A month ago I was
feeling a bit under the weather. Over
the weekend I felt kinda lousy, and on Monday, I had body aches, and felt a bit
feverish (though I didn’t take my temperature).
I slept 12 hours Monday night, and felt better on Tuesday. I just worked a half day Tuesday (morning),
and felt like I was on the mend. Tuesday
afternoon as I took it easy, I pondered the question – do I operate tomorrow,
or not? I had six cases scheduled - five cataracts, and one pterygium. By this point, I felt like I was about 80% of
normal, and figured that by the next day I’d be feeling even better. But it got me thinking, at what point do I
“call in sick” on an OR day?
The decision would be simple if I were really feeling sick, like vomiting, I’d just stay in bed! But what about the in between stuff, the mild headache, feeling run down kinda stuff?
The decision would be simple if I were really feeling sick, like vomiting, I’d just stay in bed! But what about the in between stuff, the mild headache, feeling run down kinda stuff?
If there’s a complication, it could have a life-long impact
on somebody’s vision! There’s typically
a 5% chance of complications with our eye surgeries, which is low, but you
don’t want to increase those odds. It’s
hard to live with yourself when there is a surgical complication. It definitely ruins your day, and week for
that matter! You go over the case in
your head at home, at church, wherever, thinking of it from every angle,
considering if there was something you could have done differently to avoid the
complication. You take your worry home
with you, wondering whether your patient will be seeing better the next time
you see them in clinic or not.
Now back to the cut, no cut decision. Honestly, I feel as if I have enough
experience at this point, that I can be at less than 100%, and still do well. But I don’t have an exact barometer, nor can
I tell the future (am I going to feel better, or worse tomorrow). So on Tuesday I decide I’ll operate the next
day, so long as I don’t feel worse. If I
feel worse, I’m calling off the cases.
I get up Wednesday morning, and thankfully am feeling even
better, maybe 90-95%. I head to the OR,
where I successfully complete four cases, no complications. Two of my four patients get canceled, one
because they ate breakfast, the other because of atrial flutter (heart arrhythmia)
noted in pre-op. All has ended well, and
my decision doesn’t backfire. But what
about next time?
There is rarely a time when we are actually able to function
at 100%. Who gets enough sleep? We all have more projects than time, and some
evenings we push later than expected (oh my, does that clock really say 11:00,
and I’m supposed to get up at 5:30!). Or
perhaps we actually went to bed early, but one of the kids wets the bed at
midnight, and the other has a nightmare at 2:00 am. That wasn’t on the agenda for the night. What about stress, an argument with a spouse
(no, I never argue with Karen, this is just hypothetical), or concern for a
sick relative back in the states, or …
Do I simply call off the surgery when my patient has worked up the
courage to show up, on an empty stomach, with their son who took the day off
work to be with them, because I’m a bit stressed, and sleep deprived? The stakes are much higher than they used to
be. When I was in high school, I had a
job mowing yards for the college. If I
wasn’t on my “A” game, the edging along the sidewalk might not be perfectly straight. But nobody got hurt!
My prayer is that God will help me to see clearly before a
surgical day, not after, whether or not I’m fit to cut.
