“The risks include: stroke, heart failure and death”… so I signed the consent form, and my colleague, Arthur Yue, got on and did the procedure.
I am sure that he told me some numbers to quantify the risk, something like “less than 1 in 1000 chance of dying”, but I can’t remember now, and I’m not sure I was really listening anyway.
I am 39, fit and healthy, and this was going to sort me out so I could get on with my life. I had complete trust in both Arthur and my anaesthetist, and nothing was going to go wrong for me – why should it?
But despite being a surgeon, despite knowing what goes on in an operating theatre, and despite knowing the staff…. well I was still nervous.
I wasn’t worried that both my groins had been shaved and everyone in the room would get to see my “unmentionables”; I wasn’t worried about waking up and crying like a new-born baby, or saying the most inappropriate things to people that I work with (this happens for real all the time), because the recovery room staff are pros and they know how to handle the most difficult patients (even me).
No, I was worried because, without the procedure, I might not be able to train for the New York Marathon, and with it I was going to lose valuable training time while I recovered.
And what if something did go wrong? People were relying on me, both at home and at work, and also the many thousands of people who we are trying to help by running in New York. And perhaps this is all just bravado; was I actually a little scared that I might not wake up? Or worse still wake up in intensive care unable to move bits of me that should be moving.
I was convinced that this would fix me and nothing would go wrong. But it could have. The risks from any procedure are real, I was to be anaesthetised (risky), have a hole made in the big vein in my groin (risky) and have a small tube inserted into the hole and “floated” into my heart to burn it on the inside to stop me getting atrial flutter (even riskier).
The human condition is to ignore the risk in the belief that something better will come out on the other side. Even more amazingly, people put themselves through the same (or different things) more than once if they truly believe that it will help them (watch Episode 2 of The Cancer Marathon and you’ll see what I mean).
This was my second time, and the risks for me were really very small, but 1 in 1000 becomes 1 in 1 if you are the 1 in 1000 who has the complication, and very often we have no way of telling who the 1 in 1000 will be.
Think about that for a minute, for 999 people the risk is zero but for 1 person the risk is 100% – better hope it’s someone else…
Doctors need to be totally honest about this and also be upfront about new procedures. Complications are more likely during what is known as “the learning curve”, and we now know that surgeons should be performing a minimum number of procedures each year to stay “safe”.
For complicated operation like the ones I do, bigger is better.
You might have to travel further, and it might be hard for your relatives, but it is safer to have your operation in an expert centre with an expert team.
It was the expert team that I sought out to fix me up for New York.
But did they fix me?
I was back training again within a week (I think Arthur told me to rest for longer – sorry) and since then I have covered 369 miles.
I have climbed the highest paved European mountain pass on my bike (I’m counting that as my altitude training done) and got my heart rate up to 185 without any funny business.
Arthur says I’m fixed and who am I not to believe him?
Bring on New York.
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