Best-kept secrets of surgeons around the world

“I once had a guy who was a horse trainer who started going on about how this one horse was a sure thing to win. One of the nurses collected money from everyone in the operating room and bet on the horse. It came in second place. The smart people bet the horse to place, but some had bet the horse to win, so half the staff was happy, and the other was upset. He woke up and had no idea what kind of ruckus he’d caused.”—Michael Salzhauer, MD, a plastic surgeon in Miami, Florida

“During my six weeks as a surgical intern in the ER, I inadvertently stuck myself twice with contaminated needles.

“I also briefly nodded off in the middle of suturing a leg laceration, accidentally punctured a guy’s femoral artery while trying to draw some blood, and broke up a fight between the family members of a guy who’d come in with a stab wound to the abdomen.

“I was slugged in the head by a delirious patient in an alcoholic rage, spat upon, coughed on, vomited on, farted on, bled on, and mistaken for an orderly.” —Paul Ruggieri, MD

“When I get polite in the operating room, when I start saying ‘please’ and ‘thank you’ and talking in a monotone, that’s when nurses know things aren’t going well.”

“It’s this mechanism to maintain calm. When we become unglued, everyone becomes unfocused, and that’s when patients die. How you handle stress is absolutely critical.” —Kathy Magliato, MD.

“Your doctor should not push you to make a speedy decision about prostate cancer surgery.”

“Most prostate cancers are extremely slow-growing, and there is so much misleading information out there, so you should take your time.” – Bert Vorstman, MD

“If you have unanswered questions about your surgery, ask for the report.” – Paul Ruggieri, MD

“Those are the main symptoms of a blood clot, which is a risk of just about every surgery.” —James Rickert, MD

“It’s not making a mistake in the operating room; it’s the noncompliant patients. When patients don’t do what we tell them, bad things can happen.” —Kurian Thott, MD, an ob-gyn in Stafford, Virginia

“Starting an IV is tough because chubby arms don’t have many visible veins. It’s difficult to place a central venous catheter. Post-op, they’re more likely to get infections. Just getting someone who weighs 300 pounds out of bed is hard.” —General surgeon who blogs under the name Skeptical Scalpel

“When one extremely hostile relative bombarded me every time I walked in, I developed a tendency not to go in the room. If you have three pages full of questions, show them to the nurse. Say ‘How many of these should I wait to ask the doctor about? How many can you help me with?’” – General surgeon who blogs under the name Skeptical Scalpel

About 25 percent of operations are unnecessary, but administrators e-mail doctors telling them to do more.

“This is not an insurance company putting pressure on doctors; this is not a government regulation. This is private hospitals pushing doctors to generate more money by doing more procedures. It goes on at America’s top hospitals. The Cleveland Clinic has said this system of paying doctors is so ethically immoral that it started paying its doctors a flat salary no matter how many operations they do.” —Marty Makary, MD.