Holy crap, a doctor talks about her training experience, and I’m horrified.
So here I was, handling the plane (the layer, or space) around the IVC [inferior vena cava] with care to avoid ripping it. It seemed like the intelligent thing to do. My attending asked, “Why are you being so dainty with your dissection there?” I answered that I wanted to avoid ripping the cava because they’re so much harder to fix.
I take it he interpreted my comment as fear, and decided upon a teaching moment. He took his scissors and incredibly, before my eyes, and with no warning or preparation of any kind, cut a one-inch hole in the cava.
I was stunned. As I tried to process what I just saw, incredulous that he would actually intentionally make a hole in the cava, and as dark blood poured out of the hole, the tide rising steadily in the abdomen, he remarked, “Well, are you just going to stand there or are you going to fix that?”
Whatever happened to “First, do no harm”? The patient was there to have an aneurism fixed, not to be a surgical dummy, and the doctor just decided to create an unnecessary complication as a training exercise. Stabbing a patient in a major vein next to the heart is a criminal act, and I don’t care if all the tools and expertise needed to deal with it were right there at hand — it was a deep violation of trust.
If the patient had died of complications from tearing their vena cava, would the doctor have been tried for murder? It would be the only appropriate option.
Can we also have a list of the names of doctors who think it’s OK to slash up the insides of their unconscious patients to give students something challenging to do? I’d like to avoid them. I’d rather not ever be a “teaching moment”.