{"id":12068,"date":"2021-06-05T16:00:00","date_gmt":"2021-06-05T10:30:00","guid":{"rendered":"https:\/\/www.wockhardthospitals.com\/?p=6696"},"modified":"2021-06-05T16:00:00","modified_gmt":"2021-06-05T10:30:00","slug":"the-surgical-chatter","status":"publish","type":"post","link":"https:\/\/wockhardthospitals.com\/international-patients\/general-health\/the-surgical-chatter\/","title":{"rendered":"The surgical chatter"},"content":{"rendered":"\n

When all\u2019s not well, surgeons often rely on voices in their head, where ideas and uplifting thoughts are sometimes replaced with self-questioning<\/strong><\/p>\n\n\n\n

Wake up, Elizabeth, your operation is over; everything went off very well. Now, open your eyes,\u201d I heard the anesthetist bellow as they went through the routine of reversing the anesthesia to awaken the patient and remove the breathing tube.<\/p>\n\n\n\n

It was an operation to clip an unruptured aneurysm arising from the bifurcation of the right internal carotid artery. I sat in one corner of the operating room writing down the post-op orders, feeling a kind of inner joy as I typed out my notes for having performed a masterful surgery. After I finished, I made a quick dash with my team to check on our admitted patients. When I returned to the ICU <\/a>an hour later, I was informed that Elizabeth hadn\u2019t been shifted yet.<\/p>\n\n\n\n

\u201cThat\u2019s strange,\u201d I said to myself, swiftly climbing the stairs that led to the operating room to hear four words from the anesthetist that no surgeon wants to ever hear: \u201cShe\u2019s not waking up.\u201d<\/p>\n\n\n\n

The anesthetist peered right into my eyes. \u201cThe muscle relaxant has been reversed, blood gas analysis is fine, but she\u2019s just not opening her eyes,\u201d she finished, looked at me with the finality of not having a plausible explanation for this from her end. This was also her polite way of saying, you\u2019ve done something wrong inside, now fix it.<\/p>\n\n\n\n

I went through the steps of surgery in my mind, running my hands through my scanty hair. Could it be because we buzzed a surface vein? Have I taken a perforating artery supplying the hypothalamus in the clip? Did we retract the brain too much? Is the main artery kinked by the clip?<\/p>\n\n\n\n

The self-introspection then made way for chatter. Should I have operated on her in the first place? I should have just asked the interventional radiologist to coil the aneurysm. She\u2019s a mother of two, have I destroyed her family? Do I really think I have the skill to do these complex cases? Who am I trying to impress? And at whose expense? Better do something before it\u2019s too late. Or, is the damage already done? It\u2019s a sickening feeling when someone you\u2019ve operated on doesn\u2019t wake up the way you expect them to. It is literally gut-wrenching; your intestines feel as though they are physically being squeezed.<\/p>\n\n\n\n

I looked at the numbers on the monitor and then at the anesthetist repeating the same words, over and over: \u201cWake up, Elizabeth, wake up\u2014your surgery is over.\u201d<\/p>\n\n\n\n

\u201cRaise the blood pressure to 170-180,\u201d I ordered, thinking that some crucial vessel might be in spasm. She transiently opened her eyes, but within a few seconds went back into a deep slumber. We got an urgent MRI done, but that was clean; no area of ischemia or infarction. No blood clots as well. The clip was positioned perfectly, and we ruled out her having subclinical seizures, too. We shifted her to the ICU on the breathing tube as my gaze vacillated between the monitor and her body lying motionless when it should have been sitting up in bed and talking to me instead.<\/p>\n\n\n\n

The chatter turned to a full-blown tirade. Am I missing something here? Should I call someone and ask for help? Should I just give this sometime? What would I do if someone else operated on this patient and I was called to opine on how to proceed? I use this last analogy a lot when I\u2019m in distress. I try and distance myself from the problem at hand, and adopt the fly-on-the-wall approach. It\u2019s easier said than done, of course, but all you have to do is zoom out. I remember reading somewhere, \u201cThe only people who see the whole picture, are the ones who step out of the frame.\u201d<\/p>\n\n\n\n

There is a Chinese proverb that says, \u201cHe who blames others has a long way to go on his journey. He who blames himself is halfway there. He who blames no one has arrived.\u201d I was halfway there. The countless permutations and combinations of the infinite possibilities of things that could have gone wrong kept buzzing in my head.<\/p>\n\n\n\n

We all have a voice in our heads. We tune into its incessant chatter to look for ideas, guidance, and wisdom. <\/p>\n\n\n\n

Sometimes, these conversations uplift us and sometimes they sink us into the deep, dark hole of despair. <\/p>\n\n\n\n

Ethan Kross, a renowned experimental psychologist, and neuroscientist, and one of the world\u2019s leading experts on how to control the conscious mind, has written a book called Chatter: The Voice in Our Head, Why It Matters, and How to Harness. In that, he states, \u201cIn recent years, a robust body of new research has demonstrated that when we experience distress, engaging in introspection often does more harm than good. It undermines our performance at work, interferes with our ability to make good decisions, and negatively influences our relationships.\u201d<\/p>\n\n\n\n

Instead, he reveals the tools you need, to harness that voice, so that you can be happier, healthier, and more productive. \u201cChatter doesn\u2019t simply hurt people in an emotional sense, it has physical implications for our body as well, from the way we experience physical pain all the way down, to the way our genes operate in our cell,\u201d he warns. <\/p>\n\n\n\n

I hadn\u2019t read the book at the time, and my head was spinning with thoughts as I stood at the edge of her bed for three hours, waiting for her to move just a little. I was following the old age adage of \u201cjust give it time\u201d when dealing with this unsettling experience. <\/p>\n\n\n\n

After a long, painful wait, Elizabeth moved a little. And then, a lot. She opened her eyes and made chewing movements and brought her arms to the tube as if to denote she wanted it out. We took it out once she was fully awake and briskly obeying commands, indicating to us that she was conscious, alert, and aware.<\/p>\n\n\n\n

I am still intrigued about why she took so long to wake up. Probably, it was a tiny artery that went into spasm but opened up later. But, the relief of shifting her out of the ICU the next morning and then home with the family in a few days was intense. Finally, there was no one to blame.<\/p>\n\n\n\n

The writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals.<\/strong><\/p>\n\n\n\n

Source: https:\/\/www.mid-day.com\/news\/opinion\/article\/their-worries-our-stories-23175713<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

When all\u2019s not well, surgeons often rely on voices in their head, where ideas and uplifting thoughts are sometimes replaced with self-questioning Wake up, Elizabeth, your operation is over; everything went off very well. Now, open your eyes,\u201d I heard the anesthetist bellow as they went through the routine of reversing the anesthesia to awaken <\/p>\n","protected":false},"author":2,"featured_media":51547,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[97],"tags":[],"class_list":["post-12068","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general-health"],"acf":[],"yoast_head":"\nThe surgical chatter - International Wockhardt Hospitals<\/title>\n<meta name=\"description\" content=\"Surgical chatter is an operation to clip an unruptured aneurysm arising from the bifurcation of the right internal carotid artery. 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