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A trend surfaces
Written by Sean on Tuesday, January 24, 2006
So, I got my second response today. Negative as well, no great surprise. The surprise, however, comes from the reason for refusal. "Not my specialty", which was similar to the first response I received.
The response was:
Sean- The procedure you desire is not one that falls within the doctor’s surgical specialty of plastic and reconstructive surgery.
Come on! Guys! It’s not like I’m asking for a difficult procedure. Open the skin near the spine, insert your scalpel between the vertebrae, and cut. Stitch back up. Heck, even a medical student who’s only practiced on a corpse could probably do it! Of course, a corpse doesn’t mind uneven stitches, lack of anesthetic, and these other small details, but by and large, if you can put someone under anesthesia, you know where to find the spinal cord, and stitch them up, this is not a surgery that would require a great deal of specialisation, or any at all, for that matter.
So, I can see it now, the responses I’ll get are going to be negative. They won’t commit to pass judgement on the reason or validity of the surgery. They can avoid the entire thing by saying "It’s not my specialty". Crafty, eh?
Still, I appreciate getting a response.
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2 Comments
2 On 11 September, 2007, Sean said:
While I hear and accept what you’re saying Sam, I don’t really buy it. Obviously I could be proven completely wrong, but…
I’ve done a lot of butchering and slaughtering of animals in my life, beef, pig, lamb, you name it. Ok, they were dead. Ok, they weren’t humans. But the physiology of the spinal cord is not particularly complicated.
Anesthesia is more or less standard (well, I know it’s not, but putting someone under for sex reassignment surgery should be no different than putting someone under for spinal cord transection).
Unlike amputation, there is no concern for having to tie off major blood vessels (although I recognise there are a couple blood vessels running along the spinal cord). There is also no concern for cutting bone. Nor is there concern with stretching skin and trying to make a stump look decent.
It would be, in fact, remarkably simple surgery. Incision of the skin along the pine, cutting some muscles around the vertebrae, insert scalpel, remove scalpel, and close.
The problem with a friendly surgical resident or neurosurgical specialist is that they will not do it, based on the (in)famous hippocratic oath, misplaced ethical concerns, and a general misunderstanding of the condition.
It takes someone who “gets it” to be willing to do the surgery. And those who get it are more likely to be found in the field of GRS/SRS.
As for the “they probably don’t care” bit, I suspect that they do care, very much. About not getting themselves in trouble with a controversial procedure.
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1 On 11 September, 2007, Sam said:
Hi! I just wanted to drop a quick comment, even though this entry is a year and a half old.
I work at a medical school and have a lot of contact with doctors and, to some degree, surgeons. As such, I wanted to respond to your thoughts about the SRS surgeons you have encountered.
After general surgical residency, a surgeon who has specialized or subspecialized never performs a surgery outside his/her specialty. Ever. These surgeons probably haven’t even THOUGHT about spinal surgery in years. Some of them probably couldn’t even FIND the L2! There are complications to even the most simple surgeries, but these people don’t know how to deal with them. They have no experience with this field.
These doctors may privately share a philosophy with you or they may not. But a huge part of medicine is learning to distinguish personal opinion from your job. Their rejection really isn’t about judging you or the viability of what you want–they probably don’t care. Doctors have seen it all and, for the most part, they’re over it. It’s about being a specialist and remaining within the limits of that specialty.
Seek out a friendly surgical resident or neurosurgical specialist. You might have more luck if you try a field in which the doctor is comfortable. GID and BIID may be psychiatrically similar, but they are surgically very different fields, and doctors will appreciate it if you respect that.