Taking responsibility when things go awry.

[Paa_Paw]

I'm sorry to have to break this news but we do not live in a perfect world. In spite of my skill as a mechanic, some things that I was trying to repair actually got worse in my hands. I made a decision to get married and it was a bad decision. That marriage ended badly. Later I remarried and that has been a great success.

The point is that I take responsibility for myself and for my own decisions.

We are all here because we share a common embarrassing problem. Some men simply ignore it. Some men actually take delight in it. Some men go to elaborate lengths to hide it. Some men have surgery to remove it. No one answer is right for all of us. But each of us should take responsibility for their decision.

Many men these days opt for surgery. Did they select their surgeon base on their specialty or based on price? Were they totally honest in disclosing any health issues prior to surgery? did they actually take the time to understand that there are no guarantees? Did they follow the post operative instructions to the letter?

If the result is less than perfect, do they take any degree of responsibility for the outcome?

I am getting sick of people complaining about their surgical outcome. Especially those where a person takes no responsibility for themselves.

Sorry for the rant, but some things you just need to vommit out.

[hammer]

Paa_Paw

I hope you don't mind, but I would like to say from one Grandpa to another, that was very well stated and needed to be said.

That is one of my greatest pet peeves today. So many people today do not accept responsibilities for their own actions.

Thank you

[Paa_Paw]

Thanks.

[Dr. Elliot Jacobs]

Case in point.  I operated on a patient 2 1/2 years ago.  He had taken anabolic steroids which resulted in a significant growth of tissue.  When I removed all the tissue, it looked like the volume of a softball on each breast.  Fast forward-- he healed well, but was warned never to do steroids again.

Last week, a call from him that the tissue had re-grown.  Reason?  He had taken steroids again but under the supervision of one of the websites that tout that steroids are OK if taken with certain precautions. 

He then asked me for a "revision" (at minimal cost) because the tissue had re-grown.

Huh?

Dr Jacobs

[hammer]

That is the same kinda person that gets a speeding ticket for doing 80 in a 55 speed zone, and its the cops fault! Or backs into a telephone pole, and it is the poles fault for being placed there! And how about the guy who buys the house he can't afford, but it is the bankers fault for giving him the loan.

You get my point, I could go on and on.

[Paa_Paw]

Doc you had one exceptionsl patient even at that if he was honest about the use of steroids.

The number of people who lie outright to their health care providers is worrisome. How can you effectively treat someone who is not at all honest with you?

How often do we get questions about post surgical care? Very often. Whenever I left after any sort of procedure I was given a list of instructions to follow. What do people do with those instructions? Never mind, I can answer that without help.

[Dr. Elliot Jacobs]

Further to your point, Paa_Paw

I provide my patients with comprehensive instructions -- it is like a small book!  It helps them to prepare for surgery, instructs what to do on the day of surgery and provides comprehensive information about what to do and what to expect after surgery.  In addition, I meet with the patient and his escort before he goes home to further emphasize certain of my instructions.  I then personally call the patient after surgery.

And with all that, I have many patients ignore my instructions.

Go figure!

Dr Jacobs

[Paa_Paw]

Have you noted that there have been remarkably few responses to this thread?

I think we might as well be preaching to the Choir. (While they are singing of course.)

[shaknbake]

Further to your point, Paa_Paw

I provide my patients with comprehensive instructions -- it is like a small book!  It helps them to prepare for surgery, instructs what to do on the day of surgery and provides comprehensive information about what to do and what to expect after surgery.  In addition, I meet with the patient and his escort before he goes home to further emphasize certain of my instructions.  I then personally call the patient after surgery.

And with all that, I have many patients ignore my instructions.

Go figure!

Dr Jacobs

Unfortunately Dr. Jacobs, it would seem that despite your best efforts (and likely many other doctors too), I believe whole heartedly that some people are just born stupid.  When you give explicit instructions to someone after surgery, and they ignore them completely like the idiot you mentioned that was taking steroids....what are you gonna do?  Can't help people that don't want to help themselves.  Guess taking responsibility for your own actions can be a real b!*&ch for some people!  I know as a professional, you have to be nice about these types of things, but don't you wish that just once you could say to people like that what you are really thinking? LOL!

[Cale]

I wasnt gonna bother replying, even though I was one of the recent whinges who prob contributed to your rant. But thought I might as well now.

Firstly, Dr Jacobs repeat steroid user. What an absolute retard. Don't think it gets any clearer than that kind of situation. Pisses me right off actually. It's possible I brought it on myself somewhat too, through smoking Marijuana regularly as a young teen.  Of course at that stage I knew nothing about the effects it could have. Too young. I ended up quitting and haven't touched it since, which is nearly ten years now. (Not because I found out about the possible contribution to Gyne, that was much later on. But of course now I know, I won't be touching it ever again.) 

In my case, no it was not based on price. I paid top dollar to see one of the most experienced surgeons in the business, including travel from Australia to New York. 

Yes completely honest. Including no aspirin, vitamin E etc. Didn't drink alcohol for about a month beforehand and ate healthily. I had zero health issues.

Of course there are no guarantees. It's in the clause every surgeon has you sign? Saying that, with the points above I was hoping to greatly reduce the chance of having to 'whinge'.

And yes, followed post op strictly. Which actually was very little above take it easy, rest heaps etc. The results are exactly the same now as they were over two months ago, when I got the first look. To me, unacceptably asymmetric. I can clearly feel more gland on the right side. I believe the surgeon was just careless on the day, for some reason.

So when you say do I take any responsibility, I guess the one thing I really do take on is not properly pointing out his mistake when I thought he hadn't taken enough. Even though I was already stitched and bandaged at the time, when I was shown the glands removed and noticed the lack of size difference between the two, I should've insisted he unwrap me and inspected the symmetry there and then. I assume it would've been clear enough to see, as it was on the day of unwrapping and continues to be till this day. Who knows. He might've been able to unpick the stitches and taken that bit more to flatten it and even the sides out. Kinda unheard of though? Checking a surgeons work before you permit them to finish...

I'm not really sure how many peoples poor results were significantly affected by their own poor decisions? I kinda feel it may be less than you think though? All I know is I personally went to the absolute lengths to avoid having this conversation whilst being rid of Gynecomastia, yet here I am. Not many are unfortunate enough to know from day one they will be needing a revision. It's not a nice feeling I can tell you that much. What else can be said but unlucky?

Ps. Talking about your work as a mechanic, I'm interested to know when a customer brings their vehicle to you as a professional, if you do happen to create more problems that need correcting as a result of your initial poor performance for whatever reason, do you fess up, admit fault, and fix it on your own time and cost? Or do you attempt to cover it up with something along the lines of how it was already bust and just barely hanging on?

[Alchemist]

A long time before an individual could afford a computer or even have the space for one, I was professional ski patrolman at a major eastern mountain.  I got a call to go on an accident and was told it was on trail x.  I took the sled down the reported site and found not a thing.  A half hour later I had the sled back up to the top of lift and got another call, this time for the the next trail over, trail Y.  Nobody in sight.  Another half hour later I'm back at the top of the lift with another report of the same accident coming in on trail Z this time.  These trails are all next to each other.  Once again, no accident scene.  This time there was not a call waiting for me when I got back to the top of the lift.  I was advised to go up the upper lift and wait for instructions.  About half way up the lift stopped and a message was called up, from T to T until it got to me to exit there and cut through the woods.  They had finally located the accident site with a telescope from the bottom of the mountain.  There the man was.  He gave me a thorough reaming out for taking 2 hours to get there.  As we put it together later each of his 3 friends skiing with him reported the accident, one at a time, and giving the wrong location.  He was not seriously injured fortunately, just a twisted knee and it was a sunny and warm day.  I attempted to splint his leg before transport.  I tried each of the several types of splints we carried and they were all too uncomfortable.  I ended up doing a blanket splint.  When we got down to the mid-mountain crosscut he insisted that he HAD to ride the gondola down from there and wanted me to pull the sled a quarter mile up hill for him to ride the lift down.  I refused and told him he could walk if he insisted.  He spewed his dissatisfaction all over the place but of course couldn't walk.  I just took him down the rest of the mountain, less than 5 minutes from there to the first aid room.  He started complaining loudly about all his dissatisfaction, and it was about everything.  He was going to "see you fired" for my supposedly "incompetent" handling of his case.  The patrol director rescued me at that point, took me aside and got the info and sent me back out on the mountain, and took care of the report.  The man was a doctor.  He was fit to be tied when he was informed that all his problems were caused by the "certain" incorrect reports by his friends rather than saying they were not sure where he was and work it out with somebody familiar with the mountain.  The delay had allowed a great deal of painful swelling of his knee.  It turned out that he had told them where to say he was and he couldn't admit that he didn't know.  Sometimes things don't go well for all sorts of reasons that has nothing to do with the competence of the doctor or patrolman or mechanic or whatever.  And even when things go normally, outcomes often are not perfect.  In a medical situation unsatisfactory versus bad outcomes have to be evaluated as to cause, if possible.  I had my gallbladder out some years ago.  That went differently than planned due to the gallbladder itself.  The surgery was fine with no complications.  However, in stitching me up the incision at the navel wasn't properly aligned and so my navel swerves an inch off center and the up the center hair line has a weird bend in it.  I would have preferred it to be straight but I didn't want to go through more surgery to make it so.  He was NOT a plastic surgeon.

[Dr. Elliot Jacobs]

I know as a professional, you have to be nice about these types of things, but don't you wish that just once you could say to people like that what you are really thinking?

Yes, sometimes I wish I could.  But then the same guy would just post an anonymous negative comment about me on the internet and try to ruin my reputation.  And unfortunately, doctors who might know who the poster is, cannot post an answering comment because of HIPPA regulations against revealing patient information.  We are handcuffed!

Dr Jacobs

[hammer]

The "HIPPA" REGULATIONS, some damn lawyers brain child.

I believe it was Shakespeare that said, "kill all the lawyers"!

Oh, how right he was so long ago!

[Dr. Elliot Jacobs]

AMEN to that, hammer.

Dr Jacobs

[morpheus11]

 I hear ya Cale, and I believe you have every right to rant.  Clearly, you expressed your expectations with your surgeon and I'm sure he gave you some realistic expectations. Also, you're a paying customer.  Money wise, this surgery isn't exactly a drop in the hat.  If the outcome of your surgery wasn't even close to what your surgeon said it would be, hell yeah you have a right to complain.

Conversely, I understand some people don't follow directions and begin to do things there way shortly after the surgery instead of doing what the surgeon said.  Now, that's doesn't mean all surgeons should pigeon-hole all of their patients into that category.  They should address their concerns, ask questions and admit responsibility when it's their fault. Like the original poster said, yes, we do need to accept responsibility, but I believe it's a two way street.  The egos of some surgeons are huge, and admitting when they messed up, isn't exactly something they like to do either.