Published: June 30, 2009 10:05 pm      

McDONALD: Scalpel! Forceps! Screwdriver!

As you are reading this column, hopefully I will be recovering in the hospital from cervical spine surgery. This surgery requires the neurosurgeon to operate on the spine by entering from the front of the neck while narrowly bypassing the voice box, spinal column and carotid artery.

If you don’t see my column next week, then of course you will realize that someone slipped and hit the carotid artery and you should be reading a memorial piece written by the editors at The Evening News.

Last Wednesday morning, I had surgery to fuse two cervical discs and then have a titanium plate screwed in to secure the fuse. This is not a surgery I have undertaken (oops! poor choice of words) lightly. I had a similar surgery 10 years ago and it was successful. It was the beginning of my medical tango with cervical disc degeneration.

A few years, ago I began having more upper back and neck pain. I returned to my neurosurgeon and elected instead of surgery to endure a couple of rounds of epidural shots in the back of my neck to relieve the pain. The first round worked but the second did not and left me realizing just how much pain I was having.

About three months ago, I finally reached the point that I was ready for surgery. Before I go any further, you should know that I have complete confidence in my neurosurgeon. He is a professor at a teaching hospital and he is a neat guy. The first time I went to see him, 10 years ago, my cousin (an internist) asked me to confirm a story about him that occurred during his residency.

Apparently my surgeon went to the parking garage and was held up at gunpoint and then made to drive the thug to another point in town. The thug was holding a gun to his head and the surgeon said “if you are going to shoot me please move the gun back about an inch as I don’t want to live as a vegetable.” The story was true. Anybody with a story like that can cut around my spinal column.

My first step toward this round of surgery was to update my MRIs. I was sent on the appointed date to the facility and the orders were wrong. Once corrected and verified, I went into the MRI tube.

Within a month I was back at the neurosurgeon’s office along with my personal nurse (my wife), to discuss my options. True to his oath and ethical considerations, surgery was not offered as the first option.

At some point, it would become inevitable but he offered me another round of epidural shots. I was frustrated with the pain and just wanted some finality (oops! another poor choice of words) to my pain. Lab work and a stress test were scheduled ahead of the surgery. I was also sent to see a specialist, an orthopedic spine surgeon.



What kind of job do you do?” a lady passenger asked the man traveling in her compartment. “I’m a naval surgeon,” he replied. “Goodness!” said the lady, “How you doctors specialize these days!



I went to the specialist, whose office was beautiful and did not validate parking. I knew his personality before he entered the room. Nothing like my neurosurgeon, this guy was the epitome of narcissism and self-involvement. Furthermore he couldn’t tell a good story. When he walked in (with his personal nurse in tow) looking at my chart he asked why are you here? My neurosurgeon’s office was to have faxed that information to him. I was not feeling good about this.

He tested the range of motion of my neck and shoulders. His opinion was that we should try a cortisone shot to my shoulder first and maybe avoid surgery.

I long since have abandoned the thought that surgeons or physicians are anything but subcontractors to my health management. I told him we are playing way past cortisone. We are a team. I am the captain and he and the neurosurgeon are my direct reports. If he doesn’t want to play then I would find someone else.

I told him his role was tactical (screwing in the titanium plate which by his own admission was a five minute job). He decided to come along for the ride. I later discovered from my neurosurgeon, when I asked what was up with the orthopedic guy, that the specialist only looked at the first page of the MRI results. Had he looked further he would not have made such a suggestion.

The appointed day arrived for my stress test (to see if I was fit to undergo four and a half hours of surgery). I arrived at 7 in the morning on the appointed day.

With paperwork in hand I approached the registration desk only to be told that the medicine for my test was not ordered since my appointment was canceled the day before.

Pleasantly I stated, “I am here. I have had nothing to eat or drink since midnight, I got up early and I am not leaving the premises until my test and labs are complete.” At this point, after the visitor the MRI and the specialist, I was starting to have doubts.

Until next week, if there is a next week, I leave you with these final words.

(Taking a pulse)

Dr. Hugo Hackenbush (Groucho Marx): Either he’s dead or my watch has stopped.

Tim McDonald can be reached at timothy.mcdonald@agsfaculty.indwes.edu