The Anatomy of a Complication: Surgeon Health

In this episode of BackTable Urology, Dr. Aditya Bagrodia (UCSD Urology), Dr. Casey Seideman (OHSU Urology), and Dr. Jeff Cadeddu (UTSW Urology) discuss their experiences and advice for dealing complications as surgeons.

First, the doctors talk through dealing with complications in the operating room. The doctors emphasize the importance of maintaining a composed appearance in a state of urgent need and preparation for adverse events. For expected complications like blood loss, the surgeon can set up tools to deal with an adverse scenario, such as suction and communication with anesthesia. Furthermore, it is important to teach trainees to go through all the possible post-operative complications and develop a strategy to detect and manage them. For unanticipated issues, Dr. Cadeddu believes surgeons should think about why they did not think of and prepare for the outcomes, which is often a problem of infrequent exposure to a type of complication.

Next, the doctors discuss how to deal with feelings of self-doubt and guilt after a complication has occurred. Dr. Seideman has learned to allow herself to acknowledge these negative emotions, as they are normal feelings; similarly, Dr. Cadeddu urges surgeons to keep their sense of empathy. Both doctors agree that having someone to talk to after adverse outcomes is important, whether it be an attending, a colleague, the department chair, or even a family member. They agree that morbidity and mortality boards are important, but do not have therapeutic value.

Finally, the doctors talk about the importance of using institutional resources for support, such as other colleagues, support groups, and mental health hotlines.