Old Well: UNC Chapel Hill Campus

Tuesday, September 25, 2012

The patient succumbed to complications....

In following a news story about someone's demise, we often come across something like, "He succumbed to complications following routine surgery." The truth is that anyone undergoing surgery of any kind faces at the very least a one percent risk of never making it home again.

One percent might not seem much of a risk, but then we tend to think such things happen to the other guy, not us. Unfortunately, life is replete with the improbable and unanticipated every morning we get out of bed, and death has its way of cornering us in unexpected places.

I still remember a chance conversation I had many years ago with a custodian at Harvard who told me of the loss of her child during tonsillectomy. As I was very young, I don't think I took in its resonance as to the freakish nature of life itself, contributing not only to its mystery, but underscoring its frequent tragedy. I think it was Thomas Wolfe who wrote that a young man at 25 thinks himself immortal. (Say that to Keats, who knew better.) In my case, I was just 22.

A little more than a year ago, model and actress Mia Amber Davis died following knee surgery. She was 36. Dying from knee surgery? Yup, it happens.

There was also the unanticipated death of author Olivia Goldsmith, 54, whose Wives' Club became a popular movie. Following plastic surgery, she went into cardiac arrest, possibly induced by anesthesia. For me, the latter has always been the spookiest element in any surgery I've undergone. To borrow a phrase from poet William Carlos Williams, "so much depends on" an anesthesiologist.

Then there was the widely reported death of prominent Congressman John Murtha, 77, during "minimally invasive surgery" to remove his gall bladder. A close source told CNN that doctors accidentally "hit his intestines."

While natural causes such as a weak heart or allergic reaction to medication may often be factors in surgical mortality, the human capacity for error through misjudgment or negligence always looms, increasing the risk. Even good doctors make mistakes. The quandary is the more you do something well, the more the law of averages kicks in. Let's hope your surgeon is having a good day.

The bottom line is that our bodies treat any surgery as invasive, and human error compounds the danger. Surgery may be necessary, but it's never really "routine." Consider the case of Jenny Olenick, 17, who died of hypoxia (deficient oxygen to the brain) while undergoing anesthesia to have her wisdom teeth removed. While very rare, it's not unknown.

Of course, you can help lessen your risk by choosing your doctors well or considering a non-surgical alternative.

Unfortunately, we seldom get the choice as to the anesthesiologist. They just happen to be there, often rushing in from a previous procedure, and know precious little about us.

Next to death, surgery may be the ultimate in loss of control.

rj