Getting Well

Central plains cardiothoracic surgery LLC

One of my teachers, Dr. Martin McKneally, helped me understand the nature of the relationship between doctor and patient with a beautiful image. He said that every person is born with a “sphere of identity.”

Martin believes that when a person becomes ill, the sphere of identity becomes partially disrupted. The doctor extends his or her sphere of identity to the patient, helping to make the person whole again. Professionalism means doing this just the right amount—stepping forward just enough to make the person’s sphere of identity complete—not too much and not too little. The goal is to step forward when needed, yet to step back with respect as the patient recovers and his or her sphere of identity becomes whole and vibrant again on its own.

Regarding recovery, it is interesting how things have changed since I finished my training in 1988. In general, patients do significantly better now, go home much earlier, and recover much faster.

Some of this progress is due to better methods of care. But what has really changed is the mindset. In the past, it was normal to treat patients after routine heart or lung surgery as if they were very ill. What has been learned with time is that patients are actually safer and do better when they are treated as if they are well, not ill, minimizing the use of lines, tubes, and medications, getting people up and active as soon as possible.

My intent with every operation is to set the stage in the operating room for a perfect recovery. In most heart surgery patients, the heart will be made stronger, not weaker, by the operation. The recovery is then usually a smooth one. Of course, patients, families, and care team members must watch carefully for any changes or setbacks. It is not  unusual for a minor concern to arise along the way, and even sometimes a serious problem. That is the honest reality of heart and lung surgery. Detecting changes when they are small is the key. Again the approach is the same: intervene just the right amount, then get back to normal again as soon as possible.

If problems do arise, open and complete discussion with the patient and family is the way to go. I have found that patients and families want the same thing I would—to know exactly what is happening so they can prepare themselves to deal with it, whatever it is. This kind of respectful honesty is the foundation of good care. It is the basis of trust.

Prepared with knowledge and good advice, you will decide the course of your own recovery. Many patients go home from the hospital within 2-5 days after heart or lung surgery, and are able to return to normal activities over the next three to eight weeks. A good rehabilitation program can help set the stage for a lifetime of good health. Surgery is one step on that journey.

Paul N. Uhlig,  MD, MPA, FACS

All original content on this site is © 2011 by Paul N. Uhlig, MD and may be used with appropriate attribution.

 

.

 

Paul Uhlig and Marge Glaser

Heart Nebula (IC 1805) near the constellation Cassiopeia

 

Photo by David Messier