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Is This Operation Really Necessary?
| Article
# : |
12151 |
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Section : |
LIFE
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| Issue
Date : |
3 / 1994 |
3,456 Words |
| Author
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Steve Salerno
Steve Salerno's book on selling is called The Newest
Profession. He is contributing editor at California Business
magazine and has written for Harper's and the New Republic. A
movie based on his book Deadly Blessing was recently produced
for ABC by Warner Bros. |
A 35-year-old woman visits her gynecologist for a routine checkup but complains of discomfort in the abdomen and lower back. The gynecological exam reveals the presence of fibroid tumors of the uterus, a usually benign condition. In most patients, "fibroids" cause few symptoms and can be left untreated; they are usually more of a nuisance than a legitimate health threat. "But your case is a little different," the doctor says, noting her discomfort and the fact that her mother died of cervical cancer. Inasmuch as she already has three children, he recommends hysterectomy, "just to be safe." The woman, by now anxious, promptly assents.
She is admitted to a hospital the following week and prepped for surgery; general anesthesia is administered. Everything is going well enough when, halfway through the procedure, she suddenly develops ventricular fibrillation, a rare chaotic quivering of the heart's lower chambers that can deteriorate into full cardiac arrest if not quickly converted back to normal rhythm. The surgical team succeeds in restoring her heartbeat, but, during the panic to accomplish this, the abdominal incision is contaminated. Following the operation, the woman experiences an acute infection. For a time, her body temperature hovers stubbornly at 105 degrees; doctors prepare her husband for the worst. Finally, though, she turns the corner and makes a full recovery, although she has been sore and irritable for weeks.
Unfortunately, despite the surgery--which may not have been necessary and which encompassed two separate medical crises during which she might well have died--the low-back pain persists. Her dismay intensifies after she visits another doctor who says the pain has nothing to do with her now-missing uterus. He pinpoints the cause as a slipped disk and suggests chiropractic, which works. But her torment is not yet over. Within three years, the woman has divorced her husband and remarried, and she now finds herself longing to have a child with her new mate.
Another case of questionable surgery with a poor outcome for the patient: The patient is a 42-year-old man with a family history of strokes. Though he is asymptomatic, his doctor advises using a procedure called Doppler screening, akin to sonar, to check blood flowing through the carotid artery, the major vessel in the neck. During the test, the doctor believes he detects the characteristic sounds of constriction in the artery. He recommends carotid endarterectomy, a procedure in which surgeons ream out the affected vessel to remove blockages. The patient is hesitant as his other health indicators--such as cholesterol level and blood pressure--are
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