But that implies you've had seven surgical complications. It might make you a better surgeon, but you've got seven patients who are screwed. Platitudes really suck.
@@TheRm65 If a surgeon only has 7 surgery complications over their whole career, I'd say they're probably doing damn fine work. (As an idea, a study in the 80s found that over 3% of surgeries have some level of complication. Due to amazing work, that number is going down.) Complications happen. Some happen due to lack of skill, some due to unforeseeable circumstance, and some just to dumb luck.
@@TheRm65 Surgical complications are broad. My mom has had four procedures in the past few years and had complications on two of them. One was when they had to switch to an open procedure rather than a laparoscopic and as such, she had to stay in the hospital a few extra days. Another is when during shoulder surgery, the surgeon realized there was more extensive damage than he had seen on the MRI and my mom didn't get the range of motion she expected. However, she loved how honest and caring her surgeon was. She went back to him for both her knee replacements and they went flawlessly.
Last year I had an emergency surgery after my bowels ruptured. Due to ongoing chronic illness and other risks, I wound up being on life support for 5 days and needing nurse care for months afterwards due to complications. One of the first things I remember from the experience was my surgeon at my bedside explaining what happened and telling me it was completely ok for me to be upset, scared, or even mad at them for ever doing to surgery and the aftermath. I was assured that if I put any blame or resentment on them I wouldn't be the first patient to do so and they could handle it. Then and even now I feel dumbfounded by that sentiment because if they hadn't taken that risk I wouldn't be here now. Of course I wish I could've gotten the treatment I needed beforehand to avoid the surgery and complications that I'm still working through but if anything I'm grateful. Someone saw my life and others like me worth the years of time and effort it took to even try to give me extra time in this world. A stranger looked and saw me as inherently worth saving. I'm still regularly in contact with my surgeon due to the high likelihood I'll need more in the future but knowing that if that time comes I'll have someone I can trust to be looking out for me is priceless. I just hope to never take that for granted and work to pass that love for others forward!
Yeah. It's kinda awful they're this braced to get hit with blame and shame. Mine was stunned over my kindness and trust in him. When I saw that I wanted to cry but kept it together to not distress him more. And I wanted to just stuff him in a earm blanky with some hot cocoa and make sure he's alright. It's almost complicated to shower them with kindness cause it's rough out there and the realisation that ppl can be "kind back" at them can almost come with an own trauma response 😖
Wow, that's an incredible story! My sister experienced a post-op complication that nearly killed her, and the surgeon was incredibly apologetic to her and my parents. He made a bad decision in the moment during that surgery and now I'm confident that he won't ever make that mistake again.
I'm sorry you went through that and I hope you continue getting better. I have admire that surgeon; they really explained it all openly to you. Best wishes for your continued recovery. ❤️
@@BakrAli10 it was a sinus surgery (I don't remember what exactly they were doing, she's had so many) during which the surgeon nicked an artery. He decided to cauterize rather than clip it, which is not a bad decision for most people. For my sister it was though, because she has a complicated disorder that at its core is faulty collagen production (yes, the surgeon knew about this disorder). The cautery didn't hold because of this, and she had two major bleeds a couple months after.
I actually had a major surgical complication the day this got posted and avoided watching it not wanting ha-ha jokes around the subject. But watching it now makes me feel a little less alone. Thanks, Dr. Glauc.
The thing is that anesthesia meds are complicated! That is why there is a whole specialization for it. You have to be really honest with them because they use a lot of different meds depending on the surgery, the health conditions of the patient, any allergies, any medications they take, any illicit drugs they have used (in the past 6 Weeks!), and how long the surgery is supposed to be adding more drugs if it over runs. The chances of drug interactions with medications, drugs, even supplements or vitamins you take is extremely high. Interactions can cause anything up to and including death. I know someone that went in for an emergency surgery on a blocked bowel. He can no longer retain new memories... They are not sure why.
@nikkiewhite476 The humor lies in the fact that when surgeons have complications they tend to blame it on parties at least once-removed from the case. Anesthesia, pediatrics, cardiology, or anyone else attached to the case are possible targets for shifting the blame.
Newly retired Family Doc here. This almost made me cry after 30 years in the field. IT SO RESONATES! Then again, my tears are tears of joy at realizing no one's life is in my hands as I get ready for bed tonight. Wow, its f@#ked up what you can get used to. I don't remember the last time I felt this peaceful and happy. God bless all you Brothers and Sisters holding the line.
I will start family medicine residency here in July. If you have one or two pieces of advice, I’d be grateful to hear it. Maybe something you wish you would have been told when you started.
@@jakemiller4382 Good luck! I'm a junior doctor from Croatia and I've been working as a GP/family medicine doctor for a year now. (We can work without finishing residency here). I didn't expect to love it, but I'm most likely going to take up residency in it too!
Thank you for your honourable medical service for your community over the years. Rest well, doctor, the younger ones have it from here. May you find peace, health, serenity, love, kindness and light wherever you go.
Event Debriefing is an essential part of medicine. When something goes wrong, the questions should be: What went wrong, how did it go wrong, and what can we do to minimize the risks of this happening again. This is a common practice throughout most of the world, developed and underdeveloped, but US hospitals are particularly terrible at it. We have one of the highest rates of infant and maternal mortality deaths in the first world.
Given that CRM and checklists have supposedly (based on what I've read, I'm not in the medical field) made their way into hospitals from aviation, I'm surprised that briefings and debriefings haven't done so as well.
I worked as a safety officer for awhile at a hospital. I didn't deal with patient related accidents, but everything else was under my purview. This is exactly what I did for any of the accidents I had to investigate. Employees were always worried they were going to get in trouble. I stressed to them that was never my intent. Something bad happened and I wanted to understand why so we could reduce future risk. Of course, I also had to tell them whether their direct supervisor chose to write them up or not was out of my control.
We have such high rates because of unaffordable healthcare causing people to delay treatment as long as possible so as not to go bankrupt and homeless.
As a general surgeon - I approve of this, 100% true. We have a saying here which translates to english to equivalent of 'every MD has their own graveyard' - those patients who had complications or even more so if they died on our watch, never do really leave us. That's why medicine has one of highest burnout % of any occupations, and surgery is among highest burnout and alcoholism % of medical specialities...
“Every surgeon carries within himself a small cemetery, where from time to time he goes to pray - a place of bitterness and regret, where he must look for an explanation for his failures.’ René Leriche, La philosophie de la chirurgie, 1951”
The one time I tried to get into therapy in medical school through the program the hospital offered, it was horrible rigamarole. They never had appointments after 3 pm (lol resident schedule be damned). Then they finally got me a 5 pm appointment only to cancel it and say they can't do it. And when I finally made some time to meet during the day on a lighter rotation, my therapist was the wokest, most ideological, and INCREDIBLY judgemental person I ever met. No thanks. Good therapists are valuable. And rare. I often feel worried sending my patients to therapy because I know some of them are getting shitty therapists. Which may be worse than no therapist at all.
I had to be conscious for what became a life threatening surgery. Surgeon thankfully realized quickly what mistakes had led to the result and did an incredible job of acting quickly and protecting my life before the time to act ran out. Mistakes happen. If you're going to be a surgeon, it's so much more important that you're observant and act swiftly than never make a mistake in the first place. I'm still alive and the scars aren't even bad. And he learned a lot that day about a mistake he'd dedicate himself to never making again. He did an incredible job with closing me up and my follow up care.
I did this for my surgeon. He's awesome and compassionate and he dealt with the surgery needs of my not really average body 😂 and it "bit him" and displayed a big complication a whole month later dispite him screening me TWICE for said complication post surgery cause he was worried after getting too close in one spot (cuz normally pplz have protective fat layers there that alert them that they're close but I apparently have not 🙈) where they had to remove my endometriosis. Can't forget his controlled yet "slipped up" stunned expression when he came to inform me & to apologise ..... but I gave him a big smile and told him not to worry, that stuff happens and that I'm glad he helped and sure we'll figure it out together. Another specialty surgeon had to do the surgery but after the mini-surgery attempt failed (stuff had grown close where n opening should have been), he volunteered as assistant for the 3rd surgery. He didn't make it (only as they were suturing me) due to an emergency case, but he visited me n sat with me when they were on strike nation wide & he was on absolute emergency duty. We're still talking. I'm still working that guilt out of him by showing him just how splendidly I recovered. ☺️ Not all surgeons are socially adept, yet they're all ppl and many of them really care (even the defensive ones are defensive cause it's too painful to acknowledge how much they care). And we can give them grace when it's appropriate!
Yes! Thank you so much for mentioning therapy. A lot of doctors keep neglecting their own mental health and start to burn out really fast in their life. Never be ashamed to go to the therapy
Applying to surgery right now and have been dealing with the stress of knowing one day I will unintentionally hurt someone. I cannot stress how much I needed this. I am literally in tears
Its the learning from it, and having the humility to accept that responsibility and giving onesself the grace to forgive ourselves thats a critical life skill here. I appreciate that doc here indicates that we have to accept our human responses to these very difficult situations.
...I've had multiple minor surgeries, they all improved the quality of my life. If people like you didn't have the courage needed to face the uncertainty with us, and do your best to achieve a good outcome? There would be a LOT of people out there in far more misery than there is now. You can do it. It's worth it.
As someone who is a complex patient due to a genetic disorder, and who has had five surgeries in as many years, (and I know there will be more in the future), I am exceedingly grateful for the surgeons I’ve had. Even when one surgery required a revision. These surgeries have been so vital to regaining function, including the ability to walk again. You may unintentionally hurt someone, but learn from your mistakes. It is clear that you care deeply, and that is a good thing! Don’t lose that! One of my favourite doctors (and yes, I have a lot of them now) is my orthopaedic surgeon. From my first appointment with him, I could tell how observant he is and how much he truly cares. Don’t stop caring deeply, and don’t lose that compassion; your future patients will pick up on it and that will put them and their families at ease.
My mom had to have surgery for a herniated/damaged disc in her neck a little over 20 years ago. (We just found out a year ago that we both have a connective tissue disorder, just not as outwardly obvious as her sister, who was diagnosed after a random partial lung collapse when she bent over to pick something up.) She got better for a time, then worse. The donor bone had… idk how to describe it… collapsed? One of the more bizarre and alarming x-rays I have seen, like a bunch of stars in the night sky. What had been a chunk of bone was now dispersed flecks. That was, uh, not supposed to happen. So she had a second surgery, they took bone from her own hip and then added a titanium plate to hold it together, and that didn’t collapse. She has been unable to work since, and has sustained lasting damage. She was just over 30 at the time. Now I am just over 30. And I am unable to work, but I was the one who suspected that she and I might have a connective tissue disorder, too, and was able to get checked out for it. I have more information, enabling me to be more careful and actually figure out what is going on with both of us. I spent a lot of time being bitter and angry at how much they messed up my mom. And I am still upset about how so much of our symptoms have been written off or interpreted as something else or assumed to be exaggerated, for decades. How long some of the symptoms didn’t even make it on record because it didn’t fit with more common conditions. But also, now, when it comes to the folks who did her surgeries especially, I can understand and not be so bitter. How were they supposed to know? It’s a fairly rare condition, that is still poorly understood, and has lots of disparate symptoms associated with it that are more commonly associated with other conditions. I know that providers are taught ‘when you hear hoofbeats, look first for horses, not zebras.’ Because it’s so much more likely to be horses. And that is a good point! Sensational and peculiar things stick out to us more, but it’s usually more mundane. I studied anthropology/archaeology and linguistics in school (I thought I was going to be a field tech 🤣😂😭), and we had a lot of similar sayings told to us: •Absence of evidence is not necessarily evidence of absence. (Just because you don’t find a thing doesn’t mean it was never there. Just that it didn’t remain there/intact if it was there once) •Seek first to understand, not to judge. (Before you judge how people do things, seek to understand their own thoughts and logic and cultural norms from their perspective. You won’t know what this wine actually tastes like if you won’t empty the beer from your cup first.) •No language or dialect is inferior, or incorrect, or any less expressive, or less regular/has less grammar rules. However, some varieties have been given more societal respect and codified as ‘correct’. •And the science saying I think we all get drilled into our brains: Correlation is not always causation. How could they have known, especially back then? And now with the progression of my symptoms and a growing understanding of the condition, we know that a lot of her issues were simply exacerbated by the surgery, and she likely would have been out of commission before long regardless. And it wasn’t negligence, to their understanding at the time it shouldn’t have worked that way. So much of our issues are things that the most logical response is actually, ‘Ummm, that’s not the way that works…’ because, say, novocaine goes into the tissue and works a certain way… unless you have a connective tissue disorder. And the hand structure prohibits the thumb from being able to be pushed down far enough to touch the wrist without a painful injury… unless you have a connective tissue disorder. No, that normal every day thing shouldn’t hurt… Hoofbeats almost always mean horses, unless you’re a zebra. It wasn’t their fault. S&!+ happens. Nobody’s perfect, but at least they were trying to help. Sometimes it can lead to unforeseen consequences, but it’s still a better outcome than if her cracked, herniated disk was left to bulge in and push on her spinal cord untreated. Excavating a site destroys it, and the majority of the information it contains, forever. But it’s still preferable to jut bulldozing through it without recovering/moving as much of that irreplaceable data and artifacts as you can before the plows come through. Not only do you guys have to deal with the long and arduous schooling required, the inhuman schedules, learning to be able to cut open a living person and dig around in gore day in and day out, but just the weight of the responsibility of having peoples’s lives depending upon you not f^&!@g up. That’s a lot. I know people can get used to intense stuff over time, but it’s still a lot. And it’s really, really necessary. Someone’s got to. It’s a career field that, like parenting or teaching or even just interpersonal relationships, is an impossible job. You are going to screw up. You are going to hurt people you swore to protect. You are not always going to be able to avoid it. People are not going to be able to forgive the harm. I can only imagine how tough that must be for anyone who just wants to help. But, if you can still handle it and learn from it with compassion and humility, it would be far crueler to your potential future patients to deprive them of your lifesaving skills. Nothing goes right 100% of the time. But it goes right 0% of the time if no one is there to do it. Shout out to all the healthcare workers out there actually trying to be good healers. Archaeology/history tip, if things are feeling particularly bleak and hopeless, go look up specifically ‘child mortality rate throughout history.’ I think it’s on a site called something like, ‘our world in data’. Look specifically for the one that starts way before the 1800s and is the total likelihood of dying before about age 15. Go, and look at what medicine has done for people. The fact that it is nigh unthinkable for the most people to have to bury their own child - that’s something that likely no society, ever, for the vast majority of human history got to experience. The places with the highest rates are startlingly better than the places with the best rates even just a hundred years ago. That’s one of the most incredible charts I have ever seen. And, for someone who’s field involves learning about not just things like pottery and stone tools, but also how sometimes archaeologists might be responsible for documenting 800 year old hate crimes or sifting through 30 year old mass graves to hopefully help some families finally get closure after a war or finding a heap of hundreds of severed hands, we too often end up being privy to some of the most awful things that people have managed to do to each other. And like modern medicine, the field also has a dark history. Which is all the more reason to, if one can, stay dedicated to helping make things better. Because if the sentiment that ‘no parent should have to bury their child’ has only really been comprehensible or grounded in reality for less than 0.01% of our existence as a critter, we are capable of a lot more improvement than we probably can even comprehend. Many things that are crummy don’t have to be so, and haven’t always been this way. Some things that are crummy and don’t have to be this way, though, have also never been better. Some people who are jerks and don’t want to understand the concept of invisible disability, or the idea you can put in all the ‘right’ effort to avoid it or snap out of it, but also don’t know what I have studied will ask ‘what would you have done back in [x] times when [basically you snowflakes wouldn’t have had the option for such cushy things/modern advancements], hmm?’ They’re trying for a gotcha moment to prove (to themselves, let’s be honest) that I’m just whining and if I just tried harder, like they are of course, I’d be as healthy as they are. They’re usually not expecting me to say, “Died. I would have died. Without modern medicine I actually would have died because of the complications of my birth, and probably my mother with me. And even if not, any number of times after that.” And the reality is that any person would have had odds not much better than a coin toss of making it to adulthood. I get to have nearly typical life expectancy for someone in my area and income level, because of modern science/tech/medicine. I have not, a lot of the time, had a lot of what can be considered ‘good’ experiences or interactions in healthcare settings (unfortunately typical for people with my condition, a higher percentage of whom than the average population are, like me, also autistic dealing with difficult to treat mood disorders) but even in the last handful of years I’ve personally experienced a marked improvement. Healthcare settings still send my anxiety through the roof. But having ammonia doctor look at me and say, point blank, “You’re not just crazy, you’re not imagining it, and this is a real thing you’ve been living with,” is one of the most indescribable feelings. One of the most, vindicating, affirming, relieving, and healing sentences I’ve ever had said to me my whole life. Sorry, this is ridiculously long, but I really wanted to explain the weight of what I say when I tell you: From the bottom of my heart, to all the folks, in medicine and elsewhere, who actually care and are working to make things less bad, thank you. Less bad is less bad, and is always worth striving for. And, not just for the sake of future patients and healthcare workers in the years and generations to come but just person to person: Please make sure to take care of and advocate for your wellbeing, too.
I worked with a surgeon. He was one of the scariest people I ever worked with. But deep down, he had a big heart. And he was so scary because he took his job and his patients' lives seriously. (Despite his lack of decent bedside manor). Once he worked with you long enough to trust you and gain his respect, he was amazing. I have so much respect for him to this day, and he played a big part in how i care for people.
For most surgeons, the angriest and scariest you will ever see them is when someone harms, or nearly harms their patients. There is "mamma bear/papa bear" energy that comes with the intimate relationship and responsibility of surgeon to patient.
Surgery rotation was the hardest, until I met Dr. Chin, who was a senior resident then. We were rounding in the CCU and he saw a patient that was ostensibly stable but he anticipated an emergency, and he called it! Everyone else was dragging their feet, and he grabbed me and told me to get ready to do CPR. 30s later we are doing chest compressions and a life was saved. At the end of the shift, the next day, he actually shook my hand, as he saw the transformation in me. From an MS4 who took every spare moment to practice doing UWorld questions, to a team member who stayed close to him and was ready to take on any task. Dr. Chin, surgeon extraordinaire, is tough, no-nonsense, and breaks out the compassion as needed. Cheers, Dr. HM
When I was 11, I had a surgery complication that caused CRPS, a horrifically painful disorder that has completely changed the course of my life. It's a living nightmare and I try every day to make something good out of my life in spite of it. At first, they told me- a child- that I was making it up, that it wasn't real and that it wasn't their fault. It took two years to get a diagnosis, even though it's a well known complication. I didn't expect to cry from a Glauckomflecken video. If I had been given the treatment you had shown here, my life would be very different. Thank you for finally showing a good example. I only hope someone listens.
I expected this to be the exact opposite of what it was. The therapy seems to really be helping! Until it won't, then all will be right in the world. Way to hit us in the feels, Doc.
The very best one. At four hours old, already 35 thousand views, and counting. I especially like the surgeon's greeting, as he shifts gears from incomprehensible dictation to attempting to greet..."Resident?" His lips move, but he makes no sounds. Brilliant scene, showing true compassion all around.
I'm not a surgeon, but I am a medical practitioner. I can't tell you how much I needed to hear this. How many years of doubt and grief and shame and fear of things happening again have hung over me, preventing me from what could be. This in spite of therapy , which kept me alive and in the game. Without that, I don't know what would have happened. I do know that wherever we are in our journey within helping professions, however we've come upon the precipice, we all need these words of compassionate wisdom. .Once it's determined that it had nothing to do with anesthesia of course. ❤❤❤ 2:25
I was sure you were going to say that the best surgeons feel for their patients, so the fact this resident was so beat up about the surgical complication and still wanted to practice and do better makes him great.
I don't know if you've ever seen the grieving doctor outside the hospital that went viral several years ago. It was soooo moving and real, and raw. Doctors of all stripes make mistakes. Sometimes it is minor and correctable with minimal upset, other times it is a life-and-death decision. That is the heaviest burden that the profession takes on. Much love and respect to those who have to shoulder the load.🥰
Honestly some pretty solid advice. If you work in medicine your gonna hurt or loss some people eventually may be small may not be but your only human. It is gonna suck it will drag you down but you also have to think of all the people you help as well.
People often suffer from PTSD following accidents when faced with the simple realization of how fragile and messy the human body can be. Surgeons face this realization deliberately and routinely. A certain amount of detachment is required but not always achieved.
I would much rather be operated on by a surgeon who has made mistakes in the past and learned from them than not get an operation I need because all the surgeons quit after making mistakes.
This made me feel better about having surgery. Absolutely wonderful bit. You are helping people understand the realities of doctors, not just making content. Thanks man.
Spot on! I am a vascular surgeon myself and I think you have shown here one beautiful thing about surgery. We may not show many emotions, we don’t know the names of our residents but we do care about our patients and we show lots of empathy and support when one of us has a bad time after a surgery gone wrong. Thanks!!
Doctors who show humanity to their patients and their loved ones are the true treasures of this universe. They have seen and experienced so much and they still continue to give. I'll never forget how much care the doctor treated my mother even when she ultimately passed a week after her surgical complication. At the end of the experience, the only people I were mad at during that time were my employers, who only gave me 3 days time off to grieve for my mother who had given decades of her life for me. It should not be this way.
You found a good teacher that gives advice and feedback. more of them please. this was sound advice. i watch lots of medical dramas , and this is common advice. learn as mutch as you can, get feedback by a outside source that is medically trained like watching/observing, after the surgery, go over thier notes of all the good and bad. improve. get feedback from nurses as well work as a team. they can hand you items and keep you calm. level head. doctors always say "if the residence program is good, go to it. learn all they can offer and keep learning new medicine and approach to how it's performed."
Oh the sleepless nights. Couldn’t sleep for 60 hours after i messed up fixing a supra condylar fracture of a kid. Had over a 100 successful fixations under my belt even. Thanks for touching this topic Doc ❤️
This applies to all sorts of careers, too. I'm a pastor. When I was doing my internship, I said the VERY wrong thing to a family that was grieving a loss. They were gracious about it, but it bugged me for days. Finally, the minister I was interning under sat me down and told me this: "I'm glad this is hurting you. It means you care, and we learn the most deeply from the things that cause us the most discomfort." Then he made me go see the family again. I learned deeply.
I'm sorry, but glad you are working to improve. Sometimes the impact of a seemingly small and well intended action can be brutal. I ran into a pastor's mistake a few years ago. It involved a young couple with children where the husband became moody then violent and a letter to their pastor. I wanted to state it, but it is sad and I don't want you to have to hear when you are trying to be positive and recover. I will say that the line of boundaries is very fine and treacherous. Sometimes people can't have what they want. Some relationships can't be repaired and it's as important as it is difficult to spot and accept those. If someone leaves, you don't tell where to, because it can lead to trouble. Keep safe, and I hope you do well.
"Im sure you're great!" Even with the resident's argument, that comment would still give me a nice lift. Good job, Surgeon! And yes, listening is one of the most important things you can do! In medicine or anywhere!
When you listen, often that's what people need most. That's the best answer and "fix" to most personal distress and questions. They need-we all need-connection, validation, comfort, and love. Listening is love.
I have worked in healthcare for over 40 years. I am an RN and worked with excellent and sometimes very arrogant physicians. One physician who had an excellent reputation, had a bad outcome. I told him a parable about 2 identical Chinese vases. One day a wind caused one of the vases fall and broke into hundreds of pieces. An expert came and put the vases back together. Such an excellent job was done that you couldn’t tell which one was broken. The broken vase became stronger because it knew how to be broken and be able to come back together. That is what therapy can do for you. Suppressing mistakes doesn’t teach you how to mend. Love your videos!!!!
My residency program director, ob gyn, passed awat about a year ago. His advice was nearly identical. The hardest thing is that we are our own absolutely most unforgiving critic. Peer review is a platform for processing these things in a legally protected way. When there are complications, we surgeons really do take it very personally.
One of your VERY BEST VIDEOS. Thank you. I spend a lot of time encouraging folks to have difficult and necessary conversations to build connections. And because we are humans sometimes we hurt other people. And so the steps you outlined here are not just lessons for surgeons but for all of us. ❤And ❤
Watched it twice through. I am a colorectal surgeon myself. Complications are an inevitable but fortunately fairly rare result of doing major and complex surgery particularly when the patient has comorbidities. Each serious complication is felt like a dagger in my heart. The advice given by the senior surgeon here is exactly my own mantra. One has to keep in mind that denying high risk patients life saving surgery because of a desire to have a lower complication rate is not the actions of a good surgeon.
True. My husband had an ultra rare cancer (fibrolamellar) and, despite him going to multiple doctors saying something was wrong, he went undiagnosed for a long time. (He was the number one road bicycle racer in our state, so I think it was missed because he looked healthy and was relatively young. But, this cancer affects kids and young adults who are otherwise healthy people.) His liver tumor was huge and the first major hospital’s surgeon said he’d die from too little liver left, if he survived surgery. Would not do the surgery. I don’t know that I blame them because it is likely standard of care. We went elsewhere where the surgeon said she would try. She removed all of his right lobe and part of his left. It was a 14 hour surgery that did not go perfectly and he spent 2 weeks in the surgical trauma ICU. But, he lived another 5 years after that. Two years before his death, it had spread to his head and the tumor ate through his skull in a large section and was into his brain. (The local doctors were again slow to catch what was going on, despite my husband pointing out his head lump.) We again went out of state. Surgeons at one major medical center said nothing could be done/they could not cover his brain with that skull defect. He was told to get his affairs in order. I think the risk of a death on their hands outweighed any chance of saving him. We went to a different place where neurosurgery and reconstruction teams decided to try. That surgery was also difficult and they had to rush his reconstruction due to blood loss. He got 2 more years to see his young daughter grow up more because those surgeons were willing to try despite the risk. I will never forget them. (In the end, he died from a reaction to a cancer drug. But, he only had 2 small tumors left at the time in his abdomen but his diaphragm was missing in a large section on the right. Nobody wanted to try surgery, so he was on cancer drugs for years.)
I’m a general / colorectal surgeon going on 9yrs out of residency. I love your videos in general but this one was excellent. Really hit home with my personal experience Thank You
One of the best of a long line of great videos. Beyond the humor, the concept of respecting your mistakes, owning them, and using them to grow as a professional is an awesome lesson for anybody in medicine. Great job.
As a surgeon, this is extremely important. It’s something we all struggle with. If you operate enough, you’re going to have complications. You’re going to unintentionally hurt someone. We aren’t infallible. What’s important is owning it, doing your best to understand and learn from it, and continuing to do your absolute best for that patient.
This video not only rings complete true, but I've pretty much said the exact same thing to junior colleagues over the years. Should probably listen to the advice and get myself a therapist instead of just telling other people how important they are. Good work, Dr. G. Your humor has helped me lift the mood on many a stressful ED shift and been useful in teaching students.
Been there, done that. Although I have never seen a senior surgeon on therapy. Thanks for the vid Doc, from a woman surgeon who do goes to therapy and fights the stigma.
This is one of the best videos till date. I am long gone from the clinics but I still resonate with it. It's hard to explain how horrible it feels to lose a patient (especially to non-medical folks) and how hard it is to stand back up, accept your mistake and go ahead. Thank you. I needed this.
This... means a lot. It's so good to see someone reassure a surgeon who screwed up, and offer advice. We always see berating in fiction and harshness and acting like the surgeon is horrible and should lose their license... but it happens to every surgeon. They're not perfect and we shouldn't expect them to be. Of course we hope it's not us that the mistakes happen on, but... this is such a good reminder that the surgeon probably feels horrible. Thank you so much for this.
As an orthopaedic surgeon I can say this is on point. Causing harm to a patient really, really sucks, but it's a part of the job and you can't let it keep you down. Accenture your mistake as best you can and get back to doing your good work.
My favorite surgical attending found out through chart review that the team had missed an AKI in an elderly pt and chewed the team out for it - she wasn't yelling for the sake of it, she was yelling because she cared deeply about every pt and wanted to make sure everyone learned from every mistake.
As a long-time patient who has experienced major surgical complications, this is very enlightening. For one of my complications, we still don't know why/how it happened, which I'm now sure is just as hard for her to think about as it is for me. I've been able to work through a decent amount of trauma from that surgery with my therapist, and if she has any, I hope my surgeon has processed it with her therapist too 💙
As someone who shadowed surgeons in Italy and saw a resident getting yelled at, this warms my heart so much. There a part of me that’s scared to go into gynecological surgery, but there’s so much more of me that knows I don’t want to do anything else
I've had more than my share of complex gynecological surgeries. Six months after one, I found out that most doctors would have considered me inoperable. Yet, this crazy surgeon made it possible for me to get pregnant and have two amazing kids. Thank you for going into this field.
As someone who's been a medic for 7 years and now a doctor for 5 and has "lost" many patient due to my own mistakes, sometimes due to lack of experience sometimes due to other reasons Yeah, this shit hits hard, those patients never leave you. Wish I had someone like Surgery actually tell these things but I hope this video will suffice for most people instead, also important to remember: truly no shame in therapy, better to have therapy than be devoured by your mind and problems
Retired OB/GYN here. It's true, those patients never leave you. Thank you for this video. It should be required viewing for residents in any surgical specialty.
Most wholesome surgeon, bar none. Reminds me of a surgeon who worked on me a couple times. Dude had amazing bedside manner, especially for a surgeon. He was an example for all surgeons to follow.
Great advice. Most families end up suing because no one will be open and honest with them. People can live with the admission of an honest mistake what they can't bare is the refusal to tell the whole truth or the feeling they aren't being told the whole truth.
That, and the ensuing medical bills. I know someone who had a lump of fat mistaken for his appendix. Pathology caught it and they had to do everything over again. He survived the appendix rupturing, but the only way to get the extra treatment covered was to sue the surgeon so his malpractice insurance would cover it. The surgeon said as much. It wasn't out of spite, it was just required to save him from bankruptcy. That's why nations with universal healthcare see fewer lawsuits in general. An "I'm so sorry, bro" doesn't pay a $50k hospital bill.
Wow, I have no medical background, but this showed me how much it can be stressful and nerve racking for even the best of doctors. Thank you doctors, for doing what you do!!
We all have our complications that haunt us. Although the surgeons rarely admit it, we in anesthesia have saved many patients from their surgeon's errors.
Best advice I overheard from one superstar doc to a younger superstar...you had a 1 in 5000 event congratulations that means you have a lot of experience and you have added this rare event your skill set. Made him understand nobody is immune to bad things happening, sometimes the statistics show you something to humble you. This is why I love surgeons.
When I had a major back surgery, 2 weeks later, I took my big dogs to the dog park to play. I being my usual graceful self tripped over rock and fell. My back almost immediately started hurting worse and new X-rays showed me needing some more surgery. The day after my 2nd surgery, my awesome neurosurgeon called me and told me it wasn’t the fall that caused the problem but the fact that not all my hardware had been placed correctly the 1st time. He covered the entire 2nd surgery and all of my copays for everything. Now I do know that some surgeons could have failed to have had that discussion with me. Honestly despite being a PACU nurse, I’d probably never have found out that the error was not due to my falling but I deeply respected him for his honesty
Sounds like a fever dream that an attending would be that nice The message is 100% correct. Heard on my 1st central line pneumothorax. The only ones who never cause a pneumothorax are the ones that don't place central lines. Think of how many successes you had and how many people were helped doing that procedure. 1 eventual complication does not make you a bad doctor, it makes you someone who has to guts to do what needs to be done
Stern Dr. G makes my ass sit up and take note, but he's also really kind and gentle sounding at the same time. I bet he could read bedtime stories and I'd fall asleep.
As a surgery resident, I have had some wonderful senior surgeons, sharing not only knowedge, but truths about life as a surgeon as well. Surgeons are people and they do not always feel that they are in a position to change a certain outcome and they feel guilty about it. Relaying on old dogmas and the toxic culture, that surgeons are demigods without any feelings is an absolut lie. Just remember, if you are a patient, that surgeons care. And if you are a resident, a surgeon-to-be, remeber that the mistakes never leave us, but are a chance to improve and learn how to be more human. The most private and intimite moments of patient's lives, that we have the priviledge to see throughout our carrier are something that always stays in our soul. I use them as a reminder- memento mori- that I too am mortal. It helps me live life more concious and to appreciate the small moments, as it cliche as it may sounds.
I just started as an EMT six months ago - bottom of the rung in terms of medical practice. I've already had a patient near die on me because I recognized what was happening too late, and I know I'll have more just like them in the future. Thanks for making this, I needed to hear it.
The nice surgeon who actually got therapy instead of letting it boil into random anger at trainees
He might be the one who met the Pathologist and Tabitha too
The one doesn’t preclude the other. After all, there are traditions to maintain.
Probably the only one in existence
Probably the only reason he stopped to check on the resident.
Check the glasses, this is Psychiatry infiltrating the surgeons' lounge because it's the only way he gets to see most of them
Fall down seven times, stand up eight.
But that implies you've had seven surgical complications. It might make you a better surgeon, but you've got seven patients who are screwed. Platitudes really suck.
@@TheRm65 If a surgeon only has 7 surgery complications over their whole career, I'd say they're probably doing damn fine work. (As an idea, a study in the 80s found that over 3% of surgeries have some level of complication. Due to amazing work, that number is going down.)
Complications happen. Some happen due to lack of skill, some due to unforeseeable circumstance, and some just to dumb luck.
Unless the complications make it so they can't....
@@TheRm65 Surgical complications are broad. My mom has had four procedures in the past few years and had complications on two of them. One was when they had to switch to an open procedure rather than a laparoscopic and as such, she had to stay in the hospital a few extra days. Another is when during shoulder surgery, the surgeon realized there was more extensive damage than he had seen on the MRI and my mom didn't get the range of motion she expected. However, she loved how honest and caring her surgeon was. She went back to him for both her knee replacements and they went flawlessly.
@@brillopower1492 😂😂😂😂😂😂😂
Was waiting for him to wake up from this strange dream where the surgeon is complimenting.
Same lol. Or some kind of zoom-out to a movie screen and credits rolling
@@violentbenevolence That's way better.
' _The empathetic Surgeon_ ; featuring Richard Gere '
Damn surgery dropping some TRUTHS and being nice! this was quite the treat didn't expect it to be so wholesome!
I was expecting this to be funny. It wasn't, but I'm not disappointed.
That was Psychiatry I think.
Because he is harsh in the pursuit of perfection but understands that perfection is a goal not a place to be.
@@gaysarahkit was funny because it was unexpected
Thank you so much for putting this up the day AFTER my parathyroidectomy!
😂
the ability to use your voice to communicate is overrated anyway
You’ve never had fun until you try collecting mouse thyroids….
I have a major surgery in a few days. 😭
Still, thank you for posting this.
@@lissakaye610or their salivary glands
Last year I had an emergency surgery after my bowels ruptured. Due to ongoing chronic illness and other risks, I wound up being on life support for 5 days and needing nurse care for months afterwards due to complications.
One of the first things I remember from the experience was my surgeon at my bedside explaining what happened and telling me it was completely ok for me to be upset, scared, or even mad at them for ever doing to surgery and the aftermath. I was assured that if I put any blame or resentment on them I wouldn't be the first patient to do so and they could handle it. Then and even now I feel dumbfounded by that sentiment because if they hadn't taken that risk I wouldn't be here now.
Of course I wish I could've gotten the treatment I needed beforehand to avoid the surgery and complications that I'm still working through but if anything I'm grateful. Someone saw my life and others like me worth the years of time and effort it took to even try to give me extra time in this world. A stranger looked and saw me as inherently worth saving.
I'm still regularly in contact with my surgeon due to the high likelihood I'll need more in the future but knowing that if that time comes I'll have someone I can trust to be looking out for me is priceless. I just hope to never take that for granted and work to pass that love for others forward!
Yeah. It's kinda awful they're this braced to get hit with blame and shame. Mine was stunned over my kindness and trust in him. When I saw that I wanted to cry but kept it together to not distress him more. And I wanted to just stuff him in a earm blanky with some hot cocoa and make sure he's alright.
It's almost complicated to shower them with kindness cause it's rough out there and the realisation that ppl can be "kind back" at them can almost come with an own trauma response 😖
Wow, that's an incredible story! My sister experienced a post-op complication that nearly killed her, and the surgeon was incredibly apologetic to her and my parents. He made a bad decision in the moment during that surgery and now I'm confident that he won't ever make that mistake again.
@@spoonfulofsalt may I ask what was the surgery and what was the bad decision?
I'm sorry you went through that and I hope you continue getting better. I have admire that surgeon; they really explained it all openly to you.
Best wishes for your continued recovery. ❤️
@@BakrAli10 it was a sinus surgery (I don't remember what exactly they were doing, she's had so many) during which the surgeon nicked an artery. He decided to cauterize rather than clip it, which is not a bad decision for most people. For my sister it was though, because she has a complicated disorder that at its core is faulty collagen production (yes, the surgeon knew about this disorder). The cautery didn't hold because of this, and she had two major bleeds a couple months after.
I actually had a major surgical complication the day this got posted and avoided watching it not wanting ha-ha jokes around the subject. But watching it now makes me feel a little less alone. Thanks, Dr. Glauc.
" Anesthesia had nothing to do with it" 😂😂
Doubtful
The thing is that anesthesia meds are complicated! That is why there is a whole specialization for it. You have to be really honest with them because they use a lot of different meds depending on the surgery, the health conditions of the patient, any allergies, any medications they take, any illicit drugs they have used (in the past 6 Weeks!), and how long the surgery is supposed to be adding more drugs if it over runs.
The chances of drug interactions with medications, drugs, even supplements or vitamins you take is extremely high. Interactions can cause anything up to and including death.
I know someone that went in for an emergency surgery on a blocked bowel. He can no longer retain new memories... They are not sure why.
Ok, but what about radiology
@@nikkiewhite476 How horrifying. The human body is so complex.
@nikkiewhite476 The humor lies in the fact that when surgeons have complications they tend to blame it on parties at least once-removed from the case. Anesthesia, pediatrics, cardiology, or anyone else attached to the case are possible targets for shifting the blame.
I was waiting for Psychiatry to wake up from this fever dream
😂😂
real
"Good. That means you care" so true and so important.
That problem we can fix.
Newly retired Family Doc here. This almost made me cry after 30 years in the field. IT SO RESONATES! Then again, my tears are tears of joy at realizing no one's life is in my hands as I get ready for bed tonight. Wow, its f@#ked up what you can get used to. I don't remember the last time I felt this peaceful and happy. God bless all you Brothers and Sisters holding the line.
Enjoy your well earned retirement!
I will start family medicine residency here in July. If you have one or two pieces of advice, I’d be grateful to hear it. Maybe something you wish you would have been told when you started.
@@jakemiller4382 Good luck! I'm a junior doctor from Croatia and I've been working as a GP/family medicine doctor for a year now. (We can work without finishing residency here).
I didn't expect to love it, but I'm most likely going to take up residency in it too!
Yes, it resonates, even decades later. You can change the spelling if you want, click the three dots to the right and click 'edit'.
Thank you for your honourable medical service for your community over the years. Rest well, doctor, the younger ones have it from here. May you find peace, health, serenity, love, kindness and light wherever you go.
Really hits home, especially in the middle of surgery rotation - will remember this one for a long time to come. Keep up the great work Doc Glauc!
Good luck and wishing you the best! Lol to quote the surgeon I'm sure you are great 😊lol seriously rooting for you!
👏
hits home as a practicing Nurse too...
Honestly, the message here applies to most people, not just surgeons. Nice video!
Event Debriefing is an essential part of medicine. When something goes wrong, the questions should be: What went wrong, how did it go wrong, and what can we do to minimize the risks of this happening again.
This is a common practice throughout most of the world, developed and underdeveloped, but US hospitals are particularly terrible at it. We have one of the highest rates of infant and maternal mortality deaths in the first world.
Given that CRM and checklists have supposedly (based on what I've read, I'm not in the medical field) made their way into hospitals from aviation, I'm surprised that briefings and debriefings haven't done so as well.
I worked as a safety officer for awhile at a hospital. I didn't deal with patient related accidents, but everything else was under my purview. This is exactly what I did for any of the accidents I had to investigate. Employees were always worried they were going to get in trouble. I stressed to them that was never my intent. Something bad happened and I wanted to understand why so we could reduce future risk. Of course, I also had to tell them whether their direct supervisor chose to write them up or not was out of my control.
Analyzing accidents are how plane travel and train travel have gotten very safe.
We have such high rates because of unaffordable healthcare causing people to delay treatment as long as possible so as not to go bankrupt and homeless.
@@ferretyluvThe cost of healthcare is not what's under discussion here. That's for another time.
As a general surgeon - I approve of this, 100% true. We have a saying here which translates to english to equivalent of 'every MD has their own graveyard' - those patients who had complications or even more so if they died on our watch, never do really leave us. That's why medicine has one of highest burnout % of any occupations, and surgery is among highest burnout and alcoholism % of medical specialities...
“Every surgeon carries within himself a small cemetery, where from time to time he goes to pray - a place of bitterness and regret, where he must look for an explanation for his failures.’ René Leriche, La philosophie de la chirurgie, 1951”
As a working therapist who wants to support medical personnel, thank you for acknowledging us! Please, we're here for you all!
The one time I tried to get into therapy in medical school through the program the hospital offered, it was horrible rigamarole. They never had appointments after 3 pm (lol resident schedule be damned). Then they finally got me a 5 pm appointment only to cancel it and say they can't do it. And when I finally made some time to meet during the day on a lighter rotation, my therapist was the wokest, most ideological, and INCREDIBLY judgemental person I ever met. No thanks. Good therapists are valuable. And rare. I often feel worried sending my patients to therapy because I know some of them are getting shitty therapists. Which may be worse than no therapist at all.
thank you for doing what you do. therapists who work with surgeons save lives. both those of their patients, and their patients' patients.
If you don't know an underling's name you can always try the, "If I don't know you it means you haven't effed up enough for me to NEED to know you!"
Are you sure this is not the therapist in disguise? Those glasses would give it away.
My thoughts exactly!
I don't think they make houndstooth scrubs
@@shrimpdance4761 they don't _yet_
@@Ivebeengabrieled coming soon to hospital runways everywhere!
Omg that’s what I thought! I thought the psychiatrist was going undercover
I had to be conscious for what became a life threatening surgery. Surgeon thankfully realized quickly what mistakes had led to the result and did an incredible job of acting quickly and protecting my life before the time to act ran out. Mistakes happen. If you're going to be a surgeon, it's so much more important that you're observant and act swiftly than never make a mistake in the first place. I'm still alive and the scars aren't even bad. And he learned a lot that day about a mistake he'd dedicate himself to never making again. He did an incredible job with closing me up and my follow up care.
I did this for my surgeon. He's awesome and compassionate and he dealt with the surgery needs of my not really average body 😂 and it "bit him" and displayed a big complication a whole month later dispite him screening me TWICE for said complication post surgery cause he was worried after getting too close in one spot (cuz normally pplz have protective fat layers there that alert them that they're close but I apparently have not 🙈) where they had to remove my endometriosis.
Can't forget his controlled yet "slipped up" stunned expression when he came to inform me & to apologise ..... but I gave him a big smile and told him not to worry, that stuff happens and that I'm glad he helped and sure we'll figure it out together. Another specialty surgeon had to do the surgery but after the mini-surgery attempt failed (stuff had grown close where n opening should have been), he volunteered as assistant for the 3rd surgery.
He didn't make it (only as they were suturing me) due to an emergency case, but he visited me n sat with me when they were on strike nation wide & he was on absolute emergency duty.
We're still talking. I'm still working that guilt out of him by showing him just how splendidly I recovered. ☺️
Not all surgeons are socially adept, yet they're all ppl and many of them really care (even the defensive ones are defensive cause it's too painful to acknowledge how much they care). And we can give them grace when it's appropriate!
Compassion works both ways. You showed it to him as much as he showed it to you. Here's hoping you heal quickly and without pain.
Yes! Thank you so much for mentioning therapy. A lot of doctors keep neglecting their own mental health and start to burn out really fast in their life. Never be ashamed to go to the therapy
Most definitely.
I won't ever go though can't trust those therapists
@@marlarose3105 I understand.....
Applying to surgery right now and have been dealing with the stress of knowing one day I will unintentionally hurt someone. I cannot stress how much I needed this. I am literally in tears
Its the learning from it, and having the humility to accept that responsibility and giving onesself the grace to forgive ourselves thats a critical life skill here. I appreciate that doc here indicates that we have to accept our human responses to these very difficult situations.
...I've had multiple minor surgeries, they all improved the quality of my life.
If people like you didn't have the courage needed to face the uncertainty with us, and do your best to achieve a good outcome?
There would be a LOT of people out there in far more misery than there is now.
You can do it. It's worth it.
Thank you
As someone who is a complex patient due to a genetic disorder, and who has had five surgeries in as many years, (and I know there will be more in the future), I am exceedingly grateful for the surgeons I’ve had. Even when one surgery required a revision.
These surgeries have been so vital to regaining function, including the ability to walk again.
You may unintentionally hurt someone, but learn from your mistakes. It is clear that you care deeply, and that is a good thing! Don’t lose that! One of my favourite doctors (and yes, I have a lot of them now) is my orthopaedic surgeon. From my first appointment with him, I could tell how observant he is and how much he truly cares. Don’t stop caring deeply, and don’t lose that compassion; your future patients will pick up on it and that will put them and their families at ease.
My mom had to have surgery for a herniated/damaged disc in her neck a little over 20 years ago. (We just found out a year ago that we both have a connective tissue disorder, just not as outwardly obvious as her sister, who was diagnosed after a random partial lung collapse when she bent over to pick something up.)
She got better for a time, then worse.
The donor bone had… idk how to describe it… collapsed? One of the more bizarre and alarming x-rays I have seen, like a bunch of stars in the night sky. What had been a chunk of bone was now dispersed flecks.
That was, uh, not supposed to happen. So she had a second surgery, they took bone from her own hip and then added a titanium plate to hold it together, and that didn’t collapse. She has been unable to work since, and has sustained lasting damage. She was just over 30 at the time. Now I am just over 30. And I am unable to work, but I was the one who suspected that she and I might have a connective tissue disorder, too, and was able to get checked out for it. I have more information, enabling me to be more careful and actually figure out what is going on with both of us.
I spent a lot of time being bitter and angry at how much they messed up my mom. And I am still upset about how so much of our symptoms have been written off or interpreted as something else or assumed to be exaggerated, for decades. How long some of the symptoms didn’t even make it on record because it didn’t fit with more common conditions.
But also, now, when it comes to the folks who did her surgeries especially, I can understand and not be so bitter. How were they supposed to know? It’s a fairly rare condition, that is still poorly understood, and has lots of disparate symptoms associated with it that are more commonly associated with other conditions. I know that providers are taught ‘when you hear hoofbeats, look first for horses, not zebras.’ Because it’s so much more likely to be horses. And that is a good point! Sensational and peculiar things stick out to us more, but it’s usually more mundane.
I studied anthropology/archaeology and linguistics in school (I thought I was going to be a field tech 🤣😂😭), and we had a lot of similar sayings told to us:
•Absence of evidence is not necessarily evidence of absence. (Just because you don’t find a thing doesn’t mean it was never there. Just that it didn’t remain there/intact if it was there once)
•Seek first to understand, not to judge. (Before you judge how people do things, seek to understand their own thoughts and logic and cultural norms from their perspective. You won’t know what this wine actually tastes like if you won’t empty the beer from your cup first.)
•No language or dialect is inferior, or incorrect, or any less expressive, or less regular/has less grammar rules. However, some varieties have been given more societal respect and codified as ‘correct’.
•And the science saying I think we all get drilled into our brains: Correlation is not always causation.
How could they have known, especially back then? And now with the progression of my symptoms and a growing understanding of the condition, we know that a lot of her issues were simply exacerbated by the surgery, and she likely would have been out of commission before long regardless. And it wasn’t negligence, to their understanding at the time it shouldn’t have worked that way. So much of our issues are things that the most logical response is actually, ‘Ummm, that’s not the way that works…’ because, say, novocaine goes into the tissue and works a certain way… unless you have a connective tissue disorder. And the hand structure prohibits the thumb from being able to be pushed down far enough to touch the wrist without a painful injury… unless you have a connective tissue disorder.
No, that normal every day thing shouldn’t hurt…
Hoofbeats almost always mean horses, unless you’re a zebra.
It wasn’t their fault. S&!+ happens. Nobody’s perfect, but at least they were trying to help.
Sometimes it can lead to unforeseen consequences, but it’s still a better outcome than if her cracked, herniated disk was left to bulge in and push on her spinal cord untreated.
Excavating a site destroys it, and the majority of the information it contains, forever. But it’s still preferable to jut bulldozing through it without recovering/moving as much of that irreplaceable data and artifacts as you can before the plows come through.
Not only do you guys have to deal with the long and arduous schooling required, the inhuman schedules, learning to be able to cut open a living person and dig around in gore day in and day out, but just the weight of the responsibility of having peoples’s lives depending upon you not f^&!@g up. That’s a lot. I know people can get used to intense stuff over time, but it’s still a lot. And it’s really, really necessary. Someone’s got to.
It’s a career field that, like parenting or teaching or even just interpersonal relationships, is an impossible job. You are going to screw up. You are going to hurt people you swore to protect. You are not always going to be able to avoid it. People are not going to be able to forgive the harm.
I can only imagine how tough that must be for anyone who just wants to help.
But, if you can still handle it and learn from it with compassion and humility, it would be far crueler to your potential future patients to deprive them of your lifesaving skills.
Nothing goes right 100% of the time. But it goes right 0% of the time if no one is there to do it.
Shout out to all the healthcare workers out there actually trying to be good healers.
Archaeology/history tip, if things are feeling particularly bleak and hopeless, go look up specifically ‘child mortality rate throughout history.’ I think it’s on a site called something like, ‘our world in data’. Look specifically for the one that starts way before the 1800s and is the total likelihood of dying before about age 15. Go, and look at what medicine has done for people. The fact that it is nigh unthinkable for the most people to have to bury their own child - that’s something that likely no society, ever, for the vast majority of human history got to experience. The places with the highest rates are startlingly better than the places with the best rates even just a hundred years ago. That’s one of the most incredible charts I have ever seen. And, for someone who’s field involves learning about not just things like pottery and stone tools, but also how sometimes archaeologists might be responsible for documenting 800 year old hate crimes or sifting through 30 year old mass graves to hopefully help some families finally get closure after a war or finding a heap of hundreds of severed hands, we too often end up being privy to some of the most awful things that people have managed to do to each other. And like modern medicine, the field also has a dark history.
Which is all the more reason to, if one can, stay dedicated to helping make things better. Because if the sentiment that ‘no parent should have to bury their child’ has only really been comprehensible or grounded in reality for less than 0.01% of our existence as a critter, we are capable of a lot more improvement than we probably can even comprehend. Many things that are crummy don’t have to be so, and haven’t always been this way. Some things that are crummy and don’t have to be this way, though, have also never been better.
Some people who are jerks and don’t want to understand the concept of invisible disability, or the idea you can put in all the ‘right’ effort to avoid it or snap out of it, but also don’t know what I have studied will ask ‘what would you have done back in [x] times when [basically you snowflakes wouldn’t have had the option for such cushy things/modern advancements], hmm?’ They’re trying for a gotcha moment to prove (to themselves, let’s be honest) that I’m just whining and if I just tried harder, like they are of course, I’d be as healthy as they are.
They’re usually not expecting me to say, “Died. I would have died. Without modern medicine I actually would have died because of the complications of my birth, and probably my mother with me. And even if not, any number of times after that.” And the reality is that any person would have had odds not much better than a coin toss of making it to adulthood.
I get to have nearly typical life expectancy for someone in my area and income level, because of modern science/tech/medicine.
I have not, a lot of the time, had a lot of what can be considered ‘good’ experiences or interactions in healthcare settings (unfortunately typical for people with my condition, a higher percentage of whom than the average population are, like me, also autistic dealing with difficult to treat mood disorders) but even in the last handful of years I’ve personally experienced a marked improvement. Healthcare settings still send my anxiety through the roof. But having ammonia doctor look at me and say, point blank, “You’re not just crazy, you’re not imagining it, and this is a real thing you’ve been living with,” is one of the most indescribable feelings. One of the most, vindicating, affirming, relieving, and healing sentences I’ve ever had said to me my whole life.
Sorry, this is ridiculously long, but I really wanted to explain the weight of what I say when I tell you:
From the bottom of my heart, to all the folks, in medicine and elsewhere, who actually care and are working to make things less bad, thank you. Less bad is less bad, and is always worth striving for.
And, not just for the sake of future patients and healthcare workers in the years and generations to come but just person to person:
Please make sure to take care of and advocate for your wellbeing, too.
I worked with a surgeon. He was one of the scariest people I ever worked with. But deep down, he had a big heart. And he was so scary because he took his job and his patients' lives seriously. (Despite his lack of decent bedside manor). Once he worked with you long enough to trust you and gain his respect, he was amazing. I have so much respect for him to this day, and he played a big part in how i care for people.
For most surgeons, the angriest and scariest you will ever see them is when someone harms, or nearly harms their patients. There is "mamma bear/papa bear" energy that comes with the intimate relationship and responsibility of surgeon to patient.
@@kts8900 I absolutely agree
@kts8900 my surgeon had beef with anything that even resembled a blood thinner 🤣🤣
Surgery rotation was the hardest, until I met Dr. Chin, who was a senior resident then. We were rounding in the CCU and he saw a patient that was ostensibly stable but he anticipated an emergency, and he called it! Everyone else was dragging their feet, and he grabbed me and told me to get ready to do CPR. 30s later we are doing chest compressions and a life was saved. At the end of the shift, the next day, he actually shook my hand, as he saw the transformation in me. From an MS4 who took every spare moment to practice doing UWorld questions, to a team member who stayed close to him and was ready to take on any task. Dr. Chin, surgeon extraordinaire, is tough, no-nonsense, and breaks out the compassion as needed. Cheers, Dr. HM
Damnit Doc! I clicked expecting to laugh and now I'm all teary and feeling things! Well done!
God forbid you "feel things". lol ; ) The best humans feel things, in a healthy degree, of course. : )
Seriously! This 2 minute video evoked more genuine emotion in me than most 2 hour films.
It was a fever dream
When I was 11, I had a surgery complication that caused CRPS, a horrifically painful disorder that has completely changed the course of my life. It's a living nightmare and I try every day to make something good out of my life in spite of it.
At first, they told me- a child- that I was making it up, that it wasn't real and that it wasn't their fault. It took two years to get a diagnosis, even though it's a well known complication.
I didn't expect to cry from a Glauckomflecken video. If I had been given the treatment you had shown here, my life would be very different. Thank you for finally showing a good example. I only hope someone listens.
As a surgeon, this REALLY hit home! Especially the parts of those patients never leaving you. Kudos
Second this
I expected this to be the exact opposite of what it was. The therapy seems to really be helping! Until it won't, then all will be right in the world. Way to hit us in the feels, Doc.
The very best one. At four hours old, already 35 thousand views, and counting.
I especially like the surgeon's greeting, as he shifts gears from incomprehensible dictation to attempting to greet..."Resident?" His lips move, but he makes no sounds.
Brilliant scene, showing true compassion all around.
"I'm sure you're great"
Fr tho the speech every new resident deserves to hear!
From an anesthesia provider - thank you! And to be honest, we go through the exact same ups and downs. Sucks to be human sometimes.
I'm not a surgeon, but I am a medical practitioner. I can't tell you how much I needed to hear this. How many years of doubt and grief and shame and fear of things happening again have hung over me, preventing me from what could be. This in spite of therapy , which kept me alive and in the game. Without that, I don't know what would have happened. I do know that wherever we are in our journey within helping professions, however we've come upon the precipice, we all need these words of compassionate wisdom. .Once it's determined that it had nothing to do with anesthesia of course. ❤❤❤ 2:25
That resident will be a great surgeon *because* they care enough about the complication to be upset by it.
As a practicing CT surgeon....honestly I really needed this today. Thanks.
I was sure you were going to say that the best surgeons feel for their patients, so the fact this resident was so beat up about the surgical complication and still wanted to practice and do better makes him great.
Yeah, Surgery fumbled the ball a little bit there. But we needed SOMETHING humorous in this serious and thoughtful skit.
I'm not a surgeon, but I did make a pretty costly mistake at work recently. This video came at the right time. Thank you.
I don't know if you've ever seen the grieving doctor outside the hospital that went viral several years ago. It was soooo moving and real, and raw. Doctors of all stripes make mistakes. Sometimes it is minor and correctable with minimal upset, other times it is a life-and-death decision. That is the heaviest burden that the profession takes on. Much love and respect to those who have to shoulder the load.🥰
Honestly some pretty solid advice. If you work in medicine your gonna hurt or loss some people eventually may be small may not be but your only human. It is gonna suck it will drag you down but you also have to think of all the people you help as well.
People often suffer from PTSD following accidents when faced with the simple realization of how fragile and messy the human body can be. Surgeons face this realization deliberately and routinely. A certain amount of detachment is required but not always achieved.
I would much rather be operated on by a surgeon who has made mistakes in the past and learned from them than not get an operation I need because all the surgeons quit after making mistakes.
Very few of our patients have this kind of insight. It is very much appreciated!
Exactly. Any surgeons reading this, please know this is how most people feel. ❤
@antjobert We are grateful and will always do our best to avoid complications.
I work in the lab but this still hits. I remember the name of very transfusion reaction patient I have ever had to work up.
I...I feel better. And I'm not even a surgeon. This was so nice. I kept waiting for the other shoe to drop but it never did. Thanks Dr G.
The best content creator on the platform.
This should be required viewing for all resident surgeons.
This made me feel better about having surgery. Absolutely wonderful bit. You are helping people understand the realities of doctors, not just making content. Thanks man.
Spot on! I am a vascular surgeon myself and I think you have shown here one beautiful thing about surgery. We may not show many emotions, we don’t know the names of our residents but we do care about our patients and we show lots of empathy and support when one of us has a bad time after a surgery gone wrong. Thanks!!
This is compassionate self-care, good job Dr G
"Oh, so THAT'S why he's THE General Surgery"
Always good to see an authority figure promote therapy, even if its for different reasons than the obvious ones.
Mental health is important.
This was the most wholesome surgery moment yet. Maybe the psychiatrist should get a raise!
Doctors who show humanity to their patients and their loved ones are the true treasures of this universe. They have seen and experienced so much and they still continue to give. I'll never forget how much care the doctor treated my mother even when she ultimately passed a week after her surgical complication. At the end of the experience, the only people I were mad at during that time were my employers, who only gave me 3 days time off to grieve for my mother who had given decades of her life for me. It should not be this way.
You found a good teacher that gives advice and feedback. more of them please. this was sound advice. i watch lots of medical dramas , and this is common advice. learn as mutch as you can, get feedback by a outside source that is medically trained like watching/observing, after the surgery, go over thier notes of all the good and bad. improve. get feedback from nurses as well work as a team. they can hand you items and keep you calm. level head.
doctors always say "if the residence program is good, go to it. learn all they can offer and keep learning new medicine and approach to how it's performed."
Oh the sleepless nights. Couldn’t sleep for 60 hours after i messed up fixing a supra condylar fracture of a kid. Had over a 100 successful fixations under my belt even.
Thanks for touching this topic Doc ❤️
I'm saving this video. I'm not a doctor, but it's such a good and realistic take on dealing with mistakes in medicine or life in general.
This applies to all sorts of careers, too. I'm a pastor. When I was doing my internship, I said the VERY wrong thing to a family that was grieving a loss. They were gracious about it, but it bugged me for days. Finally, the minister I was interning under sat me down and told me this:
"I'm glad this is hurting you. It means you care, and we learn the most deeply from the things that cause us the most discomfort."
Then he made me go see the family again. I learned deeply.
I'm sorry, but glad you are working to improve.
Sometimes the impact of a seemingly small and well intended action can be brutal.
I ran into a pastor's mistake a few years ago.
It involved a young couple with children where the husband became moody then violent and a letter to their pastor.
I wanted to state it, but it is sad and I don't want you to have to hear when you are trying to be positive and recover.
I will say that the line of boundaries is very fine and treacherous. Sometimes people can't have what they want. Some relationships can't be repaired and it's as important as it is difficult to spot and accept those.
If someone leaves, you don't tell where to, because it can lead to trouble.
Keep safe, and I hope you do well.
As an RN, I have to say that when I take responsibility for a mistake I've made, my surgeons are the most understanding and encouraging.
"Im sure you're great!"
Even with the resident's argument, that comment would still give me a nice lift. Good job, Surgeon!
And yes, listening is one of the most important things you can do! In medicine or anywhere!
When you listen, often that's what people need most. That's the best answer and "fix" to most personal distress and questions. They need-we all need-connection, validation, comfort, and love.
Listening is love.
I have worked in healthcare for over 40 years. I am an RN and worked with excellent and sometimes very arrogant physicians. One physician who had an excellent reputation, had a bad outcome. I told him a parable about 2 identical Chinese vases. One day a wind caused one of the vases fall and broke into hundreds of pieces. An expert came and put the vases back together. Such an excellent job was done that you couldn’t tell which one was broken. The broken vase became stronger because it knew how to be broken and be able to come back together. That is what therapy can do for you. Suppressing mistakes doesn’t teach you how to mend. Love your videos!!!!
❤
...but that's not how either glass or ceramic work? the cracks are still there and always will be
@@megt7128 this is why it's a parable not materials science course work.
This is the most RN thing ever
My residency program director, ob gyn, passed awat about a year ago. His advice was nearly identical. The hardest thing is that we are our own absolutely most unforgiving critic. Peer review is a platform for processing these things in a legally protected way. When there are complications, we surgeons really do take it very personally.
One of your VERY BEST VIDEOS. Thank you. I spend a lot of time encouraging folks to have difficult and necessary conversations to build connections. And because we are humans sometimes we hurt other people. And so the steps you outlined here are not just lessons for surgeons but for all of us. ❤And ❤
Watched it twice through. I am a colorectal surgeon myself. Complications are an inevitable but fortunately fairly rare result of doing major and complex surgery particularly when the patient has comorbidities. Each serious complication is felt like a dagger in my heart. The advice given by the senior surgeon here is exactly my own mantra. One has to keep in mind that denying high risk patients life saving surgery because of a desire to have a lower complication rate is not the actions of a good surgeon.
True. My husband had an ultra rare cancer (fibrolamellar) and, despite him going to multiple doctors saying something was wrong, he went undiagnosed for a long time. (He was the number one road bicycle racer in our state, so I think it was missed because he looked healthy and was relatively young. But, this cancer affects kids and young adults who are otherwise healthy people.) His liver tumor was huge and the first major hospital’s surgeon said he’d die from too little liver left, if he survived surgery. Would not do the surgery. I don’t know that I blame them because it is likely standard of care. We went elsewhere where the surgeon said she would try. She removed all of his right lobe and part of his left. It was a 14 hour surgery that did not go perfectly and he spent 2 weeks in the surgical trauma ICU. But, he lived another 5 years after that. Two years before his death, it had spread to his head and the tumor ate through his skull in a large section and was into his brain. (The local doctors were again slow to catch what was going on, despite my husband pointing out his head lump.) We again went out of state. Surgeons at one major medical center said nothing could be done/they could not cover his brain with that skull defect. He was told to get his affairs in order. I think the risk of a death on their hands outweighed any chance of saving him. We went to a different place where neurosurgery and reconstruction teams decided to try. That surgery was also difficult and they had to rush his reconstruction due to blood loss. He got 2 more years to see his young daughter grow up more because those surgeons were willing to try despite the risk. I will never forget them. (In the end, he died from a reaction to a cancer drug. But, he only had 2 small tumors left at the time in his abdomen but his diaphragm was missing in a large section on the right. Nobody wanted to try surgery, so he was on cancer drugs for years.)
"therapy helps to unlock the rest of the neurons" 😭 so pragmatic, I love it
I’m a general / colorectal surgeon going on 9yrs out of residency. I love your videos in general but this one was excellent. Really hit home with my personal experience
Thank You
One of the best of a long line of great videos. Beyond the humor, the concept of respecting your mistakes, owning them, and using them to grow as a professional is an awesome lesson for anybody in medicine. Great job.
As a surgeon, this is extremely important. It’s something we all struggle with. If you operate enough, you’re going to have complications. You’re going to unintentionally hurt someone. We aren’t infallible. What’s important is owning it, doing your best to understand and learn from it, and continuing to do your absolute best for that patient.
This video not only rings complete true, but I've pretty much said the exact same thing to junior colleagues over the years. Should probably listen to the advice and get myself a therapist instead of just telling other people how important they are.
Good work, Dr. G. Your humor has helped me lift the mood on many a stressful ED shift and been useful in teaching students.
This is some REAL life advice buried within a video about surgical complications.
Really solid video; empowering yourself to improve in anything you’re doing is something we need to encourage.
Been there, done that.
Although I have never seen a senior surgeon on therapy.
Thanks for the vid Doc, from a woman surgeon who do goes to therapy and fights the stigma.
This is one of the best videos till date. I am long gone from the clinics but I still resonate with it. It's hard to explain how horrible it feels to lose a patient (especially to non-medical folks) and how hard it is to stand back up, accept your mistake and go ahead. Thank you. I needed this.
Oh my god General Surgery is being nice, has hell frozen over???
It has. Halsted just called up to complain about the cold.
Yep, climate change you know!
O no, wait.............
In my head it's psychiatry, in disguise
This is food for my soul. Thank you Glauc.
This... means a lot. It's so good to see someone reassure a surgeon who screwed up, and offer advice. We always see berating in fiction and harshness and acting like the surgeon is horrible and should lose their license... but it happens to every surgeon. They're not perfect and we shouldn't expect them to be.
Of course we hope it's not us that the mistakes happen on, but... this is such a good reminder that the surgeon probably feels horrible.
Thank you so much for this.
As an orthopaedic surgeon I can say this is on point. Causing harm to a patient really, really sucks, but it's a part of the job and you can't let it keep you down. Accenture your mistake as best you can and get back to doing your good work.
My favorite surgical attending found out through chart review that the team had missed an AKI in an elderly pt and chewed the team out for it - she wasn't yelling for the sake of it, she was yelling because she cared deeply about every pt and wanted to make sure everyone learned from every mistake.
Speaking as a surgeon, this is excellent advice
I remember and regret every single complication I had in my career. Thank you.
As a long-time patient who has experienced major surgical complications, this is very enlightening. For one of my complications, we still don't know why/how it happened, which I'm now sure is just as hard for her to think about as it is for me. I've been able to work through a decent amount of trauma from that surgery with my therapist, and if she has any, I hope my surgeon has processed it with her therapist too 💙
As someone who shadowed surgeons in Italy and saw a resident getting yelled at, this warms my heart so much. There a part of me that’s scared to go into gynecological surgery, but there’s so much more of me that knows I don’t want to do anything else
I've had more than my share of complex gynecological surgeries. Six months after one, I found out that most doctors would have considered me inoperable. Yet, this crazy surgeon made it possible for me to get pregnant and have two amazing kids. Thank you for going into this field.
As someone who's been a medic for 7 years and now a doctor for 5 and has "lost" many patient due to my own mistakes, sometimes due to lack of experience sometimes due to other reasons
Yeah, this shit hits hard, those patients never leave you. Wish I had someone like Surgery actually tell these things but I hope this video will suffice for most people instead, also important to remember: truly no shame in therapy, better to have therapy than be devoured by your mind and problems
Retired OB/GYN here. It's true, those patients never leave you. Thank you for this video. It should be required viewing for residents in any surgical specialty.
Most wholesome surgeon, bar none. Reminds me of a surgeon who worked on me a couple times. Dude had amazing bedside manner, especially for a surgeon. He was an example for all surgeons to follow.
Great advice. Most families end up suing because no one will be open and honest with them. People can live with the admission of an honest mistake what they can't bare is the refusal to tell the whole truth or the feeling they aren't being told the whole truth.
That, and the ensuing medical bills. I know someone who had a lump of fat mistaken for his appendix. Pathology caught it and they had to do everything over again. He survived the appendix rupturing, but the only way to get the extra treatment covered was to sue the surgeon so his malpractice insurance would cover it. The surgeon said as much. It wasn't out of spite, it was just required to save him from bankruptcy.
That's why nations with universal healthcare see fewer lawsuits in general. An "I'm so sorry, bro" doesn't pay a $50k hospital bill.
This is a gem. Really stands out. Thank you.
I love the positive ones.
Wow, I have no medical background, but this showed me how much it can be stressful and nerve racking for even the best of doctors. Thank you doctors, for doing what you do!!
Rare moment of Surgery being wholesome
We all have our complications that haunt us. Although the surgeons rarely admit it, we in anesthesia have saved many patients from their surgeon's errors.
My father is a surgeon for more than four decades now. I showed him this. He loved it, and thanked you for making it.
Best advice I overheard from one superstar doc to a younger superstar...you had a 1 in 5000 event congratulations that means you have a lot of experience and you have added this rare event your skill set.
Made him understand nobody is immune to bad things happening, sometimes the statistics show you something to humble you. This is why I love surgeons.
Beautiful advice, well said Dr. G
I'm tearing up here and my prior complications are coming back to me. Thanks doc. And for the smile at the end!
Psychiatry sneaking in as surgery was not the video I was expecting. 😢😂
When I had a major back surgery, 2 weeks later, I took my big dogs to the dog park to play. I being my usual graceful self tripped over rock and fell. My back almost immediately started hurting worse and new X-rays showed me needing some more surgery. The day after my 2nd surgery, my awesome neurosurgeon called me and told me it wasn’t the fall that caused the problem but the fact that not all my hardware had been placed correctly the 1st time. He covered the entire 2nd surgery and all of my copays for everything. Now I do know that some surgeons could have failed to have had that discussion with me. Honestly despite being a PACU nurse, I’d probably never have found out that the error was not due to my falling but I deeply respected him for his honesty
after last night shift... I needed that, thanks a lot.
Sounds like a fever dream that an attending would be that nice
The message is 100% correct. Heard on my 1st central line pneumothorax. The only ones who never cause a pneumothorax are the ones that don't place central lines. Think of how many successes you had and how many people were helped doing that procedure. 1 eventual complication does not make you a bad doctor, it makes you someone who has to guts to do what needs to be done
Stern Dr. G makes my ass sit up and take note, but he's also really kind and gentle sounding at the same time. I bet he could read bedtime stories and I'd fall asleep.
As a surgery resident, I have had some wonderful senior surgeons, sharing not only knowedge, but truths about life as a surgeon as well. Surgeons are people and they do not always feel that they are in a position to change a certain outcome and they feel guilty about it. Relaying on old dogmas and the toxic culture, that surgeons are demigods without any feelings is an absolut lie.
Just remember, if you are a patient, that surgeons care. And if you are a resident, a surgeon-to-be, remeber that the mistakes never leave us, but are a chance to improve and learn how to be more human. The most private and intimite moments of patient's lives, that we have the priviledge to see throughout our carrier are something that always stays in our soul. I use them as a reminder- memento mori- that I too am mortal. It helps me live life more concious and to appreciate the small moments, as it cliche as it may sounds.
I just started as an EMT six months ago - bottom of the rung in terms of medical practice. I've already had a patient near die on me because I recognized what was happening too late, and I know I'll have more just like them in the future. Thanks for making this, I needed to hear it.
This is better than many hospital shows I've watched. This is great advice