Dr. David Gelber is a general surgeon and author. Over my career I've seen many surgery schedules, participated in clinical chart review activities and listened to doctors explain cases to me. A great deal was learned, but there is so much more and Dr. Gelber's books have helped me fill in some holes for a more comprehensive understanding of the human body. A consumer of surgical services (AKA the patient) might appreciate his stories from outside their brief encounters with physicians and surgeons.
The latest book in the series, Amazing Days Endless Nights, is a chronological collection of stories, observations and thoughts starting in medical school, on to residency and across the years of a private general surgery practice. As with his other books, Behind the Mask and Under the Drapes, they are entertaining and informative - especially in helping us understand why our doctors sometimes seem to be in such a hurry. If anything, these books will help us to empathize and have a bit more compassion as medicine and surgery have become more complex and the demands (especially from pesky administrators like me) have increased.
Below are a few highlights that are particularly striking and my own thoughts to carry the story(s) a bit further.
- Men and women of the sea are often skilled riggers and able to tie some fantastic and functional knots. Of course doctors also tie knots, but who knew there was so much more to those we see being tied in movies with such dramatic flair. This chapter will come to mind the next time I'm making a knot fixing a hem; and might even make me try harder to do a better job.
- The story about a bone doctor made me laugh... because I've known a few myself. What is most important about this section is the situational awareness and how it leads to better and safer care for patients when it is practiced by the care TEAM.
- Speaking about the bones, the mention of the Ligasure caught my attention because a young orthopedic surgeon once insisted we needed to purchase this device to improve the efficiency of our busy OR. I got it into the next budget and made a huge friend not only of this surgeon, but also of the others who soon loved using the device. I'm now wondering if part of the reason it was so valued is because of the whole knot tying business.
- General surgery doesn't have the glamour of some of the other specialties like orthopedics, cardiovascular and neurosurgey. However, general surgeons are probably the most important because their work is focused on areas of what is most likely to go wrong with the body. They are also blessed with the sights, sounds, smells and touch of the yuckie stuff (poop, pus, bile, decay/rot, a fecal tumor, etc) that prevented me from giving doctoring or nursing even a second glance as a potential career. But, if I could only pick one doctor to be stranded on a deserted island with my family and I, it would be a general surgeon.
- Doctors can be the worst patients! I've seen them admitted to psychiatric and chemical dependency hospitals and for medical or surgical care. I can relate to Dr. Gelber's story of his own desire to be a good patient, because I too try my best for the doctors and nurses. Sometimes the most important thing we can do is to not wait too long before seeking treatment... and being THAT patient who waits until the road to recovery is rocky or impassible.
- Every patient, and illness, is unique. Because of this. our care must be tailored to our personal needs. I agree that evidence-based medicine and standard protocols have their place in ensuring quality and safe care. However, there are times when effective and efficient care actually means deviating from evidenced based GUIDELINES. Great doctors know when it is time to deviate; and aren't afraid to do so. This is where I also want to encourage a bit of self-advocacy and speaking up, especially for those who are family caregivers.
- Many patients are resilient and have busy lives outside of the reason for seeing a physician. Their suffering and fear can make them unpleasant to be around... unless we recognize that health professionals are in the business of easing their suffering and fears. When we are compassionate, ask the right questions and listen we find truly pleasant people behind their mask, under the drape and during those endless nights.
Ironically, I read this book while my immune system and I were self isolating during COVID19. Many thanks to Dr. Gelber for making some of this time much more enjoyable.
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