I refer to the Malaysiakini article, Malaise in our public hospitals .

The above article impressed me when the writer pointed out that surgeons tend to over-emphasise their self-import whilst being from a field which started off with barbers and basic implements. However his further commentary did not flatter me:

‘To be successful in paediatric cardiac surgery, you will have to run through that deadly gauntlet that ended the careers of Professor James Wisheart and Janardan Dhasmana at the Bristol Royal Infirmary in 1999. Both found out to their costs that taking the risky gamble of operating on paediatric cardiac surgical patients with iffy paediatric cardiologists, anesthetists and ICU staff can not only end your career but may get you profoundly vilified for the rest of your life.’

The truth is, both cardiac surgeons had a higher than normal mortality rates than their field allowed, about 12 times more. The hospital attempted to cover their botch-ups to avoid bad publicity since both surgeons were senior doctors. Wisheart was close to 56 years old then. That is not exactly the age for a surgeon in training. Of course, there is learning from failure but great surgeons not only know how and when to operate, but more importantly know when not to operate.

It is unlikely the surgeons would have disclosed their higher mortality rate figures, clouding further the consent received to operate. It is reported that those surgeons forced the hand of the hospital manager, Dr John Roylance, to hide the facts, and the alleged ‘iffy anaesthetist’, Dr Stephen Bolsin who raised the potential of surgeon error was vilified and forced out of his job and to eventual migration to Australia. Wisherst and Roylance were de-registered, with Dr Dhasmana barred from operating on children in Britain.

Sadly this situation is mimicked in Malaysia in how surgeons are often above blame for poor outcomes in surgeries. Ahmad Sobri is more likely to blame ‘iffy’ paediatric cardiologists, anaesthetists and ICU staff, even if it is the surgeon who has been cavalier in taking risks and experimenting with cutting edge medical advances on behalf of the patient.

Perhaps Ahmad Sobri should revise his estimation that surgeons are brave when the only ones exposed to risk are the brave patients under the knife of ‘iffy’ surgeons. It disappoints me that a medical doctor like Ahmad has a this stance on paediatric surgeons. What of primum non nocere (first do no harm)?’