Veterinary Superstition

Posted: Aug 23, 2013
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I don’t feel like a particularly superstitious person. Cracks in the sidewalk get stepped on, black cats walk around me all the time, and I don’t generally notice that any given Friday was the 13th day of a month until a couple of days later. I do have “surgery shoes”, but that is simply a hygiene issue. I have "favorite scrubs" for orthopedic surgery, but that is because they are the most comfortable material to wear under 25 pounds of lead shielding.

But…I will admit to not wanting to tempt fate while in surgery.

For instance, none of my team will utter those fateful words, “This surgery is going pretty smoothly” or, “Gosh, she’s doing better on the ventilator than I expected”, until AFTER extubation. All of us may be thinking similar thoughts, but no one voices it until the pet is safely breathing on their own in ICU. Why? Does verbalizing a sense of patient stability somehow encourage team members to relax or lose focus? Or do we really think in some tiny part of our monkey brain that by waving a green flag we are calling unwanted attention?

If a non-team member, say an extern or a staff member who isn’t really close to the case, wanders in and makes some “Gee, things look like they are going great in here” sort of comment, it is inevitably followed by “Yep, right up until the moment you said that…” response from someone on the surgical team. We are all over-educated, over-trained, over-stressed and often suffering from over-time meltdown. Maybe that makes the remnant of superstitious brain more likely to surface during anxious moments.

Veterinary surgeon Coby Richter performing surgery at DoveLewis.

I see superstition as a separate entity from Murphy’s Law. In other words, if we haven’t needed the sterile suction canister in surgery for two weeks and today the technician assistant had to re-wrap it for gas sterilization as it was about to expire, we are sure to get a traumatic hemo-abdomen in the hospital and really want that sterile canister for auto-transfusion. THAT is Murphy in action. No one taunted superstition. Murphy interferes whether we are paying attention to him or not. Superstition, on the other hand, is called into being when we think we know better.

I have a personal rule that I will not call clients following surgery until the patient has been safely extubated. Twice I have broken this policy and twice I have regretted it. My basic premise is that most catastrophic things associated with anesthesia happen at induction and extubation. Once the pet is safety extubated and breathing on his own, I am generally safe to call the owners and give them the rundown on surgery and the plan. Not everyone is on board with my self-imposed waiting period, however. Clients are often impatient to hear how things went, particularly the ones who call 4 times during an hour long surgery and are told “your pet is just coming out of surgery now” by a well-meaning CSR or technician. Those clients do not understand why I’m still waiting 45 minutes later for their sick dog to swallow (SWALLOW darn you!) so we can pull that tube and call them.

I’ve been told by more than one technician that I am superstitious about that phone call. Maybe so, but in my defense I think it is more about the negative reinforcement than superstition. Are you wondering about those two times I broke my rule? In both cases, the dogs were very sick with guarded prognoses. They came out of surgery and showed no interest in giving up the ET tube, even after an hour of flow-by oxygen and increasingly aggressive stimulation by everyone in ICU. At about an hour post-op, I caved and called the owners to give them an update. The first case arrested literally the minute I hung up the phone with the owners, necessitating an urgent call back to dash any hopes they had formed during our first chat. The second dog waited a while longer, but same end to the story. Did these patients arrest because I called their owners prior to extubation? No, of course not. At least, that’s what I tell myself.

When you believe in things that you don’t understand
Then you suffer
Superstition ain’t the way
Stevie Wonder (Superstition)