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Sunday, October 26, 2008

Good Medical Operations










I have just had my first ever operation in an hospital. Oh no! I hear you say. Don’t bore me! Well, lend me an ear as I relate to you a delightful story of a good operation because you are only human and we just don’t know when your turn may come around.

The world is full of Good Operations and Bad Operations. Because there is more than one hospital it is inevitable that there will be various degrees of satisfaction flowing from necessary interventions for your health.

I live here in Valencia, Spain, and ever since we came to Spain we have been clients of the Sanitas system of private health insurance. It is not cheap, nor is it expensive if you get what you pay for.

There are options available to some people. For instance, should you be employed here you are automatically enrolled into the public health care program, and that continues for as long as you work, and for a while after your employment ceases. I came here as a retired person, therefore I was advised to purchase private insurance. My wife works, and her policy covers herself and our dependent son, but not myself. The two of them are double-covered by both public and private cover.

Recently, and for the first time, I have had to use my cover for something other than normal annual checkups, and the reason I’m boring you with this is because I can report that my experience was how it should be, with a liberal margin that went above and beyond.

My problem was a gradually growing bunion that was disfiguring my left foot, and it had progressed to the point at which it was becoming uncomfortable. My doctor advised that the time had come to rectify the situation, and so I got on with it. As an introduction to the operating room it seemed like a fairly gentle way to do it.

I should say that about twenty years ago I had the opportunity to observe this operation take place on live television and I thought it was fascinating and horrible. The tools employed were scalpel, saw, hammer, screwdriver, screws and file. Although the technique has improved those are still a part of the necessary equipment.

The Sanitas system in Spain is a private organisation that operates its own complete circuit of clinics and hospitals, complete with dedicated professionals. It is very clear to me that the administration has got it right when it comes to what is their number one priority. The patient is Number One! All too often systems are so preoccupied with their own concerns that they place the patient way down the list.

My operation took place at the hospital in Valencia called “ Hospital Nou (9th) de Octubre”. My instructions were to arrive at 8am for admission and preparation. My wife accompanied me, as it is expected that family will be in attendance in order to assist.

I was assigned to a private room that was more like an hotel accommodation, including the wording on the welcome cards left for me. Family visiting hours are 24 hours a day, and the room includes sleeping facilities for visitors.

I wasn’t taken into surgery until 1pm, so that involved quite a long wait during which my wife was free to come and go as she wished. I was finally wheeled downstairs and parked outside the operating arena and then I was taken in to be processed.

We must bear in mind that all business was being conducted in Spanish, and my skill is lacking. The senior surgeon realised this and kindly consented to converse with me in English. That was even more gratefully received than the anaesthetic.

They seemed to think that a bunion operation is all too routine, but as I was awake throughout I thought it very complex and difficult. The chief surgeon, who seemed to me to be about the age of my son, worked together with two others and the anaesthetist and a nurse. That seems like a lot of personnel to me, but for over an hour they did a lot of violence on my foot, including having to break my big toe in three places to straighten its direction.

My first moment of anxiety came when the surgeon said that he was going to introduce four needles into my foot in order to deaden the nerves. He then asked me whether I could feel anything and I said that I probably wouldn’t after he had done the injections. I was wearing a facemask at the time inhaling tranquillising gas. He said that the needles had been given and my foot should be nerve dead. I looked over at the anaesthetist and he smiled back at me. Lovely! He simply had turned up the gas to calm me and turned it down again to bring me back to full consciousness.

The procedure itself was very peculiar. As I was conscious I knew what they were doing through the feel of pressure. I knew when the surgeon cut my skin as I felt the pressure from the tip of the scalpel. I could tell when the bone mass was being reduced through both the sound of the saw and the feel of the pressure, and also I could feel when he was filing away unwanted edges. I really felt uncomfortable each of the three times they pressed down until the bones broke, which I could hear as a small “pop” sound. And, finally, I knew that they were affixing a small plate as they applied screws to the bones to keep it in place. I was perfectly aware of all that, but there was no pain.

What this essay is really about is competence and attitude. I am singing the praises about my experience because Sanitas got it completely right, from the moment I walked in to discuss the problem, through to my recovery. Every member of the team acted in a completely professional manner, and they even added their own personal pleasantries and wonderful bedside manner. Should you ever have to have medical attention you should be so lucky!

P.S. Had I known ahead of time that the doctors were going to break the bones in my big toe three time I may have gone to the movies instead.

Copyright © 2008 Eugene Carmichael