Secrets of the Operating Room

After an operation, most surgeons tend to underestimate the amount of blood that was lost. Whether it's ego or denial, they can't help themselves.

Fragile egos, obese patients and talking organs: A surgeon's view of what happens under the scalpel

From Confessions of a Surgeon
By PAUL A. RUGGIERI
WSJ

"Get this thing out of my operating room!" The colon stapling device exploded into pieces when I hurled it against the operating room wall. I was fed up with its failure to work as advertised by the manufacturer. The stapler had probably cost less than $100 to make. The hospital paid $300 for it (and then billed the patient, or insurance company, $1,200). Now the thing didn't even work.

I do not react well to imperfection inside the operating room. I cannot tolerate it in the tools I use, the staff assisting me, or myself. Defective devices—I can have them replaced. Unmotivated staff—I can have them removed from the operating room. I haven't quite figured out yet what to do with myself.

Surgeons are control freaks. We have to be. And when things don't go our way in the operating room, we can have outbursts. Some of us curse, some throw instruments, others have tantrums. These explosions are a go-to reaction when we're confronted with the ghosts of prior complications.

Several months earlier, I had performed the same operation on a 66-year-old patient, using an identical stapling device. Everything seemed to have worked perfectly until the patient developed severe complications four days after his surgery. We soon discovered the cause: the nonperformance of the stapling device.

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