Talk Turkey with Your Surgeon So You Don’t End Up as Hamburger

Today’s Wall Street Journal column, The Informed Patient by Laura Landro, was a great reminder of the critical importance of patients working closely with their surgeons and physicians in order to get the proper treatments and healing:

To help patients be more pro-active, health-care groups, hospitals and medical specialty societies are offering new resources, including Web sites, books and checklists of questions to ask. The aim is to help patients select qualified surgeons, prepare for operations, and overcome the fear that often inhibits them from asking tough questions.

These new efforts are spurred in part by the sharp rise in surgeries performed in outpatient facilities; including doctor’s offices and surgical centers, where patients aren’t guaranteed the same access to care as in a hospital should something go wrong. A rash of recent news has highlighted the risks, such as the death of rap mogul Kanye West’s mother after an office cosmetic procedure by a surgeon who was facing disciplinary action at the state medical board and two malpractice suits that ended in significant payouts.

Since patients can’t prevent mishaps once they are under anesthesia, it is all the more important to question surgeons beforehand. “Patients should feel free to ask their surgeon anything they want answered about the operation or the surgeon’s competency to perform it,” says Thomas Russell, a surgeon and executive director of the American College of Surgeons. “There are no questions that should be off the table.”

I strongly credit both Dr. David Albertson, Endocrine Surgeon at Wake Forest University Baptist Medical Center and Dr. Katherine Morton, formerly at Wake Forest, and now at the University of Utah School of Medicine for helping save my life 6 years ago when I was diagnosed with papillary carcinoma, a form of thyroid cancer. Both were willing to partner with me, which is so essential to healing. Both were excellent empathic listeners, despite enormous demands on their time, and no formal rewards for being such good communicators, and probably no formal training in communication (only now becoming part of medical schools’ curricula).

Dr. Albertson contacted and worked with nationally-known experts in pathology and other specialties for input and information when four pathologists at WFUBMC couldn’t make a definitive diagnosis on my biopsies. He was also willing to do two separate surgeries, spaced weeks apart, rather than the standard one, when my brother, an orthopedic surgeon, cautioned me about the potential risk, albeit very small, of losing my voice or even ability to breathe on my own, due to possible damage to my right and left recurrent laryngeal nerves which can happen during neck or thyroid surgery. He was willing to do the extra surgery, even though it wasn’t his first choice, because he understood I was willing to accept the risk of another surgery to minimize the chance that both nerves would be damaged..

Dr. Morton, in charge of my radiation treatment following my surgeries, also took it upon herself to treat the side effects of the required withdrawal of my thyroid hormone before my radiation treatment with radioactive iodine (I-131).  I became extremely fatigued from not having thyroid hormone in my body, which is a typical if temporarily debilitating side effect of the pre-radiation protocol. However, in my case, I had also become an insomniac for the first time in my life as well, which may happen when thyroid hormone is withdrawn for several weeks. My endocrinologist was unreachable, and I was literally completely alone because my family had to be out of the house for several days due to my need to ingest a radioactive element. (For “fun,” I borrowed a colleague’s Geiger counter, and it could be heard even though I was several rooms away.)  I was slowly losing my mind from not being able to sleep more than an hour or two a day even though I barely had the energy to brush my teeth. When I told this to Dr. Morton, she prescribed a sleeping pill, the first time in my life I’d ever taken a sleeping pill, which restored my ability to sleep until I could resume taking my thyroid medication.  (A new treatment now available may help spare thyroid cancer patients the agony that I and others used to have go through as part of their radiation treatement.)

Karen and I are have published our book on how leaders build trust, and we profile four physicians we’ve worked with very closely over the past few years. I haven’t seen Drs. Albertson or Morton in quite a while, but you can bet we’ll include them in our next book. They are already part of our Trustworthy Healers section on our blog.

Aneil