The surgical celebration

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It was a routine Wednesday and I was on my regular evening rounds to check on all my patients before I left for the day. I knocked and entered the room of a patient I had operated upon the same morning. I saw him sitting in a chair, his sizable single room suddenly appearing crammed because of heavier-than-usual family traffic. His two-year-old baby, who they must have sneaked in somehow - probably in a spacious IKEA bag - was plonked on his lap. His wife, a few sisters, parents, grandparents, and a bunch of cousins encircled him. Only a few hours after the spine surgery, he was in great spirits, rambunctiously guffawing away with his gang. My team and I were greeted with happy and smiling faces. "Come, come, doctor, you've come at the right time! Everyone, this is Rawnak's doctor," his wife said, introducing me to rest of the extended family, breezing through four generations in a jiffy. I was still a little befuddled as to what was going on, until I saw a tall mango cake on the table with ‘Happy Birthday' artistically engraved on it.

Clapping hands, we sang the quintessential birthday song while the little girl on his lap wisely blew out the candle before the smoke detectors went off. They offered us a big piece that we readily gobbled. Rawnak fed his daughter, his wife fed him, and then she went around the room, giving everyone a tiny bite in traditional celebratory fashion. "Why would you choose your birthday to get an operation?" I asked, intrigued. Rawnak laughed out loud, his hilarity contained only by the stretch on his stitches. "I was so bothered by this leg pain because of my slip disc, and like you know, I tried everything, but nothing worked. I just wanted a new lease of life and what better a day to do this than on my birthday!" he reasoned. "I didn't want to spend my birthday in pain," he said, devouring his cake. It was a strange perspective, but an interesting one.

"What if something were to go wrong?" I mused, raising my brow, but before he could answer, I followed it up with something more positive. After some more conversation, the team and I exited. "Good luck, buddy, have a great year," I said waving goodbye to everyone in the room. As I walked out, I realised I had completely forgotten to check on him and his pain and almost stepped back into the room to ask him, when my colleague stopped me, "Let him enjoy his day, he's obviously okay if he's smiling so much!" was the justification.

As we walked down the corridor towards the next patient, I turned around and asked my team why anyone would get operated on their birthday, still trying to get under the skin of this viewpoint. "It's the same reason why you make it a point to operate on yours," my assistant retorted, reminding me of my quirk. Earlier in my career, when I didn't operate every day, I would make it a point to schedule a surgery on my birthday, citing my unavailability a few days before or after, stating any reason I could. "That's completely different," I argued. "I want to start the year doing something I love. Nothing gives me more joy than operating!" I told them. But I understood what they were trying to say.

"By the way," my assistant added, "Did you read the article published in the British Medical Journal titled, ‘Patient mortality after surgery on the surgeon's birthday'?" "You've got to be joking," was my reaction, and he pulled it up on the phone for me. I scanned the paper quickly. Apparently, patients who received surgery on the surgeon's birthday experienced higher mortality compared with patients who underwent surgery on other days. These findings suggest that surgeons might be distracted by life events that are not directly related to work. "Oops," I thought, recollecting the outcomes of recent surgeries done on my birthday to confirm that I wasn't contributing to the statistic. "From next year onwards, we'll keep these birthday cases short and simple," I announced, unwilling to give up the tradition.

It has been my personal experience that patients put aside surgery for festivities. In the West, almost nobody has elective surgery in the last week of December. In India, hospitals see a drop in routine surgical admissions around Diwali - but injuries related to the festival make up for those. A few weeks ago, on the day of a planned admission, a patient called to cancel a surgery scheduled for the next day. I was a little annoyed, as I'd scrambled a schedule that I'd now need to rearrange. In a slightly irritated fashion, I asked, "Why?" "Sir, there is an emergency wedding in the family tomorrow, so we'll get admitted the day after that!" Amusement instantly replaced frustration. Their problems were clearly greater than mine.

I'm not a big celebrator, but I want to change that about me. I'm inspired after I attended my daughters' school orientations for their entry into the first and second grades. The principal emphatically spoke about celebrating the little things in your lives. She said, and I paraphrase, "Even if your child comes fifth in a race, celebrate; if a parent gets a raise or switches a job, celebrate; if a family member excels in a hobby or even participates in something different, celebrate. Don't only honour and laud the big events, but rejoice in small victories, even if they cannot be measured."

There is something miraculous about the mundane that we must celebrate. A simple surgery done well, a patient relieved of their affliction, a diagnosis cracked, a colleague's recruitment, a staff worker's promotion, the hospital's accreditation. If we are able to revel in small successes, we might be able to deal with failure more comprehensively. We might be able to treat the spectrum of emotions that traverse the highs and lows in a slightly more equanimous manner. We might be able to acknowledge the many ways in which we are human.

Rawnak got discharged the day after his surgery, completely pain free and thrilled with his decision to get operated on his birthday. New beginnings are beautiful; sometimes terrifying, but beautiful nonetheless. I am now also planning to conduct a study on patient outcomes when they have surgery on their special occasions: birthdays, festivals, promotions, anniversaries, etc. Do I have any volunteers?

The writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals.