What Does It Feel Like To Be A Surgeon And Have A Patient Die On Your Operating Table?

This question was originally posted on Quora and the answer was by: Chris Merry

It depends on the situation, but in answering this question I am assuming that the patient was not on the operating table for last ditch, hail Mary pass kind of operation. That is, they were not expected to die.

This happens to me about 1 to 2 times per year, despite meticulous pre op planning, seemingly uncomplicated surgery can go pear shaped.

The first thing that happens is you begin to feel a little anxious, unnerved that something is not quite right - the operation is not moving the way it should be.

This is followed by fear, fear that the patient might actually not make it off the table, fear at how their family will react, fear at what your colleagues will say to you, or worse, what they will say about you to others. At this point a little panic begins to set in, as you mentally run through possible solutions to whatever it is that is the problem.

Next comes the rearguard action, where you take increasingly more desperate measures to try and save the patient.

Then, at the end, there is almost a feeling of acceptance and calm, a little like when you finally accept that you are not going to make that appointment and rushing panicked into traffic is not the answer.

Finally, after it is all over and you have spoken to the family, the coroner and often debriefed the nursing staff comes the anxiety, different this time to the beginning. What could I have been done differently or better? Did I leave something out, did I make mistake, should I have operated at all?

This last anxiety can be brief, running through the case with a colleague may be enough to realise that it wasn't you, that there were unknown forces at work. More often it lingers, burns itself into your subconscious to the point where it permanently affects the way you practice. This can be a good thing, you need to learn from your mistakes, but it can also be destructive, turning good surgeons to nervous, conservative practitioners. Worse, it can destroy careers and lives.

It is never easy. It never 'just is'.

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