SteelyKid was delivered by Caesarean section (MacDuff won't stand a chance...). They let me in to the operating room just before the moment of delivery, and I stuck around while they cleaned her up and did the early tests that they do on newborns, before they brought her over for me and Kate to see.
While we were waiting (and quietly rejoicing), the surgeons were going about the business of closing things up. I have an unholy aversion to all things medical, so I tried not to pay too much attention to what they were doing, but I gradually became aware of a pattern: one of the nurses would count to a number less than ten, then one of the doctors would repeat the count. This happened over and over.
It probably tells you something about my state of mind that it took me a few minutes to realize what was going on: they were counting the surgical instruments, to make sure that everything was accounted for, and nothing had been left behind. The nurse was counting the wrappers and blank spaces on the instrument tray, while the doctor was counting the instruments in the discard tray.
This is so obviously sensible that it was a bit of a shock to read the news reports about a study of a surgical safety checklist. It was shocking not because of the results-- complications from surgery and deaths after surgery declined precipitously-- but because the fact of the change means that surgeons in those hospitals weren't doing this already.
Reading medical news is a real eye-opening experience for me. About half of the time, I'm amazed by the things that modern medicine is able to do. The other half of the time, I'm horrified by how badly modern medical facilities appear to be run. It's nice to know that our local maternity hospital is ahead of the curve, but this has got to change.
(I tagged the news story for the Links Dump a couple of days ago, but was reminded of this by Jonah's post.)
(Update: See also Orac's comments from a surgeon's perspective. His post showed up right after this one.)
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Actually, it does not surprise me at all. By strange coincidence, I was having a very similar conversation just this weekend with friends, wherein I observed that all professions, and nearly all practitioners of those professions, go through maturation phases where they basically want to be treated as priests: their work is too complicated, too creative, too difficult, too circumstance driven, too whatever, to be improved by any sort of standards, guidelines, or measurement technique, or even to be effectively criticized or studied.
I know this, because I have seen various engineers go through this phase, including myself, and I have seen entire working groups go through it, too. Engineering is emphatically not immune from this syndrome. But neither is any other profession-- those that don't suffer from it, such as accounting, have already been through it. Nobody likes being told they need a detailed checklist to do their jobs, but nobody who doesn't can compete against those who do in the long run.
But doctors? In particular, surgeons? Shyeah, right. Some of the worst of the bunch.
My cousin is a surgical nurse. She told me a story of one instance where she had to raise holy hell in the operating room to get the surgeon to stop closing up the patient until the count was confirmed. She was right, he was wrong.
The surgeon (and his insurance company) rightfully owed her one huge malpractice settlement for preventing a really bad outcome, but all she got was an apology.
psst, Macduff was also not of woman born. It's Macbeth who doesn't stand a chance :)