Surgery Nightmares, JAMA-style

Josh Clark

A pair of studies recently featured in Journal of the American Medical Association (JAMA) journals are, I think, a bit creepy.

First up is a study the findings of which are so intuitive I find it a tad nerve-wracking that the researchers managed to get the funding to conduct it, let alone get it published. The study, conducted by members of the Royal College of Surgeons in Ireland, used a surgical simulation to conclude that surgeons who consumed a lot of alcohol the night before created worse outcomes for their simulated patients than did surgeons who hadn't consumed alcohol. Anyone who's ever woken up hungover with the shakes after a hard night of drinking knows that rerouting the arterial blood flow in the heart of another human being is very far down on the list of things you should do that day.

The other research concerns the outcomes for surgery patients who have documented do-not-resuscitate orders. Just to be perfectly clear, "outcomes" means lived or died or suffered consequences harsh enough to require further surgery. In the study, the researchers found an overall complication rate of 28.6 percent and that more than twice as many patients with DNRs died within 30 days of surgery.

Surgeons, of course, are not God; some patients simply can't be repaired. But a DNR -- a living will where a patient refuses CPR if his or her heart stops beating -- isn't meant to be a death warrant, especially in cases where the surgery is being performed to extend the life of the patient. [youtube=http://www.youtube.com/watch?v=LqeC3BPYTmE]