moving the body underneath you.”

I remembered this surgeon — and the dramatic differences between his colleagues and him — when I read a study published recently in The New England Journal of Medicine on the relationship between a surgeon’s operative technique and patient outcomes.

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