Intended for healthcare professionals

Opinion Talking Point

John Launer: Pressing the pause button—how my operation was cancelled

BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q1336 (Published 09 July 2024) Cite this as: BMJ 2024;386:q1336
  1. John Launer, GP educator and writer
  1. London
  1. johnlauner{at}aol.com
    Follow John on X @johnlauner

Recently, I found myself booked in for an operation that was cancelled at the last minute. When I say the last minute, I mean it quite literally. I was admitted to the day ward, signed my consent form, waited several hours for my turn, and was wheeled into the operating theatre. Only then was the whole thing called off. You may think from this account that the consultant was probably called away to an emergency because the juniors were on strike, or there was a last minute technical glitch such as a fault in the oxygen supply. Neither was the case. When you’re a doctor as well as a patient, matters are rarely so straightforward. What happened was that the consultant changed his mind.

I won’t bore you with unnecessary details. Essentially, I’d been booked for a revision of a cardiovascular procedure done at another hospital. I’d discussed this with the original specialist and my new one, and everyone agreed that I needed this. The new consultant warned me in his clinic, and again that morning, that the revision might be tricky or prolonged. It was only when I was on the table but not yet sedated—it was due under local, not general anaesthetic—that he scrutinised the imaging from my previous operation one more time and decided that the chances of the revision being a success were too low. More specifically, he realised that a different form of revision, done by another specialist at another time, might be more likely to have the desired outcome. He asked me to get off the table, showed me the images, explained his reasoning, and sent me back to the day ward.

Since this happened I’ve told this tale to many friends. Nearly all the non-medical ones have been aghast. They’ve focused on the waste of NHS resources, the original hospital failing to send the images on time (they arrived late), or my new consultant not requesting and scrutinising them sufficiently at an earlier stage. Some friends were also concerned about the likely emotional impact of these events on me as a patient and on my family.

Most of my medical friends, by contrast, have had a quite different response. They’ve been aware of the ridiculous time pressure most doctors work under. They’ve been impressed by the capacity of my surgeon to stop, think, and stand down a team of eight people including nurses and radiologists, rather than continuing on automatic.

I have to say that I largely agree with the ones who admire the consultant’s decision. On my professional days, as opposed to my days as a patient, I spend a lot of time trying to teach what it means to be a reflective practitioner. Without wanting to offer undue flattery, I can’t easily think of a better example than this man’s willingness to press the pause button when I was already on the operating table.

Footnotes

  • Competing interests: None declared.

  • Provenance and peer review: Commissioned; not externally peer reviewed.