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‘The Operation Was a Success, but the Patient Died’

When the cure is worse than the disease.

by
Theodore Dalrymple

Bio

September 4, 2013 - 5:00 pm
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Schopenhauer would have enjoyed the spectacle of grand rounds in academic hospitals: his theory that people argue for victory more than for truth would have found confirmation there.

In grand rounds a physician presents a complex or enigmatic case to the other physicians of the hospital, who then discuss it in detail. The ostensible purpose is to teach, learn and sometimes to enquire; but such human desires as to show off, to appear more-learned-than-thou, and to appear brilliant are often much in evidence. I once worked in a hospital where an ancient and celebrated physician, who had had more diseases, albeit rare and obscure ones, named after him than any other physician in history, attended such rounds until well into his nineties. Once he had spoken he would ostentatiously turn off his hearing aid, the entire matter having been settled to his satisfaction by his own opinion.

The New England Journal of Medicine carries each week a case report from the Massachusetts General Hospital, presented on a grand round. Generally speaking they record a triumph of diagnosis and often of treatment, somewhat like a Sherlock Holmes story. The more obscure the diagnosis the more brilliant appears the solution, seemingly reached effortlessly by the teamwork of clinicians and pathologists. One cannot help but wonder, sometimes, what has been left out. Certainly the patient’s experience doesn’t get much of a look in.

Recently there was a case reported in the journal that brought to mind the old saying of Victorian surgeons, “the operation was a success, but the patient died.” It concerned a fifty-three year old woman who suffered from persistent redness of the skin and enlargement of the lymph nodes. She was susceptible to infections for which she had repeatedly been admitted to hospital (not the Massachusetts General) and treated with antibiotics.

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Top Rated Comments   
When I hear the litany of side effects accompanying drug ads on tee vee (drug ads didn't used to even be on tee vee which was appropriate)...I often think a variation on your headline...

"The treatment worked but the patient was really messed up as a result"
45 weeks ago
45 weeks ago Link To Comment
I've come to the conclusion that death is a side effect of life.
45 weeks ago
45 weeks ago Link To Comment
Of course the final bill was handed to her surviving family: $14,345,560.67, of which $145.67 would have been covered by Obamacare.
45 weeks ago
45 weeks ago Link To Comment
All Comments   (22)
All Comments   (22)
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They made the symptoms go away, but who can say they ever really figured out what the cause was. Sometimes the operations fails but the patient lives.
45 weeks ago
45 weeks ago Link To Comment
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my buddy's step-sister makes $72 an hour on the computer. She has been laid off for 8 months but last month her payment was $12918 just working on the computer for a few hours. Here's the site to read more......

------------------->http://www.Rush60.com

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45 weeks ago
45 weeks ago Link To Comment
I had a painful cyst in an unmentionable place. The doctor who saw me for about two minutes said surgery was required. Skeptical I got a second opinion, that doctor suggested warm, soapy baths and don't rush it. In about three days the cyst disappeared. About two years later I sat on a empaneling process for a malpractice case. When the doctors name was mentioned it was the one who wanted to operate on me. About 1/5th of the people in the room were excused and left, as I did.
The same doctor amputated a friends leg much later, when I found out it was he I had to wonder.
45 weeks ago
45 weeks ago Link To Comment
I thought by your description, you were referring to Obama.
45 weeks ago
45 weeks ago Link To Comment
The painful cyst in an unmentionable place?
45 weeks ago
45 weeks ago Link To Comment
One of my close friends just passed away last Sunday. He had inoperable cancer. His doctors were recommending that they surgically remove his soft-palate, insert a feeding tube, and stick him in a managed-care facility. With no other benefit, no prolongation of life.

He told them to shove off, as there was not only no benefit, his remaining quality of life would have been ruined.
45 weeks ago
45 weeks ago Link To Comment
When I hear the litany of side effects accompanying drug ads on tee vee (drug ads didn't used to even be on tee vee which was appropriate)...I often think a variation on your headline...

"The treatment worked but the patient was really messed up as a result"
45 weeks ago
45 weeks ago Link To Comment
I've come to the conclusion that death is a side effect of life.
45 weeks ago
45 weeks ago Link To Comment
Yeah! Let's all sue our parents!
45 weeks ago
45 weeks ago Link To Comment
I believe our friend the Doc is doing us a great favor with his honest articles. Many Docs are so busy they are hard to see, hard to understand, hard to believe, and hard to please. But when one gets relief, it's like heaven.
45 weeks ago
45 weeks ago Link To Comment
I went to several doctors over a ten year period about some problems I had. I got all sorts of diagnoses, usually allergies. The last doctor I went to spent about two minutes looking at me, came up with some off the wall diagnosis about a low grade infection, gave me a prescription, and sent me on my way. I tried his prescription, exactly as he said to follow it. He was dead on. Sometimes doctors do get it right. Heart and blood pressure problems went away. Migraines gone. I still have a few minor problems, like sniffles, but they are just because I was sick and untreated for 10 years. My body is still trying to cope with a problem that is cured and gone now.
45 weeks ago
45 weeks ago Link To Comment
So many things that go can go wrong that are described to us in polysyllabic esoteric language but have quite banal origins.

Ulcers were finally discovered to be bacteria related. There may even be a connection between healthy flora in the gut and mood disorders/dopamine imbalances. (I read that in the Daily Mail, so I know it's true...kidding )

Inflammation is another common phenomenon at the origin of sundry dis-eases.

Anyway, eat broccoli (the wonder veg of the month) and yogurt to keep those little critters in the intestines civilized.
45 weeks ago
45 weeks ago Link To Comment
"First, do no harm....." is a precept often ignored by physicians when considering treatment.
45 weeks ago
45 weeks ago Link To Comment
Of course the final bill was handed to her surviving family: $14,345,560.67, of which $145.67 would have been covered by Obamacare.
45 weeks ago
45 weeks ago Link To Comment
Priceless!
45 weeks ago
45 weeks ago Link To Comment
A triumph, then, you might think! But in the next paragraph the pathologist says, “Unfortunately, she died approximately 1 year later of transplant-related coronary artery disease, with the lymphoma in complete remission.”

They had to destroy the village in order to save it.
45 weeks ago
45 weeks ago Link To Comment
When what she really had was a allergic reaction to something in her diet.

Well I suppose that is why they call it a practice...
46 weeks ago
46 weeks ago Link To Comment
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