Showoffs & Prima Donnas

The surgeon readers of Surgery got a sound wigging in the current issue from one of their own and from a pair of practitioners in other fields. Dr. Allen Oldfather Whipple, clinical director of Manhattan's Memorial Hospital, told them how not to act in the operating room--with specifications. Then they got another lecture from Manhattan Internist Mack Lipkin and Psychiatrist Edward Joseph, who complained that too many surgeons do not know how to handle surgery patients, anyhow.

Dr. Whipple advised his fellow surgeons to avoid temper tantrums and "excessive showmanship." Said he: "Too often the ability of a surgeon is compromised by his temper exposed in the operating room, and he becomes his own worst handicap . . . His prayer should be, 'Give me skill with humility, and prevent me from becoming a prima donna.' "

Modern surgeons do an expert job of operating on human bodies, Drs. Lipkin and Joseph conceded, but too often they ignore human emotions. Everything would be fine if only a patient could calmly accept the idea of an operation. But patients almost never do. Most people have psychological weak spots and most surgical patients are "apprehensive, anxious people, reacting emotionally rather than rationally." They fear death (many make their wills just before an operation), pain, disfigurement, loss of function. The fears are as much a part of the patient as his gallstones or diseased appendix.

A surgeon, Critics Lipkin & Joseph think, should take time to talk--and listen--to his patient. He should tell the patient just what to expect, stress his chances of surviving the operation and getting well. Sometimes, Lipkin & Joseph charged, the doctor "tries to justify a large fee, or builds up his own importance in the patient's eyes by talking of the difficulty of the operation and how his experience and skill will be needed . . ." Unfortunately, the operation's danger is what sticks in the patient's mind.

Patients, conclude Lipkin & Joseph, should be treated as human beings, not as cases. "The good surgeon is also a good physician. The good physician ministers not only to tissue pathology but to the needs of sick people."

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