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ASK AMY

Surgeon’s risky behavior must be addressed

Q. I’m in my 60s and undergoing cancer treatment, therefore immunocompromised.

At both of my appointments with my surgeon, she has worn a loose fitting, thin, cloth mask. She has to get very close to me — face to face — to examine me. This has made me extremely uncomfortable, and frankly angry.

She has unnecessarily caused me additional stress during the most stressful period of my life. I didn’t say anything to her either time, because it felt too awkward.

In about a month she will have my life in her hands, and I don’t want her having any potential negative feelings toward me when I go under the knife. I’ve written an anonymous letter about this, which I haven’t sent. I want to report her primarily so she will use adequate PPE, but I don’t want repercussions.

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How should I handle this?

CAUTIOUS IN COLORADO

A. Your question reveals that the trust you should have may be missing with this surgeon. I shared your question with a friend who is a cancer surgeon with 30 years of experience at a major cancer center. He and I share concern about you, and his response follows:

”Patient safety is paramount, not just during surgery, but also before and after. Almost everyone is nervous before surgery, but you should not also carry the anxiety of mistrust with you into the operating room. You should be cautious, because no matter how many operations your surgeon has done, this is your one.

”Since COVID, I always wear a surgical mask and will frequently add a face shield when seeing patients. Your surgeon should create an environment where you are able to express your concerns and ask questions. Ideally, you should raise your concern directly to her. How she responds will be very revealing.

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“If she apologizes and thanks you for bringing this to her attention, that’s a good sign. If she is defensive, you should seek another surgeon.

”You and your loved ones are your best advocates, but if your hospital has a patients’ advocate’s office, report your concern to them. They may not be surprised by your report and, if needed, can help you to change surgeons. They may help with either having a family member join for a critical in-person conversation with your surgeon, or if that’s not possible, listen to the consultation over the phone. Many patients are stressed and will not remember what their doctor says, so that extra pair of ears helps.

”There are many fine cancer surgeons out there. For critical and important insights, read reviews of them. The Center for Medicare and Medicaid Services (CMS.gov) is working to make this information more transparent with ‘star ratings’ — and many hospitals advertise these scores.

”Surgeons are professionals with extensive training and a team to help them give you the best possible care. At the end of the day the surgeon should be there for YOU, not the other way around.”

Never forget that!


Q. A recent letter [Joyful “Libby” User in Rochester, NY] included the advice to listen to audio books while on a walk. You endorsed this idea. Please don’t! Please leave your ears open!

As a longtime user of bike paths for biking, I can’t tell you how many walkers will step in front of me even after I call out to them. The ones with earbuds or headphones often do not hear my warning that I am about to pass them.

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This is even more important in an urban setting, where walkers have been known to walk into traffic while listening, instead of paying attention to their surroundings. On group runs and rides, we are always advised not to wear listening devices.

PLAYING IT SAFE

A. You are absolutely right! A study I looked at found that injuries among pedestrians wearing headphones tripled between 2004 and 2011, with most accidents occurring in urban areas.

These injuries can be catastrophic. (I live in a rural area and don’t use earphones; I just stick my phone in my pocket and play audio, transistor-radio-style. This carries risks, too.)


Q. Your response to “Deathly Afraid” was kind and supportive, but this new mom reported that she thinks about death every day. You should have suggested that she see her physician immediately. She might have serious postpartum depression.

CONCERNED

A. Thank you for alerting me to this omission. I agree. PPD can affect mothers even up to a year after giving birth.

Amy Dickinson can be reached at askamy@amydickinson.com.