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| A gastrointestinal foreign body in situ - one of the most common causes of an acute abdomen in the dog. Not so much in human adults. |
Have you ever wondered if your doctor has had a decent
sleep, or a proper and nourishing meal? It was a question I was unexpectedly
confronted with last week when a very close human family member was admitted to
hospital with an acute abdomen. It became rapidly apparent that this was a
surgical condition.
Due to a series of unfortunate events, the surgery was
delayed. Patient X was meant to be transported to a larger hospital, but this
didn’t occur due to the patient transport staff member calling in sick. As most
surgeons know, at some critical point, time is bowel. So it was concerning that
the surgery – scheduled for the morning – was not going to be addressed until
late in the evening, when the on-call surgeon had been working constantly on
critical cases and hadn’t had a break, and Patient X had been enduring
discomfort for 48 hours. Free abdominal fluid had been detected on ultrasound.
To the team’s credit, everything went well. Patient X is recovering
(I am so used to veterinary patients that I was shocked that I was able to
converse with Patient X on the phone post anaesthesia. I wish our patients
could call us and tell us things like “my throat is a bit sore from the ET
tube” or “this pain relief is working really well”, or Whatsapp a cheery
hospital selfie. It must at least be helpful to be hospitalised in a facility
staffed by members of one’s own species). And no, it wasn't a foreign body but an obstruction which occurred secondary to an adhesion which occurred secondary to a previous surgery. (Disappointingly, at least for me, there was no surgical photo).
The following day, when the surgical registrar called to
update me, he was amused that I asked him if he’d had some sleep. But I was
serious. We need to look after our health care professionals.
The French vascular surgeon Rene Leriche, in The Philosophy of Surgery, wrote that “The
best surgeons are those who are able to maintain their fitness and comfort
during the long-lasting jobs” back in 1951. (He also wrote that “Every surgeon
carries about him a little cemetery, in which from time to time he goes to
pray, a cemetery of bitterness and regret, of which he seeks the reason for
certain of his failures” – an important acknowledgement, but somewhat
concerning to recall when you know the patient, and you know there is a
correlation between hypoglycaemia, hypohydration and errors).
I digress. It’s important that doctors
are not overworked, are well-supported, take decent breaks, eat nourishing food
and get recharging sleep. In an article last week in The Conversation,
Professor Alex Broom put it succinctly: “Doctors who feel better will make
fewer mistakes and solve problems faster.” (Read the full article here - he also makes the point that stressed doctors are less motivated to
participate in continuing education, yet “participation in continuing education
improves professional practice, and, crucially, patient outcomes”).
The Australian Medical Association lists some excellent
resources on its website, many of which are just as relevant to veterinarians
and nurses too. You can access those here.
We need to look after those people that look after
others. In terms of vets, we’re working on The Vet Cook Book which should be
published later this year. This is designed to promote collegiality and
conversation but also provides some helpful resources – and recipes. You can
follow the facebook page.
Fortunately, and thanks to excellent care despite many
challenges, patient X is doing well, having been discharged home for cage bed rest (without an Elizabethan collar).
In other news, an exhibition which opened on June 9
highlights the plight of victims of domestic violence and their companion
animals. This looks like an amazing initiative and worth seeing.
If you’re in Sydney, SAT reader Kerry shared this info
about doggy degustation events (obviously not for the canine on an elimination
or prescription diet).
