Sunday, November 17, 2013

Last Minute Wisdom ????

Last Minute Wisdom ??? Or Blues ????

Disclaimer: This post is a work of fiction and any resemblance to any person or incident in real life is strictly imaginary and no way involving any professional trust issues.

This morning I was left completely free of any work, quite unexpectedly if i may add. And no it was not of my own volition for I would much rather have been busy doing some surgery but my only patient for the day canceled her surgery and walked away without looking back. And that is the story I am going to share with you now. There i was all bright and early in the morning, with a strong filter coffee inside me and entering the operation theater for my morning surgery when I heard a mild commotion near the operation table at the far end of the room - near the anesthetic apparatus. I walked over to see what the heck was going on and that too right on my surgical time and was surprised, well shocked would be a better word - to see my patient still on her feet when by rights she should have been flat on the table conked out by the anesthesia and ready to be cut open.

As i neared the group surrounding the girl(the patient) and arguing with her- the girl shook off the nurse who had a restraining hold on her arm and saying "I don’t want the operation" she walked out of the theater leaving us all flabbergasted with her insouciance. There was nothing we could have done to stop her- she had every right to decide on the surgery- right up to the last minute and she had obviously exercised her right to walk out at the very last minute possible. My mind working overtime on the why, I hurried back after her to catch her before she left and ask her if she could at least tell me her reason for canceling at the last minute.

And as I came out through the swing doors of the theater I could see my patient arguing vehemently with her mother who was waiting outside the operation theatre and just as I neared them her mother turned towards me and said "doc, give her anesthesia and just do it, don’t listen to her, she is just afraid". I shook my head sadly at her and said "now listen Mrs. So-and-so, she is a major and she has every right to decide what’s good for her. I never treat people who are unwilling for treatment" and as soon as I said that the girl pulled her mother along by the arm and they left without a backward glance- ruining my day effectively.

A few minutes later as the entire surgical staff got back together in the empty operation theatre to discuss what had just happened there was an immediate attempt to lay the blame on me as the admitting surgeon for not getting the patients wholehearted willingness before the surgery. I immediately defended myself by taking out the case notes to show that the patient had met me thrice over the past ten days and had done all the necessary investigations promptly which showed she was willing to undergo the surgery till she had come in and I wanted to know from the operating staff nurses and the anesthetist what made her change her mind just before anesthesia.

As a matter of fact no one really could say why for sure but we all could make a guess- some patients, in fact most patients rarely realize the seriousness of what they have signed up for until the moment they are lying on that operation table staring into the overhead light and waiting for the anesthetist to start injecting. Its then that they have a profound realization that this is IT- I am undergoing a surgery involving my body parts and a lot of blood. If it’s a case of where the patient has been suffering from pain or disease for a long time then they actually welcome the surgery as the last step towards a permanent cure for their disease. But most cosmetic surgeries are not for pain relief- but just for vanity's sake. Hence second thoughts when they are on the verge of changing something they might not have liked but had been born with and accepted till now.

And later on as I sat in the canteen sipping an insipid cup of tea I went over the various visits of that girl (before today) for consultation and I could have kicked myself as I realized that the patterns fit. Right on the first visit she had said “my mother feels that I have so-and-so problem” when she described why she had come. And then later on during the second visit when I had complimented her on her punctuality she said the credit should go to her mom who had dragged her there on time. In hindsight I see now what I should have realized before - that the patient was not interested much but it was the mother who had pushed the girl to get it done to improve her chances in the marriage market and so the patient had gone along with her mother’s wishes up to a certain point and then had suddenly rebelled -causing a shock to the poor unfortunate doctors.

The trouble with doing cosmetic surgeries is most patients don’t realize themselves why they want the surgery. They are usually confused and act on the advice or more probably the taunts of their near and dear- usually a mother or a boyfriend or a husband. Many's the time when a young and good looking girl walks in to our cosmetic clinic and says straight off "My husband feels my nose is too large and wants me to reduce it". Whenever I hear this dialogue I am immediately tempted to advice her to go back to her husband and ask him how come he didn’t notice the large nose before the wedding and which body part of hers had captivated his attention so much that he was willing to marry her just to get his hands on it disregarding the obviously large nose staring right in front of his face. But of course I can’t tell the women patients that kind of truth can I? Or else I would be accused of breaking up families, god forbid. In fact, most nose surgeries are unnecessary in my opinion for every individual has a different shape and all of them have their own beauty- we don’t need to make it all the same boring type.

And this is the reason why for any cosmetic surgery we docs spend a long time counseling the patients against the  surgeries or at least make them wait and come back again and again until they are absolutely sure they want to undergo the treatment and not do it on a sudden whim. Especially when it is for young girls who  are about to enter into the marriage market and want to get things corrected beforehand- we always do counseling to make them understand that their self esteem is not affected by body issues and they are doing it for the right reasons. And as I personally keep saying every chance I get- for below 45 years of age- just diet and exercise will achieve all the results that surgery can give. It’s only in the late 40's and early 50's you need face lifts and wrinkle removal surgeries. A balanced diet and adequate exercise does wonders for your face and keeps you young forever.

And this is the respectable part of the profession I am talking about while in fact there is another less disreputable part of the profession we don’t usually talk about which involves unnecessary surgeries (from the surgeons point of view) but where the patients are willing as hell to get them done- things like breast enhancements, buttocks lifts and vaginal tightening and hymen reconstructions etc. Doctors are supposed to be non-judgmental when it comes to patients but that can’t stop us from thinking inside our own minds can it? Like itching to ask a patient "ok you get your breasts made big for one boyfriend who likes 'em big and then he dumps you and your next one fancies bigger butts and you sign up for it too..How far will you go? How many alterations will you make to all your body parts till you finally catch "that dream boy" for whom you have been holding out? Why don’t you marry an ordinary guy who will accept you as you are and not demand you get any of your body parts enhanced according to his fantasies?" That’s simple logic isn’t it? Instead of getting so many surgeries done just to impress the unworthy?

Call me old fashioned but some of the very worst/worthless surgeries in my opinion are the sexual satisfaction surgeries like vaginal tightening and new hymens for old surgeries.  The gossip in the change rooms of surgeons is about the several society ladies and businesswomen in their 40's who have had their vagina's tightened and hymens reconstructed post divorces – something which is becoming commonplace and routine over the past few years. But the worrying trend is of younger and younger ladies (even in their 20's) getting it done multiple times after every break-up just to act like a virgin for their new boyfriends and that sounds sickening to me. And in one extreme case I heard of recently -getting a new hymen every year (for the past three continuous years) after taking a nostalgic annual vacation in Goa with the ex boyfriend - who of course pays for it.  Even if it comes cheap at 30,000 bucks a pop for your cherry how many times will you get it popped? Is it that important to act a virgin/sexual innocent even if you are not and won’t it be much simpler to just find someone who accepts you as you are- even if he learns you have been around the block a few times? Hmmm, somehow I just can’t understand the logic behind some of these decisions people make. I don’t care much about the inner beauty/outer beauty concepts but the one thing I do believe is to learn to accept people the way they are.

Anyhow I guess that is enough ranting for one day and this post is getting too long and boring for you. Conclusion- lesson learned and never more a surgery scheduled unless the patient agrees multiple times in front of multiple witnesses...ok?

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