WHEN THE DOCTOR NODS.

New Zealand Herald, Volume LX, Issue 18294, 10 January 1923, Page 8

WHEN THE DOCTOR NODS.

JfeftßOßS IN SURGERY.

hLOOAL AND OTHER MISTAKES.

J SAFEGUARDS IN ■; HOSPITAL'S,

AUCKLAND SURGEON EXPLAINS. An Auckland surgeon had no hesitation at all . sibont commenting on the cabled summary in;the Herald yesterday of a book by Colonel Harold Burrows, a literary surgeon of Portsmouth, England, on the "Mistakes and Accidents of Surgery." The local representative of a ? profession that has long been subjected to the unkind; gibe that its worst mistakes are interred also "wields a facile pen when recording singular cases, and was thus able to quote some interesting examples of strange oversights in the operating theatre.' ' .'•»■■ "It is less surprising then it js amusing," said the doctor, "to see Colonel Burrows retail in book-form the tittletattle of the surgeon's- theatre as the sensational confessions of the profession. Since everybody from ex-Emperors and deposed kings and administrators down to society gossips is doing the same thing nowadays he may perhaps bo- forgiven. In any case, the confessions as to the other" fellowls mistakes need not perturb anyone requiring the services of a surgeon. The book manifestly is intended to reflect aspects of the operating theatre which appeal to the lighter minds in the profession." •'■' . . . Soma Classical Mistakes. " If the book be accepted at its jacft value," continued the commentator, _. the public as well' as the profession should enjoy most of its examples of mistakes in surgery. It is quite true that such mistakes 'do happen occasionally even in the most efficient. and highly-organised operating theatres, and every surgeon with wide experience could relate interesting cases in New Zealand as well as in .other countries. Surgeons are human, and have momentary lapses of carefulness, but as a rule" serious errors in operations under modern r conditions are as rare as white blackbirds/ '■ ■■;_■ ... " Before the advent of the excellent equipment, which is now happily available for surgeons and anaesthetists mm progressive communities, some remarkable ; mistakes did occur in surgery , It should be understood, however, that several Ol the -most notorious anecdotes are merely pleasant 1 fiction. . There is the caf.Jor example, in : the old days, when . both a poor- light' and a poor anaesthetic failed during an operation. In the aim light the patient struggled and fell to the floor. Prompt measures were taken to resume the operation -befc«e,- the -.-became exhausted, : and everything was earned out successfully. But when the lights were fullv restored it was found that an assistant had been the subject of the operation. He was probably none the worse for it. :It is the sort of -.mistake- that would tend to make '■ a medical student , a careful operator later on. ' Then there are the classical; examples of the discovery after operations of a signet ring and gold pince-nez. Scissors and swabs-have also been left in bodies upon which operations have been performed. Such carelessness is *■ practically" impossible under i modern, conditions.":;.' '.'. - --'"..--..:

Less of a- Silver Xtt&ls.

"Here is a first-hand reminiscence of' an odd case'"l personally- saw in. a famous London hospital as'"a visitor.' An operating surgeon had just told urn of how he had discovered the value pi the use of a 'heavy silver ladle in pressing back into position y certain internal . organs which readily project in the course of abdominal i operations. L Forthwith ho proceeded- in onr= presence to perform the operation with admirable skill and complete, success. A few minutes later, '■; however, an attendant announced that the ladle had disappeared. ; ; It, was v, recovered promptly from the unconscious patient, who later enjoyed -l the fact that for once in his life ha had possessed a big silver spoon." Precautions ;At the Hospital. "It can" truly be said with ■ emphasis," ' observed the .-. well-known "local surgeon, "thaV few. serious • mistakes are .; how made in a modern operating : theatre..-.-: Take the Auckland ■ Hospital, for example, . In this institution careful precautions •■■ are taken : against • the possibility; of ouch mistakes yas are quoted: by Dr. Burrows. It would be quite an unpardonable error if swabs, forceps or any instrument were: left in the body, of a patient after an operation. . Before each ; operation a careful record is taken of everything : to be used by the surgeon, -and immediately after: its performance it is the duty of - a responsible attendant, to make, a check tally of the articles and instruments used. •. Many thousands of minor and major operations ; are now performed annually ;at the Auckland Hospital, ' and: the record as to mistakes and accidents will stand .the closest .scrutiny.'":.- £.;•£■:..■ ■:':-■■■.;■ '';/..-', >" Given" efficient team work by•the staff the scope for mistakes through carelessness -or' stupidity is negligible. : - Tho his-. ; tory of each ;., case submitted its •>the operating surgeon is carefully prepared and checked < before the operation. This system is the product of a studied organisation which is progressive in its efficiency .* '.'as. medical, science advances.. Of - comae the human element exists, as* it has existed throughout the ages, but most careful precautions are taken- even against that possible source of error and accident."- ...-;■.„ ■:■:•-;, .'/■',.■ ■•'"-,-V^-:

Tiio Legal Aspect.:

In conclusion the. surgeon referred to records relating . to. the ■; legal aspect of mistakes and accidents in surgery, and cited several interesting cases and decisions in the Old World, The law requires only that degree of care which is ordinarily : and as reasonable under the particular facts and circumstances;: of a given case. The highest legal authorities in, the world have time and again paid tribute to the skill of the profession, and its remarkable freedom from gross negligence and unpardonable stupidities. Any surgeon worth his salt is as anxious as a patient to win success and •■. safeguard life against the ravages of disease and the effects' of accidental mutilations-

" Should doctors tell?" has been the cry in England of late, and the answers generally have been in the negative. The same replv would doubtless be given to the question ". Should retired surgeons write about the slips of the other fellow ?