DANGERS OF DOUBT

THE DANGERS OF DOUBT

            One single iota of doubt destroys all plans and good scenarios one can imagine. In surgery, this destroys all plans a surgeon has envisioned  prior to a contemplated procedure in the operating room.

            When the surgeon suggests  to the patient that surgery is the only alternative to the cure of his/her disease, up front he is trying to convince himself that he can do it and that he can readily cure the patient of his or her illness. This is no easy task since a surgeon’s mind is the most vicious critic of his own  His training, his upbringing, his experience and his current know-how play  a big part in this decision. Once he has crossed the threshold of confidence, he is not out of the woods yet. The patient, his relatives, his neighbors and all the people surrounding him carry a big factor in carrying out the surgeon’s plan.

            More often, those relatives who have not heard the explanation of the surgeon will be the people who will spoil the broth. They will have a better idea than the surgeon….kuno!! The oppositionist would always be that his doctor friend knows about it and that surgery is out of the question. What is more intriguing is that the supposedly expert doctor is not even a specialist of this case. He could be either an Internist commenting about a surgical case, a pediatrician or even a general practitioner.

            Even how small the doubt is if suggested to a patient who (and no other) will go under the knife and no one else could substitute for him,  he will doubt the surgeon, too. No explanation whatsoever could change his mind unless the doubting Thomas himself will correct that mistake to the patient.

            This is ok if the illness or disease can wait and no  virulent  activity is going on inside the patient. What if his case is that of an intestinal obstruction or Acute appendicitis where every minute counts? The delay is detrimental to the patient.

            That is why a second opinion must be official and that the surgeon must see the patient before he can make a diagnosis or recommendation. The problem is that relatives often will only bring the results and not the patient to his clinic. The second opinion surgeon will be forced to make a diagnosis based on paper and not on physical examination. This creates a big difference. There are lots of diseases never confirmed by diagnostic procedures and the surgeon’s hands are the only diagnostic instrument.