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I wonder, do you? What do surgeons really think of us?

Aviatrix36440Aviatrix36440 Posts: 5,904
edited 06/11/2012 - 8:47 AM in Matters of the Heart
Since this forum category is under "mind, spirit and body", I am thinking this is the best place for it.

For most of us, the longest time we spend with our OS or NS is when we are knocked out and on the table! Here is a doctor that meets you once or twice, see's the inside of you, and agrees to do the surgery. I had a weird thought today. What do they really "think" of us when they do their magic (hopefully magic) on us?

As a Flight Instructor, I've had doctors as students, as a charter pilot and commuter (smaller aircraft) I've had doctors, so lots of interaction with them - very few of those doctors by the way were surgeons. I've heard a lot of their "letting their hair down" about this poor patient, or this troublesome one (diagnosis hard to find), their love of the job, some the hate of it etc.

But... I really wonder what a surgeon thinks of the person on their table? I know in a lot of cases they don't even see the patients face, some don't want to see the face - I guess that makes it too personal then? I know a lot on here are nurses, and some surgical nurses. Any insight here? Is it all professional, or do they crack jokes about our parts, or talk family stuff ??? Dunno, it was just a passing thought that I grew interest in sharing.

PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.


  • Brenda,

    I have a very good friend who is a neurosurgeon and honestly, he talks more about the procedure he has to perform than the patient. If you look at any good sports person before they start of a big game, they get in the zone. He described the same thing to me. Some surgeons crack jokes, some prefer music and some are so far in the zone. But keep in mind surgeons are just like us, they all do things a bit different based on what is comfortable to them. I have stayed awake for quit a few surgeries only wanting a local, and I can tell you each of those surgeons and what went on in the OR was quit different. One of those surgeons discussed canning and what he got out of his garden. As someone who grew up on a farm when i was younger had a lot to add to the conversation. Another surgeon I had played classical music(which i truly love), that for the most part no one really talked in the OR other than the necessary. So I think your going to find that each person has a different preference on what they prefer or like in the OR.

    My last surgery the spine surgeon is pretty particular on what he does and expects out of the staff he works with. While before he got there they were all joking and cracking up as soon as he entered the serious faces came on, but then again he is more like that. Something was wrong with a consent form and the surgery to be completed and he was not pleasant about it. What it should of said and what it said wouldn't change the procedures but it was not the exact wording he had written. Then one of the nurses asked to take the films to the OR, he said no I will bring them they are in the exact order I am working in. He truly gets in the zone. For me as the patient it is a good sign, sense he is the one I researched and I expect that he is the leader of the team. After that surgery I had a few issues and informed him on the post op visit. Long story short he was on the phone with the facility and my phone was ringing within hours. Is he a jerk, NO, he just expects people are at work and the job gets done. After all he is the one at risk should anything go wrong. After any surgery, if the outcome is not perfect first finger pointed is at the surgeon.

    AS far as what they think about us as people, they form opinions no different than anyone you have meet in the work environment. Unfortunately it is true they probably get to know you better on the post-op than the pre-op. But you have to realize they are surgeons and see so many patients. They don't build relationships with patients like a primary or pm doc. Surgeons can only do so much and once their work is done and healed up from what they have done they are on to the next patient. Just part of the cycle. I liken it to a car. You purchase a new car as it wears down you go see a mechanic get work done and so on. Then finally you buy another car and your not seeing that mechanic any longer, as you don't need him to just change the oil. But there will be someone else behind you that will have a aging car and need work.

    For some reason people forget that surgeons are just like you and I and the rest of the world. They are at work, it is a business with a emotional twist to it. But they are at work focused on the task at hand and getting the job done the best way possible. My experience has always been on the day of surgery they have the game face on and in the office a little more light spirited. But if they took you as a patient I wouldn't worry to much as what they think of you as a person, as they can always decide who they will operate on and who they won't. Unless of course it is a emergency case and you became a patient through them being the on call surgeon in a ER.

    Now a little secret I have been known to leave a note about shaving my hair. So I am quite sure someone has gotten a good laugh about it.
  • When I read your post it made me think of what happened at my last fusion.

    I was wheeled down to the surgery floor and my surgeon was at the nurses station with the anestheologist (sp). They quickly went over their "to do list" and the gas dr. said "great, chop chop"!!!

    My Dr. looked at him, chuckled and said, "you know she's right there". He knew me well enough to know I have a sense of humor, even the macabre.

    And yes, after having an ALIF with all of my guts pulled out and shoved to the side, I do wonder what the Drs think, "hey, thats a nice set of intestines", ba dum ba bum.....:)
  • Howdy Tamtam,

    Thanks so much for sharing! A real good read. :) When flying under FAR 121 there is a 10,000' regulation. The only talking is to that of the task at hand - flying the airplane! Once above 10,000' 'casual' conversation is allowed providing the priority of the aircraft remains so. So in saying that, most cases in the OR can be deemed "below 10,000' feet - the patient, just the patient (surgery).

    Oh and I fully agree that they are like you and I. They just have 'their' jobs, and us whatever we do. Same for off duty activities, married, kids etc. I guess my thought of the day was if negative (joking, comments of the patient etc.) convos go on. I've had 2 surgeries that I was awake for. Like you each was different. One I just pretty much laid there, the other (my knee), we all cracked jokes and talked of general things - very pleasant "nickel tour" in my knee!

    I like your little secret! That is cute. When my Ulnar was about to be worked on, I took a black marker and wrote on my left arm - "nope other arm please". My surgeon got a kick out of it. :) Now you got me thinking! (EG)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Brenda love the topic. I think we were all raised in the generation that put doctors on a pedestal. They were gods to us lowly people.

    But, I was also raised by parents who gave me a tremendous feeling of self worth. I was the unexpected last child so I spent more time around their friends than around kids. I had lunch with university presidents and deans etc. I knew my high school principal personally.

    So when I go to a doctor I expect to be treated as a person. My orthopedist (17 yrs with this guy) is great like this. Not too friendly but will ask for my husband or the kids. I remember when his son broke an arm skiing and I teased him about it.

    But I am amazed at how many doctors treat us like dirt. Those are the ones I won't go back to. If you can't treat me like a person then I don't need you. I want a doctor who sees more than a medical chart when he comes in that room. So let the jokes fly...
  • Great title to your post Kris! :)

    Nodding, I too was brought up with the "they are god" generation. Do you remember the Neurologist I went to that lam-bashed me for being allergic to Latex? I told his office like 3 times before I came (and I'd been a patient of the main doc for 3 years), and yet he tried to blame my surgeon, then blamed me. My impression of doctors changed that day. I used the "f" word on him, and too yep...threatened to hurt his you know what if he didn't leave the exam room! Stinks because the primary Neurologist there knows me, is kind and also tells me things straight. This jerk blew it for me even going near that office again!! Part of me wants to go back to "my" Neurologist in that office - if I can get assurances that HE is the one I see, I would get *my* trusted Neuro back.

    I agree, especially after Dr. Latex, if I feel disrespected, or like you, they don't review my chart (Dr. Latex didn't even know my dang name!!) or pretty much blow me off, I blow them off. Fortunately for me, so far most doctors I've dealt with have been professional and attentive.

    My big thing was the OR "chatter" while we were under. (G) Being human, I figured sometimes we on that table where a source of humor! (G) Maybe I was over thinking or something! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I remember being awake once during surgery.

    I had a tubiligation that failed. The result was my daughter.

    I accepted that there was a higher power in control. You know I was right back in there after she was born getting another tubiligation done. LOL!

    During this second one I was awake.

    They were all in there talking about the previous outing on someones boat and where they were headed on the boat the following weekend. The whole time they were digging around in me trying to revise the previous tubiligation that didn't work. I had just given natural childbirth and was content to lay there and listen. (Great Rock music playing in the back ground.)

    All of a sudden I hear the doctor say, "Oh gross, look at that." and then the nurse says, "I've never seen anything like it. "How did that happen?" Of course, I'm like hello, I'm right here wide awake what do you see. They quickly remembered I was awake and tried to tell me it was all OK. I wasn't buying it. They changed the subject the talk remained completely professional and strictly business from there on. The next thing I knew I was waking up. Funny how that happened.

    I don't know what the surgeon really thought of me. Actually, I don't think he thought about me as an individual at all. I think he was just going through the motions at work while he planned his next boating trip with friends. I do know, as I type, my daughter is upstairs singing her heart out to the music on TV. It's all good!

    Thanks for the reminder of that MIRACLE!
  • Frog,

    Interesting surgeries there! See that is in part what I figures goes on too! If the procedure is something they do day in and day out, routine - but ready for things going askew. You hit on something in the end there that might be part of the answer I was wondering about.

    Once you're on the table (no face - covered), you are a "procedure" and they complete that "job" assignment. I have a feeling that might be more the norm, as it also takes the "personal" side out of it, and therefore they focus without emotion on "the patient on the table." Thanks Frog, I think that is more of what goes on. :)

    Oh, did you ever find out what the "Oh gross, look at that." and then the nurse says, "I've never seen anything like it." deal was with that?

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Yeah Brenda I did,

    It would seem the first surgeon had used clips to close the tubes. Instead of closing the tube on one side he actually split it in two creating two tubes. It quickly healed that way and in fact increased my chances two fold.

    What are the odds? I could have played the lottery that day instead!

    I had the surgery done in one state and then we relocated to another. I found myself in a new state new job, new doctors, no family or friends and PREGNANT. Hilarious now. Not so funny back then!

    I really do think, especially for the routine stuff, it's just a procedure. I think to an extent they have to take the personal element out of it!
  • Nodding, yeah I can see how it would be funny now vs then. Instead of "no more pregnancies please," you where given more likely to BE pregnant options! Wow!

    I guess in the grand scheme, we have to be "an assigned" job of sorts. If you watch like Grays Anatomy or Mystery ER, they have a patient, a problem to fix, badda bing, badda boom! Almost sad, but logical too! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Brenda,
    Whatever we may think, trying to enable those in pain to improve quality of life and improving PM is one goal, it is not easy for anyone to watch someone in pain and being unable to help, my own GP said, he would get the best treatment possible, knowing how this event has impacted on myself and family. Our perceptions of how we are perceived do differ from a purely medical perspective and we should be encouraged to support ourselves though kinship and experience.

    Most of the academic writings describe our persona in graphic detail that even as a patient is not easy to digest, although we may disagree with those assertions that may not distract from its authenticity, knowing who and what we have become takes time. Even though surgery is a balance between hype and hope, we have to live with what is left and find some semblance of self in our new normal.

    My own failed fusion may be attributed to my underlying condition rather than anything invasive and I had equal chance of success at that initial stage, my professor said no addition operation would help in the future, that took courage and guts to tell anyone at the age of 35, all the things I had worked so hard to attain gone with those comments.

    We need to be reasonable with our expectations and that is not easy when in constant pain we all wanted to be the person we once were, more importantly what do we think of ourselves, it is us that leave with the pain. We are all an amalgam of thoughts feeling and emotions and to that extent our CP existence as unique as our Dna, the route to improvement in ahead of us and it would serve no purpose to inform anyone how the failing they have are perceived, the traits of behaviour we develop good and bad are not done with any malice and we use what we know until we know better.

    The Textbook of Pain, Melzack and Wall would inform anyone eager to read the creation of CP in all its formats, in knowing and some acceptance of these concepts I am more able to help myself, surviving pain is a team event and any knowledge is only one facet of that improving strategy.

    Take care.


  • Since we are swapping funny stories.....my first pregnancy ended in an emergency c-section. The brat had flipped around and was wedged under my tail bone...he's still a pain in the butt 17 yrs later lol.

    Since I had already had an epidural I was awake for the delivery. They put up the drape so you can't see but you hear everything. They tell my husband that he has to sit up by my head and can't look because they don't want him passing out as they cut me open.

    So smart ass me tells the whole operating team that my husband is a hunter and the sight of blood won't bother him. The whole place was hysterical. Funny part is that I was serious :)

    Another similar experience was my knee surgery. I was awake while they prepped everything. Doctor comes in and does his stuff. They had injected something to numb it. So I asked if I could watch :) Again I was serious and they said NO.

    Well it's time to get something done. PM appt at 11 today. I am hoping that she will have some info about the change in meds that my neuro is doing.
  • dilaurodilauro ConnecticutPosts: 9,878
    I have a number of friends that are doctors and surgeons. This has been a question I have asked them before.

    They respond the same. We really need to concentrate only on the procedure we are doing and NOT the patient. If we started to think about the patient, then emotions would come into play and that could potentially impact our medical approach

    Think about it, it makes so much sense.

    The last thing I would want to have is for a surgeon to start thinking about me as a person during the operation. That thinking can come after the surgery.

    But it is very entertaining to hear stories about what the surgeon and their OR staff talk about during a procedure. It can be from anything about a fine restaurant, music they like, stock market prices, etc.

    Of all the people in the OR, the one person believe or not that really does not participate in some of the above is the nurse/technician who's responsibility is to know the number of instruments/materials/etc used prior to surgery and the count after surgery.

    So you think, why would that seem to be more important or need concentration more so than the surgeon performing the procedure? I really don't know the answer for that one, but it does seem pretty consistent.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • So Kris,

    I gather after all the hysterical laughter was done, their answer was no? (G) I'm great if it's someone else's blood, but someone I know and care about - whole different animal there for me! Maybe they were thinking similar for your hubby? They've seen it a lot more than we ever will! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Ron,

    I didn't think about the tech/nurse that keeps a track of all that! As to "personal or patient" and them trying to keep it as neutral as possible to keep emotion out of things makes sense.

    When I consider here I have a surgeon (or surgeons) with very very very (did I mention very?) sharp knives near my spine, the less emotion in that OR the better! Thanks Ron, it's nice to see I am not the only one that wonders this question. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • You know some of those surgeries are video now and you can get a copy of it. But the other thing is if you want to see some of those live surgeries go to ORlive.com and you can watch the flick of the day. Some of those videos have made it on youtube and I have watched a few of them. Now what I want to see is the person who has to flip someone and they say wow she needs to loose some weight? Haha, jk. I heard once on my shoulder surgery all techs to OR 3 need lift assist. Now the only question I want to know is what I have said on those drugs, I know I have remarked about the surgeons cologne. On my post op he said tell your boy friend he might want to get xyz cologne. So I am sure i have said more than that. But then again maybe I really don't want to know?
  • Tamtam,

    I love ORLive! I think if I remember right, I saw 1 or 2 cervical fusions on there. Yes, that's right, because the lead Surgical nurse also had an ACDF and was showing how hard it was to see her scar! What got me what when they hammered that graph in place! Yowzers! Other than that visual, the video on that site made me a whole lot more comfy with my first surgery. :)

    My hubby told me on my second surgery for the neck (same surgeon), my "coming out of anesthesia was a little slower this go around. He said when my surgeon approached (me still out of it), that I told him he was nice on the eyes, but too skinny for his height! OMG! You know what, my surgeon never said a word! When I asked him if I said anything stupid to him, he replied with "No worries, anesthesia makes us all have a good day!" Hurmf! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • dilauro said:

    Of all the people in the OR, the one person believe or not that really does not participate in some of the above is the nurse/technician who's responsibility is to know the number of instruments/materials/etc used
    prior to surgery and the count after surgery.

    So you think, why would that seem to be more important or need concentration more so than the surgeon performing the procedure? I really don't know the answer for that one, but it does seem pretty consistent.
    It would seem that is a pretty important job. One that would require ALL YOUR CONCENTRATION. I can personally speak for what happens when it is not done correctly! What goes in MUST COME OUT!

    Too much other chatter in the room breaking your concentration PERHAPS....
  • having worked in cardio thoracic ICU recovery (from open hearts and such)...I sat in on many cases just to view and learn anatomy and such and CT surgeons...similar to Neuro surgeons are notoriously known for being arogant and snotty. Well, it just depending on the surgeon...one would talk and teach and quiz me on everything (very studious)...one was very fun...telling jokes and listening to Dave Matthews Band and another was very quiet you could hear a pin drop, noone said a word, another talked small talk and actually did tell stories (good) about the patient lying there with chest open, heart stopped and on bypass. So, they are all different.

    However, as a nurse, I know there is A LOT of talking about patients b/n nurses...that is for sure. Mostly if it was a mean or needy patient, it would get told to the others, but also, there would be good stories about the patients and who they were and what they did and such...So, perhaps the surgeons are more focused in surgery on the body part (which is good)...but in a more "relaxed" environment, there is some talking...even amoungst doctors regarding patients. Not all was right obviously...but most times it was something that distinguished that persons character that was talked about. For example Brenda...a doc may say to the nurses, "Hey, did you know she is a pilot and blah blah..."...things like that.

    Good question though!!
  • Tarheelgirl,

    I hear ya there! In '02' when I had emergency surgery, my room was next to the nurses station, and I heard bunches! (G) I pretty well knew that happened, as the nurses are more interactive with "us" the patient, than is the surgeon. And yes I am sure about the "problem children like" patients.

    Thanks too for the surgical nurse perspective. That makes perfect sense in that all are more or less comfy, and therefore music for one, chat for another, and teaching with another. Makes them sound more and more "the regular guy" on the street. Thanks Tarheelgirl!!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I have always wondered the same thing :? ! I do think you can tell what an OS or NS or even the PM think of you by there bedside manner :S . Some just see us as work, procedure, but theres some thats sees us as us The Patient :) ! But it does make you think what they do say about us :? 8> HMMmmmmm

    Angie xx
  • My ortho is an excellent surgeon, with the same "bed-side" manner. He is very light hearted, and just a really nice guy. Funny, while waiting outside the OR, the nurse came up and had me sign the release and consent forms, while I was doing that, they were marking my leg with a sharpie. I asked what they were writing, and they said, we do that to ensure the right leg gets operated on, and the right operation gets done. I sat up, looked at my leg, and there was a smiley face on my knee with lateral release written above it! So, I get wheeled in, they're setting up the table, inserting my IV, and the ortho walks in, says hi to each of the members of his team by name, jokes a bit, and reviews my chart. He sees that it's my birthday, says "well, that kind of sucks, doesn't it?" and gets the team to sing Happy Birthday to me!! Then he clapped his hands and said okay, time to get down to business. As to what happened after I was knocked out, I don't know, but I'm pretty sure it was one of those light-hearted atmospheres, but with the seriousness required to get the job done.
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • Too funny! I would have paid a ticket for entrance to that! When I had my Ulnar nerve transposed in my right elbow, my surgeon using a purple sharpie put a smile on my right arm along with "Yes", and then on my left, "Nope, don't touch".... I wonder when they started doing that? My knee in '89' they didn't do that.

    Sounds like your team was comfortable with each other, and confident in your procedure. :) Thanks for sharing. *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Yeah, they didn't do that in '95 for my right knee either. But they wrote on my tummy when I had my appendix out in '07, the year after my lateral release. Those two were done in hospitals on opposite sides of the country! I don't know when they started doing it, but a great idea, indeed, I don't mind in the least!! :)
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • I get the feeling Kelly that after 'enough' oops wrong leg, arm type stuff it became the norm. On our local news a few years ago, they actually suggested pre-op patients mark their own limbs with permanent marker! I brought one with me for my elbow, but hehehe...as I said, my surgeon came in the pre-op room and marked me up!

    In aviation, the phrase for 'new regulations?' They are written in blood! The medical field probably isn't much different? :?

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • We have a hospital locally that has had some trouble lately- maybe they need that trick?
  • So maybe it isn't a nation wide thing? I've had 5 different nerve surgeries in 3 different hospitals, and they all marked me. Whelps HB, do what my "plan A" would have been I recon, bring that sharpie and go to town! (G) Actually thinking about it, my NS marked my neck before they knocked me out on this last go??

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I will never again let them operate on me without marking the spot. Since they decided to move my ipg placement from what we had discussed without my consent.

    I should have known better, but day of surgery jitters and just wanting it over with, I let it slip.

    The hospital I go to actually has one use felt tips for marking people! In their own little sterile tear open packets! They give it to you if you want it. Otherwise they toss them. Talk about being germ conscious!
  • Wrambler,

    With all the MERSA and Staff infections now a days, I am all for them being 'germ conscious'. :) I don't know if mine were from their own sterile container. I didn't worry too much about that aspect since they sterilize and dress the whole area before they start.

    I know for me, more than once I've gone to the hospital for a follow up from surgery, only to find I had the raging flu later that night or when I awoke in the morning! Germ factories!!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • :SS My NS came in the night before and grabed my collar and pulled it to the side and made a mark, he said "that is the side", "do you have any questions?" I said, "what can I expect?" he said, "nothing, few donor bones a small plate and some other stuff, you will be good as new after surgery." I was sooooooooooooo stupid. I woke up HOURS and HOURS later and life was not the same. Kind of forgot to tell me about the how big the plate was, screws, and oh yeah, the cage, or maybe it was the a serious multi-level. oops, He might have been the best surgeon ever, but his bed side manner mad me scream w/regrets. Needed the surgery yes, but I could have lived a lil better w/the honesty, the real story, and etc......I at least could have prepared mentally for the surprise of a very long surgery and cut he made from my ear to collar bone. Dah....what happen to the cut across the neck? oh no, I had to look like I got into a terrible fight and didn't win. Poor me. :)
  • My Neurosurgeon was wonderful to me as well as my family. Also as Tam said my surgery was filmed too. Also I so agree with Ron, we really built our relationship after my main clipping of my aneurysm. I have had several angiogram's and when the show starts so to speak, he was totally in his zone, even has a move that he does to let all the staff now that he is done. Really cool actually. Angio's they need you to be awake so that you can follow there directions, but when weird sensations started happening he was right there and he was still in the zone. He saved my life. Our first conversation was silly and we actually were joking and talking about sex,( he is totally hot too, so there are blessings when you look.......hehe) but when I needed to get into the zone i had the chapel come and then i followed directions. I was totally trapped so i had wonderful nurses wiping my tears and wrapping me in heated blankets. I have had several now so i know what to expect, just not the outcome.
    I went on to always tell him how alone i was and support and wanting to meet others like me would be great. Having a common problem and being with others to talk is priceless, and he is great, but has never had an aneurysm. So in that area he was missing. After about 9 months from major brain surgery Doc Eric and I and a nurse got a monthly support group up and running for other people that are in the same situation. So in Tampa Bay we now have a support group for survivors and there families. My doc is always available via email as well as appt to see him. He is a real gem.
    I totally get that not all are available. This experience has really taught me that i am worth it, so if a doc is not, i move on, it just is not a good fit. Also life is short, live , love and laugh..forgive.......
    Even my fusion surgeon was great, but when pain continues they do not like to hear that. That i have learned. Brain experience is and has been totally different.

    They are no different then you or I. I am just grateful they have wanted to study, go to school and study and work there butts off........

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