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.

10 comments:

Frank Drackman said...

Used to do that with some of my Circumcision Post Ops...Kids screamed just as loud, ended up with a nice wallet though..

Anonymous said...

I had a teratoma tumor removed from my abdomen a year ago, and I wish I could have been able to seen that thing goodbye. That's pretty cool though how you take a picture of those things for your patients.

Anonymous said...

Intraop video and/or stills. Good idea for lap situations such as gyn surgeon to show pt endometriosis, adhesions, fibroids etc. especially when gone undx for years. This proof physical validation of pain and suffering e.g it's not all in your head. Invaluable.
-SCNS

Roxanne said...

My son had his tonsils out five years ago. We had the surgeon take a picture post removal (they're lying on a blue pad next to his name tag). He likes to gross out new friends with the picture. If bringing them home in a jar had been an option, he'd have done it.

Ming said...

Oh yeah, there was a guy who used to do that sort of artsy thing with human body parts... what was his name? Ed Gein? I think they put his ass in jail. Way to go, buckeye.

Buckeye Surgeon said...

every once in a while a little black humor seeps into this blog. sorry if that offends you Ming.

Ming said...

Nah, doesn't offend me. Just poking fun at you. I'm guilty of the same black humour, being a pathologist and all.

Guiac said...

Have to say I did enjoy reading the path report on my pus filled appendix. Would have gladly taken the little sucker home in a jar if I could have(if only I thought about the idea).

horsetech said...

I still have my friend's young horse's wolf teeth rattling around in my car, but that may say something about the state of my car, which contains everything needed to live out of it for a day or two, and then some.

Speaking of which, I've been meaning to ask if I could have some representative CT scan pics of my recent pneumonia . . . what? When my friend broke a couple cervical vertebrae (no neuro issues, thank god) a few years ago, she brought the CD to a party a few months later with her rads for our enjoyment. Is there something strange about that? :)

Bianca Castafiore said...

I wonder if there is also something to the verbal acrobatics that patients put their surgeons through...

"My surgeon said it was the biggest fill-in-the-blank she had ever seen..."

"Doc swore that if it had gone in one millimeter to the left, I'd be a goner..."

Verbal mooseheads.