Surgeons Out of This World

I have come across a large number of surgeons. Many of them follow a standard technique of surgery. Maybe one person will hold an instrument with a ten degrees more or less tilt than others. But other than minor variations, there is overall uniformity. But I have come across some rather peculiar ones too, and today I am going to write about two of them. One was an honorary professor when I was an undergraduate student and then a resident. He had a very busy private practice, and used to be quite pressed for time. If he had a patient in his private practice could not afford his charges, he would send her to our hospital, and operate on her for free. But that could took valuable time, which he did not afford. So he adopted a technique which was unique. Hysterectomy or surgical removal of the uterus usually involved application of a clamp to six pedicles, one at a time. The clamped structures are cut and a ligature is placed in place of the clamp. The ligature prevents bleeding from the structures cut. The process is then repeated for the next pedicle. Our erstwhile professor would use six clamps. He would clamp and cut each of the six pedicles one after another, without replacing any clamp with a ligature, Then he would leave the patient with six clamps poking out of her open abdomen, instructing his assistant to put a ligature in place of each damp, and then close the abdomen. It worked for him. But had any of the ligatures become loose and the patient bled, he would have got into serious trouble. Luckily for him and the patients, nothing of this sort happened. It is definitely wrong to do so. But in those days, doctors were like Gods, allowed to do whatever they pleased. The other one I want to write about is a modern professor working in my department at present. She is a full-time worker with plenty of time on her hands between9.00 a.m, and 4.00 p.m. to do things. She does not have to rush anywhere. She does not put six clamps at a time like our erstwhile honorary professor. She probably cannot, because it would require skill far beyond her. She places one clamp, cuts the pedicle, and then asks her assistant to place a ligature to replace the clamp while she stands there and observes. Then she places the clamp on the next pedicle and so on. It is not known why she does this. One theory is that if the patient bleeds due to a loose ligature, she can put blame on the assistant who tied the ligature. How it will work in a court is difficult to say. Another theory is that her tummy comes in the way and she cannot bend forward to tie the ligature. The third theory is that she thinks it is below her dignity to suture something she has cut. It is like the old-time bosses doing a case and going away, asking the assistant to close the abdomen, or the autopsy surgeon asking the autopsy room servant to stitch up the open abdomen of a dead body after he finishes the autopsy. Hopefully I will ask her one day why she does this. If I learn the reason, I will definitely let you know.