Ethical Question with a Drunken Surgeon

[uclaussr]

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So say your on an island with your attending surgeon, and ur the 3rd year med student.someone needs emergency apendectomy and will die if you dont perform it. there is no one around to help you. the surgeon's breath reaks of alcohol. what do you do?

 

[WhizoMD]

So say your on an island with your attending surgeon, and ur the 3rd year med student.someone needs emergency heart surgery and will die if you dont perform it. there is no one around to help you. the surgeon's breath reaks of alcohol. what do you do?

I think the surgeon is still in a better position to perform this operation. Asking a 3rd year to do this is like asking a pro ace combat gamer to fly a fighter jet...

 

[mmmcdowe]

So say your on an island with your attending surgeon, and ur the 3rd year med student.someone needs emergency heart surgery and will die if you dont perform it. there is no one around to help you. the surgeon's breath reaks of alcohol. what do you do?

I stop watching grey's anatomy.

 

[SOcash]

I'd say it's time for both you and the surgeon to put down the bottle.

 

[WhizoMD]

also, this is a horrible hypothetical; does the island have an OR? Anesthesia? Surgical Equipment, nurses, etc..

 

[CptCrunch]

Is this a tropical island?

 

[DoctwoB]

I stop watching grey's anatomy.

Clearly the correct answer is C. "sleep with the surgeon"

 

[Torr]

So say your on an island with your attending surgeon, and ur the 3rd year med student.someone needs emergency heart surgery and will die if you dont perform it. there is no one around to help you. the surgeon's breath reaks of alcohol. what do you do?

Where did this come from?

 

[goldenwest]

What kind of fruits are indigenous to the island?

 

[cowme]

 

[ReptarBar]

if hes tipsy, let him do it. drunk...no one.

 

[BushidoBrown]

How is this an 'ethical' question?

 

[Cleavername]

id go surfin.

 

[sideways]

Is there any cocaine on the island?

 

[cowme]

So say your on an island with your attending surgeon, and ur the 3rd year med student.someone needs emergency heart surgery and will die if you dont perform it. there is no one around to help you. the surgeon's breath reaks of alcohol. what do you do?

Care to enlighten us on what type of life-saving cardiac surgery procedure can be done on a friggin island?

I know what you are getting at. And the answer is, the surgeon. As a third year medical student the extent of your surgery skills will be tying knots, maybe throwing a couple sutures and holding a retractor. I'd take a drunken surgeon over a 3rd year, thank you very much.

 

[BushidoBrown]

Care to enlighten us on what type of life-saving cardiac surgery procedure can be done on a friggin island?

http://www.ascts.org/

 

[Reaction]

I think the surgeon is still in a better position to perform this operation. Asking a 3rd year to do this is like asking a pro ace combat gamer to fly a fighter jet...

Probably even worse than that.. Its like asking a Chipmunk to perform open heart surgery..

 

[cowme]

http://www.ascts.org/

touche

 

[uclaussr]

i got this in an interview...and am still beating myself up over if i answered correctly

 

[Cleavername]

http://www.ascts.org/

clever.

 

[juliedi]

From the title, I thought this thread was going to be a story about the OP getting drunk with his surgeon buddy and asking each other ethical questions. It didn't quite live up to my expectations.

 

[BushidoBrown]

cleaver.

fixt

 

[Cleavername]

fixt

god damn it why must every one rub it in mah face.

 

[LizzyM]

I see this has been changed from cardiac surgery to appendectomy.

My response would be to wait the 4-6 hours it may take for the surgeon to sober up. With antibiotics and comfort measures, it is unlikely that infection and death of the patient will occur before the doc metabolilzes that ETOH.

 

[gettheleadout]

god damn it why must every one rub it in mah face.

Because you say things like "mah"

 

[armybound]

This is why I think there should be at least 2 months during residency where residents practice drunken surgery.

If they need to be able to operate while sleep-deprived, they should also have to be able to operate while tipsy.

 

[Cleavername]

Because you say things like "mah"

some times i find my self typing "my", and then back space it and then type in "mah". cuz thats how i roll.

 

[rhesuspieces]

I see this has been changed from cardiac surgery to appendectomy.

My response would be to wait the 4-6 hours it may take for the surgeon to sober up. With antibiotics and comfort measures, it is unlikely that infection and death of the patient will occur before the doc metabolilzes that ETOH.

leave it to LizzyM to solve the ethical dilemma like a boss.

Is there any cocaine on the island?

Has anyone else read the Stephen King short story where the guy is stranded on the island with a ton of cocaine so he snorts it all and saws off his limbs for food? No? Just me? ok....😳

 

[ReptarBar]

nah he clearly stated emergency. that means a decision NOW. thats where the fun begins.

 

[Bacchus]

If you have to wait, you can blow your interviewer's mind by telling him or her you want to practice counterstrain for the time being as a throw out to your osteopathic brethren.

 

[2012mdc]

nah he clearly stated emergency. that means a decision NOW. thats where the fun begins.

If he's on an island with only himself and the attending surgeon who is drunk how do they even know that the patient needs an emergency appy? I'm not trusting a MS3 or a drunk doc to make that call

 

[sideways]

I see this has been changed from cardiac surgery to appendectomy.

My response would be to wait the 4-6 hours it may take for the surgeon to sober up. With antibiotics and comfort measures, it is unlikely that infection and death of the patient will occur before the doc metabolilzes that ETOH.

Then the drunk surgeon punches the 3rd year in the face and cuts the patient open.

 

[ReptarBar]

If he's on an island with only himself and the attending surgeon who is drunk how do they even know that the patient needs an emergency appy? I'm not trusting a MS3 or a drunk doc to make that call

overthinking it man. i would be pissed if someone pulled this answer on me as an interviewer.

 

[cpants]

The correct answer is give antibiotics. There is evidence that appy patients do as just about as well with antibiotics and supportive measures as they do with surgery. Quote the studies for instant acceptance.

 

[ReptarBar]

wtf when did he change it to appendectomy?

 

[Charles English]

Has anyone else read the Stephen King short story where the guy is stranded on the island with a ton of cocaine so he snorts it all and saws off his limbs for food? No? Just me? ok....😳

i was just talking about this story with my wife. i forgot the point of it, just that the guy started eating himself.


looked it up. "survivor type" from skeleton crew.

not his best.

🙂

EDIT: apparently it was heroin he had. and yes, he was a surgeon.

 

[wrestler445]

Does the patient have insurance???

 

[LizzyM]

nah he clearly stated emergency. that means a decision NOW. thats where the fun begins.

The decision can be to delay surgery for 4 hours. This isn't an aortic dissection.

If the choice were between an incapacitated but otherwise qualified surgeon and an untrained, unlicensed M3, I think you would need to conclude that there is no one available to perform the surgery at this time and it is most unfortunate that the patient will die for lack of a provider.

 

[blehm98]

has anyone even bothered to ask how drunk the surgeon is?
If he's just buzzed or kinda drunk i can see it being acceptable, but if he's gonna be falling asleep mid surgery that's a different story

 

[SilentSoldier]

This is why I think there should be at least 2 months during residency where residents practice drunken surgery.

If they need to be able to operate while sleep-deprived, they should also have to be able to operate while tipsy.

If they provide the alcohol, including choices of beer, wine, mixed drinks, and hard alcohol. I'd be all for that 😀

 

[45408]

wtf when did he change it to appendectomy?

Last edited by uclaussr; Today at 04:50 PM.

 

[45408]

The correct answer is give antibiotics. There is evidence that appy patients do as just about as well with antibiotics and supportive measures as they do with surgery. Quote the studies for instant acceptance.

Link to said evidence?

 

[getdown]

It's called "shut the hell up and let the surgeon do his thing". I'd be more worried of him ruining my future career than anything else. But than again, what future career is there on a deserted island anyway?

 

[mmmcdowe]

It's called "shut the hell up and let the surgeon do his thing". I'd be more worried of him ruining my future career than anything else. But than again, what future career is there on a deserted island anyway?

You could make partner.

 

[2012mdc]

overthinking it man. i would be pissed if someone pulled this answer on me as an interviewer.

My reply in an anonymous forum is different than the reply I would give in an IV. I probably would have said push abx and fluids until the surgeon can operate. And if they force me to choose between drunk surgeon and MS3 I'm choosing the drunk surgeon

 

[Geneticist]

How would the surgeon perform surgery without any surgical equipment? Or anesthesia, for that matter?

 

[uclaussr]

What if you were told you had assisted with this surgery a few times in the past?
My answer was that you have a responsibility to protect the patient, and in this case i would ask the surgeon to verbally guide me through the procedure if i had already assisted a few times.
I hope i didnt screw this up 🙁

i dont think the answer to this was to test my knowledge of the latest literature on appendectomies and whether or not i knew of the antiobitc therapy, more so how i would handle the situation...

 

[cpants]

Link to said evidence?

It's been evaluated by a few randomized trials as early as 1959. Hey it's not level one evidence, but in the scenario presented it is definitely the best option. This is probably the best one:
Hansson, J. (2009) Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients. British Journal of Surgery 96(5)
http://onlinelibrary.wiley.com/doi/10.1002/bjs.6482/abstract

 

[dbeast]

What if you were told you had assisted with this surgery a few times in the past?
My answer was that you have a responsibility to protect the patient, and in this case i would ask the surgeon to verbally guide me through the procedure if i had already assisted a few times.
I hope i didnt screw this up 🙁

Call 911? Most islands have hospitals...

 

[cpants]

What if you were told you had assisted with this surgery a few times in the past?
My answer was that you have a responsibility to protect the patient, and in this case i would ask the surgeon to verbally guide me through the procedure if i had already assisted a few times.
I hope i didnt screw this up 🙁

Dude, you could not do an appy with or without verbal instruction as an MS3 after assisting a few times.