Heroes Not Zombies

Orthopaedic surgeons at St Louis University School of Medicine were a bit puzzled when their clinical tests on patients post hip surgery indicated they were recovering well but the patients own reports didn’t confirm that. What they did was ran a parallel questionnaire which amongst other things asked about emotional well-being. The two sets of results didn’t correlate

“What we found was surprising – the clinical test found good-to-excellent results, while the self-test taken by the same patients showed significantly worse recovery.”

Now, to you and me that might not be a surprise but, strangely, to these surgeons it was a shock. You know why? The surgeons see themselves as technical fixers. In this case they were fixing hips and they were assessing how well the new hips worked. But they are being confronted with the fact that the hips in question are inside people and people are a lot more complex than just the bits of their bodies.

You can’t but applaud this conclusion from Berton Moed MD

“The number one issue is recognition – we need to acknowledge that there’s more going on with patients than what current clinical tests tell us,” he says.

But wait, his suggestions for what do about this problem is worryingly medicalised –

“Do we need to look at other interventions besides fixing their hip? I think we might have to,” he says. “That could include bringing in social workers and psychologists to work with the patients in the areas that surgeons, who often are super subspecialists, may not be able to deal with.”

OK, I’ll let the “super” and “sub” bit connected to the “specialists” go for the moment but do we really need social workers and psychologists to help patients recover? Because surgeons don’t know how to address a patient’s issues and feelings?

Please, let’s recognise that people are always more than the sum of their parts and that every health care intervention should take into consideration the whole person, not just the wonky bit! Recovery, true recovery, from an operation is a complex phenomenon. If we don’t recognise this we are in danger of wasting a lot of time and good effort only doing half a job. Every surgeon and every nurse on a surgical ward should be able to address and care for the human needs of the patients in their care.

By the way, just what is a “super subspecialist”? Someone who only has the skills to deal with bits of people?