I spent about 5 hours doing a bowel resection for cancer of the recto-sigmoid.
Why was I doing this "elective" case on call?
The patient has quite severe lung disease (industrial exposure and smoking) with CO2 retention, requires home oxygen and even with the O2 he can basically walk from his bed to the bathroom but not much farther. The cancer was asymptomatic but had been picked up during screening for anemia. He had been canceled once because of no ICU bed and now one had opened up.
Fortunately we weren't very busy so the second call person didn't have to hang around long and there were no cases to follow.
The poor fellow is now residing in ICU on a ventilator and hopefully will be weaned off over the next few days although I have my doubts.
The "bottom" line is that rectal cancer while undoubted not a nice way to die, it is unlikely to kill him before his lung disease so why did we even bother?
But of course I am only an anaesthesiologist.
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it is unlikely to kill him before his lung disease so why did we even bother?
Good question and I can only think of three possible reasons and I will list them in the most likely order.
1) There is insurance or medicare for the wallet-ectomy.
2) Someone needed practice.
3) An unreasonable fear of law suits.
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