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There but for the grace of God go I . . .From: Clifford J. Goodman, Jr., MD (momdoc@getnet.com)Sun Apr 28 16:54:09 1996
Another question/comment for the list . . . A friend of mine, trained after laparoscopy was fully taught in residency, is an experienced, very skilled and competent gynecologist with excellent, mature judgment. He has excellent laparoscopy skills, is known to be very careful, and to have an excellent rapport with his patients. He genuinely loves and cares about his patients, and has a very good personality. Friday, while inserting the trochar for a diagnostic laparoscopy for a slender patient with only one risk factor (appendectomy as teen), he got into the lower large bowel. He recognized it immediately, had a general surgeon in from the next room in seconds. There were no adhesions or other findings to explain why he hit the bowel. They opened the patient, fixed the rent, and temporarily exteriorized the bowel, planning to release it back into the peritoneal cavity in three days. My friend walked out to the waiting area, carefully and openly reviewed the whole chain of events with the husband, who immediately exclaimed, "You really blew it, didn't you, doc? Who is your malpractice carrier?" Didn't even ask how his wife was doing. I have been in practice long enough to dread being called "doc" by anybody less than sixty years old. In the 70's when I trained, recognizing such a complication in an informed patient (well-documented, thorough informed consent in this case) and dealing with it appropriately was protection enough. We have seen that change, haven't we? Is there anything anyone can add to console or prepare my friend?
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