Re: Surgeons

1

Yes. Notoriously. "You don't have to like your surgeon, he just has to be good," as I was told.


Posted by: ogged | Link to this comment | 11-12-15 7:55 AM
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I mean, I know some very nice surgeons, but never be surprised that your surgeon is a prick.


Posted by: ogged | Link to this comment | 11-12-15 7:56 AM
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They used to all be nice before Obamacare.


Posted by: Moby Hick | Link to this comment | 11-12-15 7:58 AM
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4

Did you ask him why Joseph built the pyramids?


Posted by: Sifu Tweety | Link to this comment | 11-12-15 7:58 AM
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5

Relevant.


Posted by: Sifu Tweety | Link to this comment | 11-12-15 7:59 AM
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The surgeon who did my back was a reasonably nice guy. Very self confident, but not in an annoying way.

The boutique urologist I went to to talk about a vasectomy was also quite nice, but that's minor surgery so probably doesn't count.


Posted by: togolosh | Link to this comment | 11-12-15 8:01 AM
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Apparently, writing papers that say "This type of surgery doesn't appear to do any good" will get you difficult notes from reviewers who are probably surgeons. Or so I've heard.


Posted by: Moby Hick | Link to this comment | 11-12-15 8:01 AM
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Also, often sociopaths. I mean, these are people who chose to devote their lives to cutting other people open. It pays very very well, but it's grueling work, and you have to be really into it.


Posted by: ogged | Link to this comment | 11-12-15 8:05 AM
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This guy has a nice demeanor, he just thinks I'll regret forgoing reconstruction. I was feeling insecure and wanted to be coddled, and instead I found myself in this gentle-combative situation, where he was lobbing arguments at me that are utterly nonsensical*, only I was too taken aback to see it clearly until after I left the office.

*Primarily, that having the excess skin removed requires a 4" incision, whereas the skin-saving procedure is only a 2" incision, and is thus the easier procedure. The implication was that I was opting for a more difficult medical procedure due to my eccentricities or vanity and that I'll regret it. It's ludicrous because you only have the skin-saving procedure if you plan on having ANOTHER FUCKING SURGERY WHICH IS EVEN WORSE ie when they put in the implants.


Posted by: heebie-geebie | Link to this comment | 11-12-15 8:07 AM
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10

Laproscopic surgeons are barely into it at all.


Posted by: Moby Hick | Link to this comment | 11-12-15 8:07 AM
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11

9: Doctors in general are like that when you try to do something they don't usually do given whatever it is you are having done.


Posted by: Moby Hick | Link to this comment | 11-12-15 8:09 AM
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Sorry, Heebs. That's a tough situation. Often when people make stupid arguments like that, it's because they don't feel like they can say what they're really thinking, which in this case is probably the standard stuff about how a woman should have boobs.


Posted by: ogged | Link to this comment | 11-12-15 8:10 AM
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13

My hand surgeon was nice aside from the previously mentioned 1920s style financial record keeping.


Posted by: SP | Link to this comment | 11-12-15 8:10 AM
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Also, what 12 said is probably more applicable than 11 in this case.


Posted by: Moby Hick | Link to this comment | 11-12-15 8:12 AM
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I'm sure 11 and 12 are right. He is probably not that bad, comparatively, in prickishness. But I was definitely in a heightened, sensitive mood and did not see it coming whatsoever, and felt like I got whacked with a 2x4.


Posted by: heebie-geebie | Link to this comment | 11-12-15 8:13 AM
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"You don't have to like your surgeon, he just has to be good,"

How do you evaluate this?


Posted by: heebie-geebie | Link to this comment | 11-12-15 8:15 AM
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Orthopedic surgeons do actually whack patients, but not while they are conscious or with a 2x4. They have special hammers that you can put into an autoclave without them starting on fire.


Posted by: Moby Hick | Link to this comment | 11-12-15 8:15 AM
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I got whacked with a 2x4.
McMegan became a surgeon?


Posted by: SP | Link to this comment | 11-12-15 8:19 AM
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How do you evaluate this?

Docs who refer people to surgeons will have a very good idea of who is good. I made appointments all over town and called friends of friends who knew doctors, etc. Also be sure to ask how many procedures exactly like yours he's done. Experience matters a lot.


Posted by: ogged | Link to this comment | 11-12-15 8:20 AM
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Based on a limited sample of n=1 (my ex-husband), YES.


Posted by: Ume | Link to this comment | 11-12-15 8:22 AM
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Generally the ones who are willing to be least invasive are the better ones. My wife had to have some tissue removed from near her spine and the first guy she got referred to wanted to open her from the front to dig around, she asked some doctor friends for a connection to someone else and the second opinion said that other guy is insane.


Posted by: SP | Link to this comment | 11-12-15 8:22 AM
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Generally the ones who are willing to be least invasive are the better ones

Whoa, now. The opposite was the case for my surgery, so I'm not sure it's a good standard.


Posted by: ogged | Link to this comment | 11-12-15 8:25 AM
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Perhaps "least invasive as necessary to get the job done." As noted above some have God complexes so they want to do the super heroic look how awesome I am at this complex surgery.


Posted by: SP | Link to this comment | 11-12-15 8:26 AM
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The vasectomy with the incision through the abdomen is a rare, but beautiful thing.


Posted by: Moby Hick | Link to this comment | 11-12-15 8:27 AM
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25

16: There's a local magazine that regularly publishes lists of the best $WHATEVER in the area, including doctors and surgeons. I selected mine from the top ten in the region. There might be something similar in your area. Google is how I found the boutique urologist, by searching for something like "best vasectomy doctor."


Posted by: | Link to this comment | 11-12-15 8:34 AM
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26

25: me


Posted by: togolosh | Link to this comment | 11-12-15 8:34 AM
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I had a hard time finding Surgeon #1, ten years ago. Surgeon #2 was recommended by my hysterectomy surgeon (himself also a prick, but also hard to find.)

I chickened out on asking him how many times he'd done mastectomy without reconstruction, because I was flustered and I had a big list of questions, and the appointment seemed to be going so badly. He's certainly been doing mastectomies for decades.

He did:
- connect me with another patient who skipped reconstruction and has similar circumstances to mine
- say that if I was unhappy with the cosmetic results, it can be fixed over the summer.


Posted by: heebie-geebie | Link to this comment | 11-12-15 8:38 AM
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Be wary of the magazine lists, though. Here's a good rundown (by a doctor) of what to make of those lists, and also how to choose a doctor.


Posted by: ogged | Link to this comment | 11-12-15 8:39 AM
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Are most surgeons pricks?

I imagine that if they see the choice as one of being a prick or having a stroke, most rational homo-economicus types would opt for the former.


Posted by: marcel proust | Link to this comment | 11-12-15 8:42 AM
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30

Are most surgeons pricks?

Your typical surgeon is a cut up. Phlebotomy is where the pricks are.


Posted by: Stanley | Link to this comment | 11-12-15 8:47 AM
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31

I talked about this once with a doctor friend of mine, and he said the nature of the work attracts people who were pricks in the first place, and socialisation into the field further amplifies their prickish tendencies. Seems not dissimilar to law in this way.


Posted by: real ffeJ annaH | Link to this comment | 11-12-15 8:58 AM
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32

Probably not helpful for this situation, but ProPublica recently tried to move beyond the traditional "mutual lovefest" methodology to a scorecard based on risk-adjusted complication and death rates of common non-emergency procedures. Some doctors howled but it's definitely a step forward that they're not (collectively) offering an improvement on.


Posted by: Minivet | Link to this comment | 11-12-15 8:58 AM
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33

He's been in practice for 26 years, so that's not fresh out of the gate, in terms of experience.


Posted by: heebie-geebie | Link to this comment | 11-12-15 8:59 AM
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34

32 is amazing, but only available for select procedures.


Posted by: heebie-geebie | Link to this comment | 11-12-15 9:04 AM
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35

When my dad had to go in for emergency stents a few years ago, after we spent the ENTIRE DAY sitting in the emergency room waiting to be moved to the cath lab despite having an appointment and be pre-cleared, and his surgeon finally came out to speak to me following the procedure (and we were all super stressed out because on top of everything else, my stepmom, who would normally be his health care proxy, was across town in ANOTHER hospital recovering from back surgery), the guy took the opportunity to comment on how I was heading down the same road because I was overweight. Despite knowing absolutely zero things about my medical history.

Dude, I'm not even your fucking patient and you're fat-shaming me?

So, yes. Surgeons are assholes.


Posted by: sam | Link to this comment | 11-12-15 9:09 AM
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28: Using a "best of" list isn't optimal, but it gets you an above-average result far more often than not and it's cheap in time and money. Sure there's a chance you'll get someone who schmoozed their way onto the list, but you can presumably pick that up as well as you'd be able to pick up any other sign of incompetence in your sample of off-list doctors. Even if you use his recommended "spend time and money when you are not sick to find a specialist just in case" method, you need to start somewhere and a "best of" list is an excellent starting point.


Posted by: togolosh | Link to this comment | 11-12-15 9:22 AM
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I'm sure I'd use such a list if I needed to, it's better than nothing, but as indicated in one of my links, it's really bullshit that they've worked out a decently objective metric of surgeon performance for internal tracking but never share it.


Posted by: Minivet | Link to this comment | 11-12-15 9:38 AM
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38

The disadvantage you are at as a prophylactic mastectomy patient and not a cancer patient is that you aren't already seeing a ton of doctors who are happy to gossip about your other doctors. The main reason I'm sticking with my breast surgeon, despite the fact that he can sometimes be very crotchety, is that my other doctors have raved about his surgical skills and lack of post-op complications.

But yeah, the idea that a mastectomy without reconstruction is worse than one with is ridiculous, and wrong. You're healing and risk of complications is going to be so much better than mine. Yes, your scars will be longer, but you already know that! And if you do want some cosmetic adjustments (like with divots, or whatever), you should see a plastic surgeon for that, not a breast surgeon.


Posted by: J, Robot | Link to this comment | 11-12-15 10:09 AM
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39

My surgeon coddled me and gave me chocolate and a tour of the operating room beforehand, but that was probably because I was 5. I don't know how good he was, because he told me my scars would fade completely by age 24 (which to a 5 year old might be a million), but they're still faintly visible today. OTOH, the surgery successfully fixed the reason for the operation.

After typing this, I remember I did get a mole removed a few years ago, and that surgeon told me in his gruff, unidentifiable vaguely SE European accent that my skin was too soft, which meant I was going to get ugly varicose veins. He also had the med student actually do the surgery, with him just popping in every once in awhile to inspect the procedure and tell me about how ugly my legs were going to be in middle age.


Posted by: Buttercup | Link to this comment | 11-12-15 10:23 AM
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40

There's only one possible response to that. "I can read so, unlike your mom, I won't have to work as a stripper until I'm sixty."


Posted by: Moby Hick | Link to this comment | 11-12-15 10:30 AM
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41

The one surgeon I ever consulted with was a jerk but did a good job as a doctor (properly diagnosing my condition unlike the other specialist and telling me I didn't need surgery).


Posted by: Bave | Link to this comment | 11-12-15 10:38 AM
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42
how I found the boutique urologist,

This is a thing? Did he leave little peppermints on the examination table?


Posted by: Mossy Character | Link to this comment | 11-12-15 10:49 AM
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43

42: It is a thing indeed. They have a person in the waiting room who brings you drinks and snacks. They also have complimentary top shelf whiskey in the recovery room. And the doctor meets with you for a full hour. I went partly because I wanted to see play rich guy for a little. Not covered by insurance, natch.


Posted by: togolosh | Link to this comment | 11-12-15 11:32 AM
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Mammogram centers are like that. They totally channel the spa vibe and there are cookies and freebies. At least the ones I've been to.


Posted by: heebie-geebie | Link to this comment | 11-12-15 11:40 AM
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31 is right. You have to be unusually self-confident and focused to go into surgery in the first place, and by the time you've survived the sleepless hell of residency and clawed your way up the ladder to consultant status, when you're treated as a god-like being by everyone around you, those qualities can harden into conceit and self-absorption. Add a large dash of misogyny imparted by an almost entirely male peer group, and the person who was a pleasant, open-minded medical student may by his late 30s become a dogmatic, self-centered schmuck. (I don't think my ex's transformation along those lines was entirely due to being married to me, though I can't entirely rule that out as a contributing factor.)


Posted by: Ume | Link to this comment | 11-12-15 11:46 AM
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My first surgeon, the one who took out my thyroid when I had cancer, was wonderful, an old guy who had been practicing in Fayetteville, Arkansas since the dinosaurs roamed there. I still remember him with fondness.

Every surgeon since him, though, yeah, a prick.

IME, surgeons are all certain they know better than you what should be done to your body, and if you question their conviction at all they get furious. When I was having my shoulder operated on, for shoulder spurs, I asked -- once! and politely! -- if this surgery had a good result, as a whole. (As in, you know, does it work, is it worth doing.)

And the surgeon literally had a tantrum, shouting at me in the consulting room, about why would they do the surgery unless it worked, and did I think they did operations that didn't work, and bullshit like that.

Um, hello, Western Civilization, mister? Yeah, I know you guys do shit that doesn't work. ALL THE FUCKING TIME. Can you just take a Xanax and give me the numbers?

Which, in the end, he calmed down and did. But holy hell.


Posted by: delagar | Link to this comment | 11-12-15 11:58 AM
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On the other hand! He did a wonderful job on my shoulder.

And three years later on my other shoulder, when it developed spurs. So, you know.


Posted by: delagar | Link to this comment | 11-12-15 12:00 PM
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48

I remember getting an offer to sign up for a "concierge" medical practice in NYC for something like $1,000 a year, maybe less. (Like, it was more money than I would spend, but not crazy money if you had money.) Recently heard that concierge membership in the South Bay is something like $35,000.


Posted by: Bave | Link to this comment | 11-12-15 12:05 PM
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Also, I had to get a new, medicaid approved dentist who I'm sure is fine, but he is like, 115 years old and his dental office is like time traveling to 1965.* I was nervous to get my teeth cleaned by him (what if he scratched them?) and then realized I was being an elitist snob and needed to get over it. Also, in HS I had managed dental care, which was fine but pretty utilitarian, so it's not like this guy is too far off. I mean, when I went to my most recent previous dentist (who specializes in dental cosmetic surgery and does not take medicaid), he saw my crooked teeth and silver fillings in my mouth, and assumed I was from a former Soviet Republic.

*Nothing in his office is computerized, and when I had a cavity, he put rubbed a chunk of ice on it with his fingers as the first diagnostic.


Posted by: Buttercup | Link to this comment | 11-12-15 12:24 PM
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48: I use OneMedical, which is another concierge service. It costs $149/year.


Posted by: Josh | Link to this comment | 11-12-15 12:29 PM
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concierge membership in the South Bay is something like $35,000

Everybody aboard the tech gravy train! God, fuck those doctors.


Posted by: ogged | Link to this comment | 11-12-15 12:48 PM
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They totally channel the spa vibe and there are cookies and freebies.

I learned last night that there's a chain (!) of spa-style midwife centers (!!), rumored to be coming to our area. The consensus was that this would not be a threat to our business model, but I do worry that we're going to be ghettoized as the birth center for hippies and poor/minority women (the latter group is one we're making big efforts to reach out to as part of our mission), especially since the local behemoth hospital system is planning on opening a free-standing birth center in the burbs (or maybe more than one! Why not, they have all the money), which won't siphon the spa ladies, but will cut into our middle class professional clientele.


Posted by: JRoth | Link to this comment | 11-12-15 3:00 PM
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53

I thought standing birth was inherently hippie.


Posted by: Moby Hick | Link to this comment | 11-12-15 3:02 PM
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54

Oh God, it's these people.

"A maternity boutique with the comforts of home."


Posted by: JRoth | Link to this comment | 11-12-15 3:05 PM
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55

"UPMC presents recipes for your placenta."


Posted by: Moby Hick | Link to this comment | 11-12-15 3:05 PM
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56

53: Whaddya mean? We have beds.


Posted by: JRoth | Link to this comment | 11-12-15 3:06 PM
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57

55 to my own unrelated train of thought.


Posted by: Moby Hick | Link to this comment | 11-12-15 3:06 PM
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58

56: I deliberately misread "free-standing birth center" to make a stupid joke.


Posted by: Moby Hick | Link to this comment | 11-12-15 3:08 PM
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59

My own crazy surgeon story has been told here twice before:

http://www.unfogged.com/archives/comments_14360.html#1778051

http://www.unfogged.com/archives/comments_10621.html#1198747

Which when I think back, I'm still a bit amazed by. When I saw him in a shop a year or so later, he remembered my name, which suggests he was maybe waiting for the lawsuit.


Posted by: nattarGcM ttaM | Link to this comment | 11-12-15 3:13 PM
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60

I don't know, it kind of sounds like he knew what he was doing. Old school!


Posted by: ogged | Link to this comment | 11-12-15 3:21 PM
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61

JRoth runs a birthing center?


Posted by: ogged | Link to this comment | 11-12-15 3:23 PM
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re: 60

I suppose, to be fair, there is now only a very fine scar. But I did have to go to a nurse to get wadding pushed into the gaping hole for a few weeks.


Posted by: nattarGcM ttaM | Link to this comment | 11-12-15 3:24 PM
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63

Old school!


Posted by: ogged | Link to this comment | 11-12-15 3:40 PM
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61: Board member. It's come up.

There are only 2 other guys on the board or staff, so the responsibility for cock jokes is almost solely mine. Heavy hangs the head, &c.


Posted by: JRoth | Link to this comment | 11-12-15 3:46 PM
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Some of the biggest dicks I've ever met are surgeons, but this guy who I know from Church is a leading heart surgeon here and is one of the best people I've ever met. 50% of his income to charity, liberal but deeply religious Christian in the best sense, super humble, friendly in presentation and easy going, committed feminist. I've always wondered how he gets along with the other surgeons or what he's like in the OR.


Posted by: Roberto Tigre | Link to this comment | 11-12-15 4:02 PM
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Ex-gf was a surgeon in training. The established surgeons were all dicks. Gratuitous yelling seemed to be the norm. She and her classmates were mostly nice enough, but occasionally obliviously entitled. They seemed generally low on empathy and high on self-absorption compared to the average person, though whether that's a self-selection process or part of the job or part of the training, I couldn't say.


Posted by: F | Link to this comment | 11-12-15 4:09 PM
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67

Actually that's not fair. Three of her classmates were among the nicest people I know. One other was egotistical and the rest were about average for professionals.


Posted by: F | Link to this comment | 11-12-15 4:12 PM
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68

Uneasy sits the board that chairs to crown?


Posted by: Minivet | Link to this comment | 11-12-15 4:12 PM
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69

I guess "surgeon" is still the most viscerally physical of the respected professions, right? I'm a little unclear on how good your manual dexterity needs to be now that they have nano-robots or whatever but still, I can't think of any remotely status-comparable job where you're working so much with your hands. I dunno why that would self-select for jerks but it does seem like something unique to surgeons.


Posted by: Roberto Tigre | Link to this comment | 11-12-15 4:27 PM
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how good your manual dexterity needs to be now that they have nano-robots or whatever

From what my sister says, manual skills are still very important.


Posted by: LizardBreath | Link to this comment | 11-12-15 4:30 PM
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69,70: Right. My ex ate with his chopsticks in his left hand for over a year when he was training, to try and improve his dexterity on his non-dominant side and thus overall.


Posted by: Ume | Link to this comment | 11-12-15 4:39 PM
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A lot of the robotic surgery seems to be dubious - they can do some procedures well but they're being marketed for a lot more, and the lack of manual feedback is still a significant drawback.


Posted by: Minivet | Link to this comment | 11-12-15 4:47 PM
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73

http://maisonneuve.org/article/2015/11/10/worth-risk/

Totally terrifyingly relevant from so many angles ...


Posted by: dairy queen | Link to this comment | 11-12-15 4:50 PM
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74

We should make a surgeon president.


Posted by: ogged | Link to this comment | 11-12-15 4:52 PM
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75

There's a big banner outside Oakland Children's Hospital, facing the freeway, saying "Our doctors are rock stars." I've always felt that reinforces the wrong message for the doctors, and a much better banner would be "Our doctors are valued members of a team that includes many other skilled, crucial personnel who also make key contributions." But maybe that wouldn't fit on the banner.


Posted by: freight train | Link to this comment | 11-12-15 4:59 PM
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To be fair the second description is a pretty good description of at least most rock stars as well.


Posted by: MHPH | Link to this comment | 11-12-15 5:02 PM
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My sister is a very nice surgeon. Given that and the pronoun in the main post, maybe it's only surgeons with pricks who are pricks.


Posted by: beamish | Link to this comment | 11-12-15 5:07 PM
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I remember an anecdote about the heart surgeon Denton Cooley as a student practicing surgical knots while reaching inside a half-open matchbox. The ambition and skill of these guys is very admirable in a way, even with all of the characteristics that go with them.


Posted by: idp | Link to this comment | 11-12-15 5:15 PM
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79

Oh god, that article about morcellation. I am horrified.


Posted by: Megan | Link to this comment | 11-12-15 5:17 PM
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80

Go get a new surgeon.


Posted by: Bostoniangirl | Link to this comment | 11-12-15 5:22 PM
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71

So did mine. Must be a thing.

From what I understand, figuring out exactly where you are (no Google maps for bodies yet) is a bigger challenge than the manual dexterity.


Posted by: F | Link to this comment | 11-12-15 5:23 PM
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Except in unusual situations, there is not a lot of money (read: surgeon money) in veterinary medicine. It is, however, a lot harder to get into vet school. I've never met a vet who was competitive in the obsessive compulsive, callused way. I mean, they aren't people who just want to memorize the answer, and they don't have 4 color clicker pens. Obviously, there's a bias, but it's still striking. Plus, they have a tougher job - since the animals can't tell you how they're feeling.


Posted by: Bostoniangirl | Link to this comment | 11-12-15 5:35 PM
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Yes, it manages to pack in so many layers and types of horror.

My surgeon was not a jerk, but was also I presume pricklesd. And the daughter of a wiccan but that probably not decisive on either kind of prickness.


Posted by: dairy queen | Link to this comment | 11-12-15 5:36 PM
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84

Morcellation law suit commercials have outpaced vaginal mesh lawsuit commercials. Asbestos barely on the charts.
(Why yes I do watch ID Discovery.)


Posted by: oudemia | Link to this comment | 11-12-15 5:38 PM
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85

This very evening I had a conversation with a friend who is a professional colleague of Ben Carson. The friend told me a hilarious story about a dinner they attended together that confirmed that the good doctor is not merely crazy, but also a breed-typical prick. Alas, I am not at liberty to share the story.

The same friend recounted a conversation with a mutual friend at a prominent MSM publication. The mutual friend explained, in language that could have been written by a liberal blogger, why the press doesn't report forthrightly on Carson's crazy. Basically, they all know it, and acknowledge amongst themselves, and are champing at the bit to write about it. But they are waiting for one of the other GOP candidates to call Carson out on it, and they are frustrated that no one has. The moment the cork is out of the bottle, they can start writing stories saying "Other candidates say Carson is a howling at the moon crazy, conspiracy theory believing nut case. Dr. Carson's spokesman denies the allegation."


Posted by: Salty Hamhocks | Link to this comment | 11-12-15 5:45 PM
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84, how is Xarelto doing?


Posted by: Cryptic ned | Link to this comment | 11-12-15 5:49 PM
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vaginal mesh lawsuit

What is this ohmygodnevermind.


Posted by: JRoth | Link to this comment | 11-12-15 5:54 PM
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88

What lawsuit isn't a vaginal mesh?


Posted by: Roberto Tigre | Link to this comment | 11-12-15 5:55 PM
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89

Every first date, too.


Posted by: ogged | Link to this comment | 11-12-15 5:57 PM
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85.2 is also howling at the moon crazy. Why can't the press just report on what Carson has said with a modicum of intelligence and point out that it's all bats?


Posted by: nosflow | Link to this comment | 11-12-15 6:04 PM
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91

What do you think the odds are that Carson cheats on his taxes? 80%? 90%?


Posted by: snarkout | Link to this comment | 11-12-15 6:11 PM
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92

Publishing obviously true and easily verifiable facts isn't objective. Everyone knows that.


Posted by: MHPH | Link to this comment | 11-12-15 6:11 PM
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Wow to 73. Horrifying and riveting.


Posted by: heebie-geebie | Link to this comment | 11-12-15 6:14 PM
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$5, no, $10 to the first reporter to call Ben Carson apeshit crazy.


Posted by: ogged | Link to this comment | 11-12-15 6:15 PM
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95

Unless he's in Missouri, where that's probably not an innovation.


Posted by: ogged | Link to this comment | 11-12-15 6:16 PM
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I have a number of colleagues who have interacted with zu/rC and report that he can be unobjectionable in a dinner and drinks interaction but a viperous monster when seeking to impose his will. I believe he has a decent shot at the nomination and if he is on the ballot will vote for clinton *fervently*.


Posted by: sissi of Bavaria | Link to this comment | 11-12-15 6:20 PM
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91: now that it's been brought up it seems like it must be 100%.


Posted by: nosflow | Link to this comment | 11-12-15 6:20 PM
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98

That seems like unnecessary levels of google hiding for a well known public figure. Unless someone is looking for zu/rC + vaginal mesh morcellation.


Posted by: SP | Link to this comment | 11-12-15 6:35 PM
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Ugh. A switch just flipped in my head and now morcellation has become morsel-(iz)ation. That's not a mental picture I wanted.


Posted by: F | Link to this comment | 11-12-15 6:39 PM
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he can be unobjectionable in a dinner and drinks interaction but a viperous monster when seeking to impose his will

No fooling, this is the most complimentary thing I've heard about Cruz from people who know him.


Posted by: ogged | Link to this comment | 11-12-15 6:41 PM
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I'm having trouble mentally reconciling morcellation and Morgellon's.


Posted by: heebie-geebie | Link to this comment | 11-12-15 6:42 PM
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And it really amuses me that he plotted this career as the most outlandish national conservative, only to find himself outdone when his moment came. Plus, creepy.


Posted by: ogged | Link to this comment | 11-12-15 6:44 PM
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103

101

Me too. That was my first response. It's good to see that Morgellons has pretty much been officially debunked now, though.


Posted by: F | Link to this comment | 11-12-15 6:46 PM
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No idea who zu/rC even is. Is it Carson or Cruz?


Posted by: Roberto Tigre | Link to this comment | 11-12-15 6:54 PM
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Tigre, you do know that everyone can read your musings, right?


Posted by: CharleyCarp | Link to this comment | 11-12-15 6:56 PM
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Um, yes? When they're posted here anyway.


Posted by: Roberto Tigre | Link to this comment | 11-12-15 6:58 PM
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What, specifically, are you trying to say.


Posted by: Roberto Tigre | Link to this comment | 11-12-15 6:59 PM
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it had been assumed that missed particles, without a blood supply, would simply be reabsorbed

What the fuck? Assumed? Isn't there an approval process?


Posted by: fake accent | Link to this comment | 11-12-15 7:01 PM
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Somewhere in someone's oppo research files, to be used in the event that Cruz ever surges in the polls, must be a dusty VHS tape of Ted Cruz arguing, as a college parliamentary debater, in favor of affirmative action for racial minorities. It wasn't a sincere conviction, of course; the nature of parliamentary debate is that you argue whatever position you are handed. But argue it he did. If it were circulated with enough subtlety on the right wing viral email circuit, it could do him a lot of damage with the yokels.


Posted by: Salty Hamhocks | Link to this comment | 11-12-15 7:03 PM
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It's Superman's other arch nemesis, General Zurc.


Posted by: SP | Link to this comment | 11-12-15 7:04 PM
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?si Cruz ohw llet t'nac yllaer uoY


Posted by: praCyelrahC | Link to this comment | 11-12-15 7:08 PM
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Well, I've never been shy about being stupid online.


Posted by: Roberto Tigre | Link to this comment | 11-12-15 7:15 PM
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But now that I know, I agree with 100. I have heard that he is absolutely totally 100% objectionable in an ordinary dinner/drinks interaction, from 5 or 6 separate people.


Posted by: Roberto Tigre | Link to this comment | 11-12-15 7:25 PM
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109: If the Democratic party nationally was any use they'd have a whole bunch of paid operatives living in the middle of that whole right wing viral email/forum/mailing list ecosystem. At this point it's at least as powerful as any of the obviously organized bits of the party, and probably the easiest to influence of all of them since it's basically a whole system set up for people to spread really fun lies around to feel adventurous. The possibilities for screwing things up for the Republicans would be endless.


Posted by: MHPH | Link to this comment | 11-12-15 7:29 PM
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Ratfucking. It's for everyone!


Posted by: md 20/400 | Link to this comment | 11-12-15 7:38 PM
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101- Actually this sounds like what the root cause of Morgellon's might be. People swallowing* Cookie Monster toys and then getting incompetent surgeons to remove them.

*or whatever.


Posted by: E. Messily | Link to this comment | 11-12-15 8:19 PM
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is a licensed HeartMath coach, and licensed in Kinesiology by Brain Gym. She also has Management & Leadership training from C------ University's certificate program in Executive Leadership.


Posted by: lw | Link to this comment | 11-12-15 8:32 PM
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73 is indeed horrifying. All the moreso because I have a dear mentor who died just a few years ago, a few months after having a large uterine mass removed. I can't help but wonder...


Posted by: parodie | Link to this comment | 11-13-15 2:11 AM
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85.1 should be a bannable offense. Go presidential or go home.


Posted by: Barry Freed | Link to this comment | 11-13-15 4:00 AM
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85.2 makes no sense. If a reporter discovers that someone who's running for President is in present need of a very long sleeved vest, they should report it. It's their job.

73 leaves me feeling rather unwell.


Posted by: chris y | Link to this comment | 11-13-15 5:00 AM
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re: 120.1

Lots of past threads has long since shown that the US media is pathologically obsessed by balance, and by deference.


Posted by: nattarGcM ttaM | Link to this comment | 11-13-15 5:07 AM
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So: I called and talked to the nurse, and asked her how many surgeries the doc has done. She said he does a mastectomy about weekly. But she said that he only does 2-4/year where they skip reconstruction. I don't know how to interpret this about whether or not I should scramble and find a new surgeon. It would be a high cost not to get it done during this calendar year.


Posted by: heebie-geebie | Link to this comment | 11-13-15 8:36 AM
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Oh, ha, the nurse just called me back. She'd been thinking "women in my age range", in which 2-4/year. But she realized that I was just asking about the procedure, so she clarified that it's ~3-4/month skipping reconstruction. So that's a less worrisome.


Posted by: heebie-geebie | Link to this comment | 11-13-15 8:47 AM
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Yeah, that sounds like plenty.


Posted by: LizardBreath | Link to this comment | 11-13-15 8:56 AM
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His cup overflows.


Posted by: Moby Hick | Link to this comment | 11-13-15 8:57 AM
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Sorry.


Posted by: Moby Hick | Link to this comment | 11-13-15 8:59 AM
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122: It seems to me that your surgeon thinks you'll regret the 4-inch scar because he thinks you'll regret not having reconstruction. But the relevant question for you is whether a 4-inch scar gets in the way of the kitties tattoo of your dream. So, I'd ask to talk to him again and make it very clear that you've thought hard about how you want your body to look after surgery, and you need to know whether he can make an incision that will work with your plan.

But you shouldn't take my advice about surgeons, because, I just learned from the article in 73, one of mine (Michael Mu/to) has been advising women to have their tumors ground up and spewed throughout their bodies. So I can add to the discussion that while he didn't seem prickish in the standard surgeon way, he was possessed of certain retrograde ideas about women, advising me that I wouldn't be up to the cognitive demands of my job if I didn't go on hormone replacement therapy and then telling my partner that my being on HRT would certainly benefit him as well, if you know what I mean.

And ugh, the worst part is that one of my good friends learned a few years ago, after morcellation, that she had LMA, and I referred her to Mu/to for a second opinion! I just never thought that the Brigham would fuck up this much.


Posted by: Mme. Merle | Link to this comment | 11-13-15 9:01 AM
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the worst part is that one of my good friends learned a few years ago, after morcellation, that she had LMA,

Oh my god. I'm sorry.


Posted by: heebie-geebie | Link to this comment | 11-13-15 9:03 AM
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"advising me that I wouldn't be up to the cognitive demands of my job if I didn't go on hormone replacement therapy and then telling my partner that my being on HRT would certainly benefit him as well, if you know what I mean."

!!!!!! Wins the prickstakes.


Posted by: dairy queen | Link to this comment | 11-13-15 12:41 PM
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Although inducing cancer also bad bad bad.


Posted by: dairy queen | Link to this comment | 11-13-15 12:49 PM
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109: I learned last weekend that I do indeed know people who had debated at the same time he was on the circuit. I hadnt thought our circles would overlap, but I had forgotten about a few old timers. They really hated him.


Posted by: J, Robot | Link to this comment | 11-13-15 4:05 PM
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LMA is the cancer my father had, in a beyond unusual location behind his eye. ( The plan was to remove it and then do radiotherapy on the inevitable remnants. Derailed by a massive brain bleed post-op, equivalent to a major stroke.)


Posted by: emir | Link to this comment | 11-14-15 7:39 AM
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LMS, I mean.


Posted by: emir | Link to this comment | 11-14-15 7:41 AM
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advising women to have their tumors ground up and spewed throughout their bodies.

The FUCK?

"Sorry you were shot. The good news is, we've extracted the bullet and now we'll break it into splinters and hammer them into all your limbs and torso..."


Posted by: chris y | Link to this comment | 11-14-15 7:45 AM
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I don't actually find the article in 73 convincing either way. We are told

He and his co-authors gleaned data from ten studies in which presumed benign masses were morcellated and they found that the risk of having a hidden sarcoma was not the reported one in ten thousand at all. It was in fact much higher: about one in 415.

Then later in the article we're told

William Parker, a fibroid specialist at UCLA Medical Center, claimed in a blog post that one in every thousand women who underwent abdominal hysterectomy would die from it.

One in 400 and one in a thousand are pretty similar numbers. How uncertain are they? The procedure sounds ridiculous and horrifying, but if the death rate from abdominal surgery is comparably high to the chance of morcellation spreading cancer, which one should doctors prefer? This doesn't seem like an obvious decision.


Posted by: essear | Link to this comment | 11-14-15 8:36 AM
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one in every thousand women who underwent abdominal hysterectomy would die from it.

But isn't this the wrong number (whether or not it's correct as stated)? It's not how many women die from an abdominal hysterectomy, it's how many more women die from an abdominal hysterectomy than from a trans-vaginal hysterectomy (the kind that requires morcellation) not counting the cancer-spreading risk.

That is, if a bunch of the hysterectomy deaths are, e.g., something going wrong with the anesthesia, that'd plausibly be the same regardless of method, so the cancer-spreading risk would be on top of the surgical risk for the trans-vaginal hysterectomy.

I'd believe that the abdominal method is more dangerous surgery, but it seems unlikely that the other method is literally zero risk.


Posted by: LizardBreath | Link to this comment | 11-14-15 8:44 AM
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136: the next sentence that I didn't quote is "The ACOG wrote in its report that a woman was three times as likely to die from a large incision hysterectomy than from a laparoscopic hysterectomy."


Posted by: essear | Link to this comment | 11-14-15 8:58 AM
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So that knocks the excess deaths down to 2 in every three thousand, or 1 in every fifteen hundred. Which is looking more distinguishable from 1 in 400 than it was.

And then I can't help but think that there are alternative methods to reduce that death toll -- tightening up whatever surgical best practices are -- rather than morcellation. Framing morcellation as the only alternative for reducing that toll seems implausible.


Posted by: LizardBreath | Link to this comment | 11-14-15 9:08 AM
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So that knocks the excess deaths down to 2 in every three thousand, or 1 in every fifteen hundred. Which is looking more distinguishable from 1 in 400 than it was.

We have no idea how distinguishable the numbers are, because we don't really know the numbers. "One in every thousand" is clearly a ballpark estimate someone pulled out of their ass, and neither number is attached to an error bar. All we can conclude from the article is that they're the same order of magnitude.

And then I can't help but think that there are alternative methods to reduce that death toll -- tightening up whatever surgical best practices are -- rather than morcellation.

But there might also be ways to reduce the risk from morcellation. Mostly, it just seems to me like when the article is presenting one viewpoint and saying that basically the whole medical community this guy was part of is distancing themselves from him, there are probably sane arguments in the other direction that we're not being given.


Posted by: essear | Link to this comment | 11-14-15 9:14 AM
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Yeah, here I'm working from my priors. On the AA story, my priors are fairly strong that an excited story about a drug that works spectacularly well for a terrible problem but isn't being prescribed enough is overstated.

On this kind of thing, my priors are fairly strong that where a genuine problem with standard medical practice is uncovered (that is, no one seems to be disputing that the hidden sarcoma thing is a thing, or that morcellation does spread it -- the existence of the problem isn't under dispute), and the response is "Based on numbers I'm pulling out of my ass, the horrible sounding problem is less significant than the reasons to keep doing what we had been doing because we were right all along and the horrible sounding problem is comparatively unimportant", that the response is defensive bullshitting. But you're right that if you don't go in believing that, it's not necessarily an unconvincing response.


Posted by: LizardBreath | Link to this comment | 11-14-15 9:21 AM
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My last surgical experience was when I went in for what turned out to be an emergency appendectomy, and had the bad manners to do it late on a Saturday afternoon. Surgeon came over and had a prod, and then went to the phone on the other side of the ward and had this conversation with his (I assume) girlfriend or wife:
"Hi... I'm really sorry but I've been given an operation and I'll be back a bit late for dinner this evening... no, not a big one, just an appendix... what?" (he turns round and gives my abdominal area a thoughtful, assessing look) "...ooh, not more than quarter of an hour, I should think."

He told me afterwards: eleven minutes, a personal best.


Posted by: ajay | Link to this comment | 11-15-15 9:50 AM
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I'm not sure I'd want my surgeon to be going for a personal best. Given the chance to prioritise 1. not having various sharp instruments accidentally forgotten in my abdominal cavity and 2. The surgeon's girlfriend's cheese souffle not collapsing before he gets home, I'm afraid I'm going to go for 1 every time.


Posted by: chris y | Link to this comment | 11-15-15 10:08 AM
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Surgeon who removed burst appendix from child at 3am was fabulous and appropriately empathetic, but made the little bugger get up and walk across the hospital room from his bed to me at noon the next day. Child gave him the dirtiest look. Was only like 6 years ago, he was so small!


Posted by: dairy queen | Link to this comment | 11-15-15 12:50 PM
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Evidence-based medicine says you have to make then walk.


Posted by: Moby Hick | Link to this comment | 11-15-15 1:13 PM
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