Dr Aparna Govil Bhasker MS, Bariatric and Laparoscopic Surgeon, Mumbai, India The business of saving lives begins in the company of death. For most of us something changed the moment we walked into the anatomy dissection hall on the first day of our medical […]
Dr. Aparna Govil Bhasker The other day I saw a tweet from United Nations about the gap in gender pay parity. “Worldover……women across professions, earn 20 to 30% less than men.” It has been quite sometime and I just cannot get the figures out of […]
By Dr. Aparna Govil Bhasker
Bariatric and Laparoscopic Surgeon
There are only two types of surgeons. Those who have had surgical complications and those who are going to have. The law of averages catches up with us eventually. As the old adge goes, if you have never had a complication, you’ve probably not performed enough number of surgical operations.
Surgical training is all about minimizing complications. As surgeons we are also trained to first find fault with ourselves. When a patient has a complication after a surgery, the first thought that enters our mind is – “What did I do wrong?” The second is- “Could there have been a better way to do this?”
Unfortunately, in retrospect there is always a better way to do it. And sometimes when patients go asking for second opinions, they come back confused about why their surgeon did not choose the obvious better way.
Surgery is not mathematical. Ofcourse all of us plan before a surgery. We prep and we go through the steps mentally. We anticipate certain events and keep things ready. Unfortunately, there are times during surgery when things are not straightforward and clarity may elude us. There are times when we have to choose the best possible solution from the available options. There are also times when we run out of options. There are times when saving a life becomes a priority over everything else. There are times when help may not be available and the buck stops with us. And then there are times that despite our best efforts things still go wrong.
What follows for the patient has been talked about. Ofcourse the patient is a priority and the one who suffers. But what about the surgeon? I recently read an article about the surgeon being the “second victim”. I would say that a surgeon is the “neglected second victim”. Carrying the burden of someone else’s health and life is not easy. No surgeon wants to have a complication. We feel guilty and accountable. Every inch of our existence wants the patient to get better. Every minute is spent waiting to get some good news. Every complication takes away a bit of our life because when someone is in pain because of us, we don’t feel like doing anything else. Many a nights are spent thinking what we could have done to avoid it. We go through every step of the surgery in our minds wondering how we could have done it better. Complications take their toll and forget socializing, we find it difficult to focus on our daily family lives. Our children and our spouses become the “third victims”.
People say it’s a part of growing up and eventually every surgeon gets used to it. Well, I am yet to see a surgeon who can take it in a stride. In today’s day and age, there is also a fear of litigation, of being abused and of things being dragged in the media. Many young doctors today suffer from high stress levels and depression. Today, suicide rate is amongst the highest in doctors.
One complication is equal to thousands of successful surgeries and sometimes that one complication is enough to ruin work and reputation of an entire lifetime. There are no easy answers. Artificial intelligence and robots are still eons away from the magical number of zero complication rate. At the end of the day surgeons are only human and there can never be a perfect 100% good outcome. The complexities of human bodies are sometimes beyond us. The worst patients sometimes recover unexpectedly and complications may happen when we least expect them.
We have many a workshops and conferences that focus of management of complications but I am yet to see a workshop where they talk about stress management for surgeons. Technical skillset is important but at the same time, it is also important to deal with the stresses of a surgical career. We need to retrain ourselves to not expect too much from ourselves. We need to learn to become more realistic. We need to accept that sometimes things are out of our control. We need to know that human body is too complex and 2 plus 2 is not always equal to 4. We need to understand that we are not God.
At the end of the day, the bottom line is that, we can only try our best but ultimately it is He who heals.
“THE GIRL IN THE HIJAB”
By- Dr. Aparna Govil Bhasker
It was midnight as I stepped out of Mumbai airport. I had had a busy week at work. This was a week that pulled me down in many ways. Certain incidents in the week kept me wondering about the lot of women in our country. How women not only fail to question certain norms, but feel compelled to conform to outdated traditional values even if it comes at a heavey price that they may have to pay.
It was midnight and I desperately wanted to get home at the earliest and get some rest. At the prepaid taxi counter I was informed that I will be getting a “woman driven cab”. As I stepped out to find the cab, I was pleasantly surprised to see this young girl in Jean’s and shirt and a hijab that covered her head. She greeted me with a warm smile and we started our journey together. “Mam, I am not very familiar with the roads of Mumbai, please do guide me”.
At 12.30 am in the night, I was being driven home by a girl in a hijab who was crazy about driving cars and was completely okay with driving around the city alone, in the dark hours of the night without a care. I asked her if her family was okay with her work and she just said that, it didn’t really matter… she just loved to drive.
Normally when I sit in a cab, first thing I do is to ask the cabby to switch off the music. But, yesterday, while I felt emotionally depleted, her energy was infectious and it changed something inside me. I needed a sign to tell me that all is not wrong with this world and there is a lot to be hopeful for. She loved Bollywood music. We kept the music on and chatted along the way. At the end of the journey, I told her that I was proud of her for being so brave and a million dollar smile lit up her face.
It lifted my spirits as I realized that women across the world are breaking barriers one step at a time. The journey is long and the destination very far, but it is heartening to meet such lovely women for whom breaking barriers comes naturally. They make us hope that all is not wrong with the world and it indeed is going to be a better place in future. May their tribe grow.
I guess inspiration is all around us, we just need to open our eyes and hearts to find it.
#HerStory #Priyadarshini #womendrivencabs #wethewomen #womenempowerment #motivation #inspiration #womenofindia
Dr. Aparna Govil Bhasker Bariatric and Laparoscopic GI Surgeon, Global Hospital, Parel; Apollo group of hospitals, Currae hospital, Thane; Namaha and Suchak Hospitals, Kandivali and Malad It is widely believed that the cohort of children born in the year 2000 in the USA, may live […]
©Dr. Aparna Govil Bhasker Come December and its the season of weddings. Be it DeepVeer, Nickyanka or the Ambani extravaganza, this year it seems to be unending. Social media has gone into a frantic frenzy with hundreds of shared images of exquisite wedding locales, star […]
©Dr. Aparna Govil Bhasker
As the year comes to an end, we finally wrapped up writing, editing, rediting and re-re- editing our book on doctor- patient relationships. Oh no…dont get me wrong! This is not a promotional post! Those will come later :), closer to the release, and there is still some time for that!
However, as we spent hours researching facts and hard data on doctor patient relationships, one fact that really struck me very deeply was that 92% of patients “trust” their doctors! For more than 25 years, medical professionals have topped the charts by being the most trusted profession of all. People trust their doctors more than they trust teachers, judges, engineers, professors and lawyers…… Need I say anything about media, government, politicians and advertising? I dare not…. I can just blame it on the data! Lol 🤣
©Dr. Aparna Govil Bhasker
In this era where negative news sells like hot cakes and probably rakes all the moolah, positive news tends to get buried under the weight of all the negativity. No one is interested in the positive. Positive ofcourse is boring. Which newspaper would like to publish that today 10,000 patients underwent successful medical treatment in the city of Mumbai! Is that even news? No way…But ofcourse they would jump on- “one patient had a complication” or “one doctor screwed up” or “xyz sues abc”. That is interesting and that makes people buy newspapers and watch news channels!
Coming back to the core issue of doctor patient relationships. Today a lot of patients think that doctors are predators. Infact some doctors also think that doctors are predators! Well……what can I say to that……….On the other hand, a lot of doctors view every new patient as a prospective litigant. No one can blame us for being defensive because afterall, tomorrow we may get sued for some rare test that we didnt order. ©Dr. Aparna Govil Bhasker
However, the fact that more than 90% of the patients still trust their doctors places us at a very important “Y” junction. I think this is the time to initiate a conversation. Not every doctor is a predator and not every patient is a potential litigant. In day to day life, doctors and patients generally share a beautiful relationship. Most of us doctors, enjoy conversing with our patients, some of our patients become our best friends, we wake up to messages filled with heartfelt gratitude and most us have the talent to connect with others easily. As for patients, most of them have high regards for their doctors, they share their darkest secrets with us and trust us deeply. Afterall they place their lives in our hands. Having said that, even though this is a transactional relationship and there is a fee to service, no amount of money can ever be equated with the value of life and the weight of responsibility on the doctor’s shoulder.
In the recent years, morale in the medical community has been at its lowest. There have been increasing incidents of assaults on doctors, hospitals being vandalised and all kinds of violence pervading into our system. Politicians (including you know who!) and media have just added fuel to the fire. ©Dr. Aparna Govil Bhasker
Doctors today have the highest rate of depression and suicide. Burn out rate amongst medical residents is one of the highest in the world. We probably are the only profession made to feel guilty about charging a fair fee and have to justify it every single time. Most doctors I know and that includes myself, do not want their next generation to be a doctor. ©Dr. Aparna Govil Bhasker
So, where are we heading in 2019? Are there any solutions to these questions. In my mind the solution is evident. I agree that their are outliers amongst doctors and patients but more than 90% of doctors are good doctors, and more than 90% of patients, trust these good doctors.
Need of the hour is to generate more positivity from both the sides. Somewhere the tracks have to converge and a conversation needs to be initiated. Fear of laws can only help us temporarily but ultimately the behaviour of people is reflective of the society they live in. It is heartening to see such reports and it gives us hope that the present and the future are not as bad as they are made out to be. Just like patients are looking for doctors they can trust, doctors are also encouraged when patients trust them. I hope and pray that the new year brings a fresh wave of change and positivity. This shall not be a twain that will never meet!
©Dr. Aparna Govil Bhasker
Ref: IPSOS Mori veracity index 2018