Atul Joshi
Before surgery, I entered the preoperative area and greeted both my patient, a 15-year-old boy, and his father. The boy was in line for a major laparoscopic surgery. He had major surgery when he was a baby and had long scars all over his stomach. As required, I gently re-discussed my concerns about the surgery with the father, asked him to sign a high-risk consent form, and acknowledged that as a team we were committed to doing what was best for the boy. I reassured him. The tension and anxiety were palpable on his face.
I had a son of the same age, and I was keenly aware of his predicament. I could see out of the corner of my eye what was going on between father and son while I was busy explaining the course of events to the surgical team. The father grabbed the boy’s shoulders, looked him straight in the eyes, concentrated for a few seconds, then blurted out in a firm, determined voice, “Go on, don’t worry.” I hate to admit this, but I had my heart in my mouth. In that moment, I felt a great sense of responsibility that I was carrying. Here, there was a boy who lived his life with the dreams and hopes of his entire family. Firmly believing in my determination, I moved the patient into the operating room. The surgery went as planned and I was ready to go home earlier than planned. It was redeeming for sure, but emotionally draining.
A few days later another situation occurred. Near midnight, as I prepared to treat a critically ill patient with a perforated bowel in the operating room, his wife looked me anxiously in the eye and said, “This will be a life-threatening intervention. do you?” he asked. Without blinking, my answer was affirmative. With tears in her eyes, she said, “This was our second marriage. I lost my ex-husband and I don’t have the courage to go through it again. I feel writhing and depleted.” It was my turn, and I wondered what could be more difficult than operating on this critically ill patient and trying to save his life, or keeping my mind away from its ill effects.
The result was a success, but I shudder to think that the result would have been different. During sleepless nights, we relive the emotional dilemmas of the moment.
