I won't fail, I won't flop,
Stall or stutter yes I won't stop,
It takes hard work, to be like this,
(You should know) cause I'm a perfectionist
Run DMC (Perfection)
Negative can be a great thing in veterinary medicine. Negative Parvo test – great! Negative chest met radiograph screening – whoopee! Negative auto-agglutination - thank goodness! But negative explore? Now that’s something else entirely.
I can rationalize and say the negative explore is really a good thing. There's no bowel to resect, no tumor to be found, no horrible “-itis” to deal with, but really it turns into a slur against the surgeon pretty quickly. “Oh, that dog? He had a negative explore… he’s going home today.” Served with just a teaspoon of scorn, can you hear it?
I haven’t performed very many negative explores, but I still feel some pain for each of them. Could we have made a different decision? Should I have pushed the owners harder to wait on surgery or go for the repeat ultrasound exam? Did I allow someone else’s perception of the case to cloud my own interpretation? Did we ask all of the right questions? In truth there is nothing inherently wrong with a negative explore. The procedure is called an “exploratory” celiotomy for a reason. More than one mentor told me that if I never perform a negative explore, it means I’m not doing enough surgery.
I used to play basketball. I know, glory days and all that. Bear with me. I distinctly remember my coach berating me after a game when I was high scorer and shot 100%. Yes, every shot I took went in the basket. Believe me, I was shocked too. But I was even more stunned that my coach was so irate with me. In short he said if you aren’t missing any shots, you aren’t shooting the ball enough. I’ve tried to keep that in mind when my guts are slowly sinking in surgery because I cannot find anything wrong inside the pet.
Oddly enough, we take loads of radiographs that don’t show anything wrong, but no one calls them “negative.” Perhaps we can come up with a new term. How about an immaculate exploratory? According to my handy e-dictionary, immaculate is “very clean, unspoiled” or even “blameless.” I like that. A blameless exploratory. Sign me up!