Oops daisy

Some people not only hate to make mistakes, but hate other people to know they've made mistakes. They'll do anything to cover up their cock-ups, even if that involves fingering innocent people.

Politicians and public bodies do it all the time of course, but so do many ordinary individuals who hate to be caught out in any way.

I left my last job after my boss accused me of releasing confidential documents to a civil servant. I pointed out that the documents were already freely available on our website, but he wouldn't listen. He sent me a three-page email accusing me of not doing my job properly, not obeying instructions and so on.

If only he could have admitted I was right and he was wrong, there wouldn't have been any problem. But no, he had to insist I was the one who'd screwed up.

The famous neurosurgeon Henry Marsh admits that in his early days as a brain surgeon he was somewhat arrogant and self-satisfied and wouldn't admit he'd been at fault at all. It was only later on in his career that he admitted making mistakes or misjudgments, and his ex-patients appreciated his honesty.

My prostate operation apparently went very well, but if it hadn't and the surgeon had made some bad mistake, I would have expected him to be frank with me, and not cover up and pretend everything went fine (if he'd done so, I probably would have smelt a rat anyway).

What exactly is wrong with admitting mistakes? It's only by freely examining your mistakes that you learn lessons and become a better person. I'm happy to acknowledge my mistakes and whatever they might teach me.

Pic: Henry Marsh

A prank too far

How would you react to finding out that your surgeon had carved their initials on your liver while they were operating? Would you be horrified or would you just shrug it off as a childish prank?

I pondered my own possible reaction when I read about Simon Bramhall, who autographed the livers of two liver transplant patients. Nobody reported it at the time, and he might have got away with it, except that another surgeon doing a follow-up procedure noticed the initials and duly reported it.

He has just been found guilty of "assault by beating" and will shortly be sentenced.

My first reaction was to dismiss it as a rather trivial incident that did no harm to the patients. In fact one former patient, Tracy Scriven, said "Is it really that bad? I wouldn't have cared if he did it to me. The man saved my life."

But then I thought, no, if my surgeon had done that to my liver, I wouldn't have the same trust and confidence in them. I would feel they hadn't taken my operation seriously but were fooling around. And it wouldn't just damage their reputation but the reputation of other surgeons.

And yes, he saved a patient's life, and of course the patient is grateful, but that still doesn't justify what he did.

It's one thing to carve your initials and a romantic message on a tree trunk. It's quite another to carve your initials on someone else's liver while they're under general anaesthetic and oblivious to whatever you're doing inside their body. It's not just taking advantage of an unconscious person, it's a total lack of respect for them.

Hopefully there aren't any initials on what's left of my prostate....

NB: Assault by beating doesn't literally mean beating. It refers to the use of unlawful force on another person

Risky procedures

I know more and more males are opting for cosmetic surgery, but I have no desire to join them. I'm quite happy with my body and feel no need to maul it about in the name of being marginally prettier. Plus I'm very aware of the risks and potential complications of surgery, and if it isn't necessary I'm not interested.

I had a very necessary prostate operation a few months ago, and hopefully there'll be no more surgery needed, but who knows?

Too many people are lured into cosmetic surgery by slick advertising and the knowledge that so many celebs have resorted to it. If the celebs do it, then it must be safe, right? It's just a routine way of perfecting yourself, right? The botched procedures (procedures - what a lovely euphemism!) get a lot less publicity than the happily enhanced individuals smiling for the cameras.

Many of the botch-ups are carefully hidden so nobody knows of the pain, the distress, the embarrassment, the regrets, and the damage done to a once-healthy body. Damage they may have to live with for a lifetime.

Not only have I steered clear of cosmetic surgery, I would never suggest it to anyone else. It disgusts me that some men will actually demand that a woman gets bigger breasts or a more attractive vagina. If I was the woman, I'd break up with him straightaway.

I must say I'm puzzled as to why any woman would want bigger breasts to begin with. Not only are they a big and often uncomfortable nuisance but presumably they attract a lot more unwanted male attention. A flat chest must avoid all the gawping and the man-talking-to-my-tits syndrome.

So no "corrective" surgery for me, thanks. Keep those scalpels to yourself.

PS: I'm not referring to "reconstructive" surgery after a physical injury or an operation. That's fully justified.

Risk assessment

My attitude to risk is very contradictory. Some highly risky things don't bother me at all. Others bother me a lot, probably more than they ought to.

I have no qualms about flying, even right across the world. I know there's always a risk of crashes, of fires, of hijacks. But statistically it's the safest form of travel and I have every confidence my next flight will be disaster-free.

I'm okay with driving too. I know that's a very dangerous form of travel, and that serious, possibly fatal, accidents occur all the time. But I'm confident that as long as I'm always alert and attentive, catastrophe is unlikely.

On the other hand, I'm very nervous about hospitals and operations. I'm aware that most operations are routine and successful, but I'm rather too aware of the small percentage that go horribly wrong and leave you in a worse state than before - or even dead. I mean, just suppose I'm one of that small percentage?

I'm also wary of financial risk. I keep my money in the bank and that's it. I'm suspicious of investments and fancy money-making schemes that may go suddenly pear-shaped, swallow up all my money and leave me penniless.

I can be very timid about making big changes in my life, be it a new job, a new home, even a new political allegiance. It might seem like a positive move, it might enhance my life, but what are the unforeseen consequences? Could I be making a reckless mistake, one I live to regret?

Oddly enough though, I was quite sure that moving from London to Belfast was the right thing to do, even though I had no job to go to, I had no relatives living there, and the peace process was only in its early stages. I somehow had confidence it would all work out, and it did.

Why am I quite nonchalant about some risks and over-anxious about others? Why am I so inconsistent? The vagaries of the human mind are a constant puzzle.

Check and survive

As you know, I'm far more nervous about going into hospital than I am of getting on a plane. Hospital procedures can be so erratic and staff so careless that I might easily come out in a wooden box.

My qualms have been more than confirmed by a new study that says a simple cockpit-style checklist could cut the death rate after surgery by 47 per cent and the complication rate by 36 per cent.

What's amazing is that this elementary checklist (Sample questions: Is this the right patient? Is this the right limb?) has never been standard practice and hospitals have relied solely on the surgical teams knowing what they're doing.

Unfortunately even the most experienced and intelligent surgeons and nurses are still liable to human errors that can be fatal and irreversible. Once the patient has collapsed and died, the surgeon's experience is not much comfort to the grieving relatives.

So the sooner British hospitals introduce this checklist the better, and the sooner I can have a bit more confidence about checking in.

Some of the questions on the World Health Organisation checklist:
Is this the right patient?
Is this the right operation?
Is this the right limb?
Is this the right organ?
Have we got all the necessary equipment?
Have we got enough blood?
(And afterwards)
Have we removed all the swabs?
Have we removed all the needles?

Stunningly obvious, you might think - but also so obvious they can easily be overlooked.
.................................................................................

The successful emergency landing of the plane on New York's Hudson River is astounding. It's practically impossible to land a plane safely on water. It usually disintegrates on impact. The pilot's skill and presence of mind was extraordinary.

Operation blues

Countless cancelled operations in the UK's health service are prolonging misery and pain for thousands of people. The latest cause is cock-ups over surgical instruments.

Surgeons say they are more and more likely to be broken, missing or dirty. In which case an entire surgical team, ready to operate, has to down tools and tell the patient to go home again.

Yet again the government has handed over a job to private businesses which are failing to do the work properly. Ward cleaning was farmed out and still isn't up to standard. Many nursing posts were farmed out to agencies, again causing lots of complaints. Now it's providing and decontaminating surgical instruments that's being screwed up.

The politicians are still besotted with the idea that private firms can do the job better than their own NHS staff, even though they've been proved wrong repeatedly.

So people like Helen R. in Leeds, whose hip operation has been postponed twice because the surgeon didn't have the right instruments, is angry and upset at such elementary blunders.

"This is supposed to be the 21st century. We're supposed to have sorted these things out" she said.

There are already tens of thousands of cancelled operations because of sick staff, vacant posts, funding problems or emergencies taking priority. A lot of operating theatres aren't even used in the evenings or at weekends.

Now even more people are finding they have to put up with that excruciating pain or disabling condition for longer than they thought because of the results of political dogma.

Clearly the politicians could do with a bit of emergency brain surgery themselves.
.................................................................................

The BBC reports today (Sunday) that there are 10 times more deaths across the UK from the superbug clostridium difficile among over 65-year-olds than in any other country in the world. And one person dies every hour in our hospitals from this deadly infection.