Thursday, November 5, 2009

Annoying surgeon's request

Okay so I've detailed a couple of outrageous, maybe even dangerous, surgeon's requests. Now here is one that is simply annoying. We were in the middle of a breast biopsy. The surgeon was operating by himself with just the scrub nurse helping him. Suddenly he looks at me and asked me to hold a retractor for him through the drapes. I was taken aback. I thought, was he serious? When I refused, he appeared surprised and irritated. He then asked the circulating nurse to hold the retractor for him.

So now this became a hassle. Everytime the surgeon needed a new suture or the phone in the OR rang, the nurse had to drop the retractor. Plus she was standing at the head of the bed, partially obstructing my access to the patient. The broader implication of this request was that the surgeon had no respect for my job. He thought I had nothing better to do than to stand there holding a retractor for him, as if I was behind the drapes only playing video games or something. He obviously did not appreciate my work keeping the patient stable so he could have a successful operation. If I was holding a retractor, that would make it impossible for me to adjust the anesthetic if the patient got too light, or give her a pressor if her BP got too low, or a hundred other things I do during a case that the surgeon doesn't see and apparently doesn't care.

When I querried other anesthesiologists later about this, some of them surprisingly said that they have been asked and have assisted the surgeon by holding the retractor during a case. But it gnawed on their dignity while they were doing it. It was just easier to help out the surgeon than to look him in the eye and say no. But by doing so, the surgeon gets the idea that he can get away with operating without an assistant by asking the anesthesiologist to do the work, trivializing our job. So this is a good lesson for me. Sometimes you have to do what's right for the patient, even defying the surgeon if necessary. By saying no, the surgeon may be upset but at least he'll know I take my job seriously; I'm not some gasman sleeping behind the drapes.


  1. I've heard that one before as well. I refused, even in my lowly resident state. There was a surgeon's blog I used to follow where he remembered, fondly, an anesthesiologist who would assist him by holding retractors. He had written a couple posts where he tried to talk about anesthesiologists, but he always came across as arrogant and condescending. I stopped following after a while.

  2. I agree that surgeons' blogs are usually condescending and dismissive of anesthesiologists. They frequently complain about how anesthesiologists are there only to delay or cancel their cases. Didn't matter that it is for their own patient's safety since they did not get the proper preop evaluation.