#038 Why being a surgeon is a Loser's Game

Sweat beaded on my brow. The nausea started to rise in my stomach and my heart started to race.

Had I actually done that? Had I cut the nerve to this woman's leg?

On training courses we were taught about the steps to avoid cutting a nerve root in lumbar spine surgery. Naïve and oblivious to my lack of experience I scoffed at the thought with my friends.

Now hear I was.

I composed myself and stopped operating and pretended to study something on the scan. I asked for my consultant to attend the theatre to, "Have a quick look". During what felt like an eternity, I started to really look at the scan and noticed something odd (we'll talk about this later)*.

If there is one quality I could choose in a surgeon it would be honesty. As soon as my boss arrived and peered down the microscope, I told them exactly what I thought had happened.

"There's been a complication. I think I've cut a nerve root."

I was fully expecting fireworks. What came was the complete opposite, "OK. I best take over and have a look."

The rest of the operation went smoothly. My boss removed a large disc that was the cause of the patient's leg pain. We confirmed I had cut one of the two nerve roots at that level, but there was no leak of spinal fluid to repair.

But none of this made me feel any better as I waited for the patient to wake up in recovery. Only then would I know if I had caused irreversible paralysis.

"How's your leg feel? Any pain still?" I asked standing at the end of the bed. "Fine," was the reply.

"Can you do these movements?" She could do them all. The next day she asked if she could go home. Her chronic leg pain was gone. She had no new leg weakness. She was over the moon and remained so as I detailed what had happened.

"These things happen," she said.

They do. They really do.

This mistake taught me more lessons than any other in my career, but I want to talk about one that I wish I had known a lot earlier.