With everything in life we all have differently weighted values. The same applies to surgery and the expectations that doctors have and how they compare to that of the patient. In my field, there are two procedures in which the urologist and the patient may have different expectations. The closer that our expectations align prior to surgery the happier the outcome will be for all. But as we are all made up differently, that’s not always possible.

Radical cystectomy is a major surgery that we do for invasive bladder cancer. Most often we create an “ileal conduit” after removing the bladder to bring the urine to a drainage bag. For the surgeon, great care is taken with the various “joins” because we know the ramifications of a leak. And even after the most precise care, the body still has to heal and that’s not within our control. The “vision” of the surgeon after this procedure is seeing that everything is healing well.

For the patient however, they are dealing with tiredness, sleep issues, bowel disturbance and weakness. These are all significant and troublesome in the eyes of the patient, but the surgeon looks at them in a different way. We take the view of “noted but not serious”, and allow time and simple medications to resolve them. Patients don’t see the spectrum of issues that may occur with a major operation despite the best technical procedure.

Both parties though must try and be cognisant of the other. Whilst the surgeon is focussed on a patients bowel healing up, they must also address more “minor” issues. And for the patient, though they are focussed on “minor” issues, the need to understand that the surgeon must first and foremost ensure the critical things are taken care of first, because these can be very serious.

Major surgery is a journey for both patient and surgeon, riding through the bumps and the curves together. And once recovery has been made, it is a shared feeling of triumph and gratitude to the forces that allow tissues to mend and joins to heal.

In Health and Wellness

Ranjit