Wednesday, September 2, 2009
Moosehead on the Wall
Via Mindhacks, a recent study from neurosurgeons at the St. George's University in London, UK demonstrates that patients who are able to see the actual fragments (bits of intervertebral disc tissue) from their microdiscectomy procedure have superior long term outcomes in terms of pain and neurologic sequelae compared to those patients who did not get to see the vittles. The study seems to suggest that one's perception of pain/persistent neuralgia is affected to an appreciable extent by the mere visualization, after the fact, of the offending etiology.
No surprises here in terms of the human psychology involved. Any trauma surgeon will tell you that the first thing a gunshot victim will ask after successful, lifesaving surgery is....."did you get the bullet out?" And I suppose if you find yourself mano a mano with a grizzly bear in the woods, recuperation from any injuries incurred in battle will be a lot quicker and easier knowing that your local taxidermist is preparing the grizzly's hide and head as a rug for your mancave at home. Trinkets and hunks of flesh always cement an triumphant experience in one's mind more than the vagaries of mere memory, right?
In my practice, I will occasionally take a picture of a gallbladder splayed on the back table or an appendix intra-abdominally, just before I stick it in the EndoBag. Patients seem to get a kick out of it. I jokingly tell them to frame it and put it in the family archives. But after reading this article, maybe I ought to do more. Perhaps I ought to cut a deal with the pathology department; make sure they save all specimens for me after my operations. Then I could present patients with several options, an a la carte menu so to speak. Appendix in a jar, floating harmlessly in the formaldehyde. Gallbladder anchored on a lacquered oak wall frame, the stones aesthetically spilling out the neck like a Thanksgiving cornucopia. Colon segment, partially opened, displaying angry-red fungating carcinoma, spiralling its way down from a ceiling mount. Breast lumpectomy specimen arranged tastefully in a snow globe paper weight. The possibilities are limitless. Right next to your rack of antlers. And home from the hospital percentage points quicker than the guy who still has only an abstract relationship with his now defunct gallbladder.