Surgery is a privileged profession in so many ways. But under the cloud of Covid-19 I discovered a new profound privilege.

I had to operate on a 16 year old girl. She had injured her knee before lockdown and we had planned a knee ligament reconstruction. She was due to come into Kingsway Hospital with her mom and be treated with care and attention in our orthopedic ward.

We had to delay surgery because of lockdown. Then the hospital closed and re-opened, and at last we were able to schedule surgery for this past Saturday.

Surgery is not about the incision. It is about the healing: people entrust their bodies to the surgeon to remove, repair or relieve. There are moments on the path that the surgeon and patient walk that stand out. There is the introduction, understanding who they are and what they want to become. Assessing them clinically and then interpreting the investigations. Discussing options and guiding them to what you believe is the correct choice. Then the surgeon has to engage about the details and obtain consent. The capacity to make choices about your body, even as a child, is enshrined in our constitution, so it is good to engage with minors although their guardians have to sign the consent.

I had an new responsibility on Saturday. In the consultation we had decided that her mother would not come into the hospital with my patient. It would be an additional cost for her mother to be tested for Covid-19, and there was also the small risk of possible exposure. 

It felt awkward at the time to exclude her mother from her hospital admission. She would be in hospital for a little over 24 hours. Even so, I had never done this before. 

That meant my patient was taken to the front entrance of my hospital by her mother. There she would be left to enter alone with a clerk showing her the way to the ward. 

This whole thing had been preying on my mind for days. 

I saw her pre-operatively in the ward. She was alone in a normally occupied three bed ward. As  healers we have had touch taken away as part of our skillset  by this virus. Our faces are guarded by plastic visors and hidden by masks. Intonation and smiles are lost, and breathing and speech is difficult. Communication fails even though the need to care is heightened.

Over the years I have had children with injuries whose parents have given telephonic consent for emergency procedures to be performed. So seeing a teenager alone in bed was not something unusual. Yet the knowledge that her mother would not be allowed in as we had decided not to have her tested for Covid-19 meant that my patient was alone because of new policies and requirements to contain the possible spread of the disease.

I felt a sense of loss in that some of the humanity of my profession was gone. When she was wheeled into my operating theatre I realized I was entirely responsible for her. She was in my care in a manner beyond my commitment to my patients before this pandemic.

It was a new sense of responsibility. It was almost as if she was my child for that moment.

Antarctica is the only continent free of Covid-19.

6 thoughts on “A New Sense of Responsibility

  1. Basil, I feel the emotion of you as a surgeon but more so as the special kind human being you are. I cannot imagine how stressed and helpless the mom must have felt, but I think she knew she could entrust he child with you. As you have soooo much love and compassion to give. As all whom knows you can attest to this 😊 she was privileged to have you doing this for her.

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    1. These last few weeks have been stressful on us, but my daughter has been patient and Dr Stathoulis has been so supportive through the whole journey. My daughter is very brave and I am so proud of her and we knew that she would be in the best hands and well looked after! I am so grateful to Dr Stathoulis and all the medical staff at Kingsway. Dr Stathoulis talked us through every single step of the way and we were confident that she was going to be safe. I honestly can’t thank you enough.

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  2. I have just re-read all the articles on your blog and, as a result, have another perspective on the Covid19 pandemic that has effected us all so enormously.
    A perspective that makes me extremely grateful for so much.
    Makes me more aware of those working the “front line” at all levels and to appreciate being part of a caring community.
    The empathy shown the Matriarch and her grand daughter(?) on not being able to pay their last respects, and the account of the sixteen year old in your care are both deeply moving!
    It reminds us all to be more aware of those requiring extra care, love and assistance in these difficult times.
    Thank you for sharing.

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