tag:blogger.com,1999:blog-4968787219619380438.post1434580949879724881..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Surgeons Are Not Pilots or Long-Distance Truck DriversSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-4968787219619380438.post-50964471037993849282013-02-04T16:58:10.535-05:002013-02-04T16:58:10.535-05:00Thanks for commenting in a more civil way than Gar...Thanks for commenting in a more civil way than Gary above. <br /><br />As I mentioned in answering your comment on another post, I am intimately aware of what it takes to be a military aviator. To protect my anonymity, I won't disclose details. <br /><br />Again, I exaggerated to make a point (lost on Gary).Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72280334720959775772013-02-04T16:19:35.535-05:002013-02-04T16:19:35.535-05:00You may enjoy researching into military aviation. ...You may enjoy researching into military aviation. I can guarantee you even a <br />"routine" flight in Tactical Aviation, Search and Rescue, or a catapult launch from a carrier is by no means boring or exempt from small errors which can be caused by fatigue. The environment in which these indivuduals operate may prove to be a truer comparison for a surgeon. I work in Aviation Physiology; fatigue is frequently addressed, trained against, instructed to avoid, regulated against, etc. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-8216633580722115072011-09-22T07:44:55.312-04:002011-09-22T07:44:55.312-04:00Scalpel: I'm working a 1 in 2 roster like Vin...Scalpel: I'm working a 1 in 2 roster like Vince. It's pretty tough.t. a.https://www.blogger.com/profile/15964467263742330758noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-7712627978038824402011-08-10T08:45:58.576-04:002011-08-10T08:45:58.576-04:00Thanks for the link to those papers (re: fatigue)....Thanks for the link to those papers (re: fatigue). It's unintuitive that it should make no difference in this field, but I can't argue with these results.<br /><br />Yes, it would be great to get "no fault" incident reporting in medicine. Perhaps we have more chance in the UK than the US.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-44319921632248691432011-08-09T21:36:30.283-04:002011-08-09T21:36:30.283-04:00@Anonymous
I agree that comparing surgeons to sol...@Anonymous<br /><br />I agree that comparing surgeons to soldiers is valid. I have blogged about this. With all due respect to the valiant Navy SEALs who lost their lives, see my post which was written In late June of 2011. http://tiny.cc/cn0s3.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-6368845092565097482011-08-09T21:07:09.310-04:002011-08-09T21:07:09.310-04:00I am a surgeon. I think the most valid comparison ...I am a surgeon. I think the most valid comparison is that to active duty soldiers. I'm surprised that similarity is rarely (never?) mentioned.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-22709454934755383292011-08-09T16:46:17.752-04:002011-08-09T16:46:17.752-04:00@Expat-I'd love to know where you work. Also l...@Expat-I'd love to know where you work. Also loved "...almost always extra-curricular."<br /><br />@Vince-Sounds like an "old school" tough schedule. No days off or time to nap?Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-74240899088181125782011-08-09T07:21:48.883-04:002011-08-09T07:21:48.883-04:00I'm a surgeon. And i can clearly remember many...I'm a surgeon. And i can clearly remember many MANY close calls and mistakes due to fatigue. Some first world medical students and residents are lucky because of laws which limit working hours. No such luck in my country. <br /><br />Usually we have a 3 day schedule. Day 1: Operate or do other stuff all day (7am to beyond 5pm). Then Spend the night trying to sleep. If you're unlucky you have problematic patients who keep you up. Day 2: endorse or hand over to the incoming team (6-7am). Then operate or do other stuff (7am-beyond 5pm). Then go home. Day 3: operate or do other stuff from 7am to beyond 5pm then go home. Then repeatVincehttps://www.blogger.com/profile/13306998397327136176noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-76336340070763665472011-08-09T07:21:09.305-04:002011-08-09T07:21:09.305-04:00I'm a surgeon. And i can clearly remember many...I'm a surgeon. And i can clearly remember many MANY close calls and mistakes due to fatigue. Some first world medical students and residents are lucky because of laws which limit working hours. No such luck in my country. <br /><br />Usually we have a 3 day schedule. Day 1: Operate or do other stuff all day (7am to beyond 5pm). Then Spend the night trying to sleep. If you're unlucky you have problematic patients who keep you up. Day 2: endorse or hand over to the incoming team (6-7am). Then operate or do other stuff (7am-beyond 5pm). Then go home. Day 3: operate or do other stuff from 7am to beyond 5pm then go home. Then repeatVincehttps://www.blogger.com/profile/13306998397327136176noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-5731525037392403822011-08-09T06:19:14.860-04:002011-08-09T06:19:14.860-04:00While oral sex in the operating theater is rare, a...While oral sex in the operating theater is rare, and almost always extra-curricular, the same in the consulting rooms, either with patients or nursing staff, is common enough to count as 'significant'.<br /><br />I don't think this point invalidates your thesis though. Nice article.An Expat who learned metricnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-14231666976808692012011-08-08T11:14:34.694-04:002011-08-08T11:14:34.694-04:00Thanks for the comment.
I am aware that pilots re...Thanks for the comment.<br /><br />I am aware that pilots report near misses and are not penalized for them. Too bad that is not the way it is in medicine. <br /><br />The effects of fatigue have been looked at in surgery. Two months ago I blogged about two papers that show that sleep deprivation had no adverse effect on outcomes of two different types of thoracic surgery procedures [http://is.gd/TBnRRI].Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-50985002350055152142011-08-08T10:24:13.396-04:002011-08-08T10:24:13.396-04:00Hmm, maybe. Is there really nothing that becomes r...Hmm, maybe. Is there really nothing that becomes routine, automatic in your surgery? No step that goes the same way so often that you could almost do it blindfold?<br /><br />Pilots are under unique scrutiny. Most people are aware that plane _accidents_ are investigated. Did you realise that even non-accidents make a difference? Any incident which, had things turned out differently, could have resulted in an injury or damage to property is reported and analysed.<br /><br />As a result of this unique scrutiny, things began to show up that you'd take centuries to notice if you looked only at (mercifully rare and getting rarer) accidents. Fatigue is a big one.<br /><br />When people suffer fatigue they don't just fall asleep -- if only it was so simple. They miss the obvious, they make unjustified assumption, they react slowly to unexpected stimulus.<br /><br />Without measuring the effects fatigue has on surgeons and their unique patterns of work we can't know how dangerous it is. But past experience (in aerospace and railways) says that professionals themselves are very bad at guessing how their performance is affected by fatigue.Anonymousnoreply@blogger.com