Neonatal cardiac surgery

is under the spotlight here. There have been four deaths attributed to the lack of availability of such surgery due to problems arising out of the Covid19 travel restrictions.

Why? This state sends tiny newborns who need such surgery to a neighbouring state. There are no facilities here for them. There are said to be "too few" cases here. This is not just about the cost but about other associated things - such as experience.

When the story of the four deaths came up yesterday someone I was working with asked, "Why don't they just fly a surgeon in?" 

Good question I guess from someone who knows nothing about the world of surgery. I don't know much either but I do know enough to know that this is not about "a surgeon". There are teams of people involved in surgery. When the surgery is complex and perhaps requires many hours in theatre there is an incredible amount of planning which goes into it. People need to know one another. They need to know what is expected of them and how they are going to work together. 

I have written more than one communication board for surgeons and their teams working under the even greater difficulties of not speaking the same language. I have been snapped at for not understanding medical terms and how to get them across. The people involved are under stress, trying to save lives.  Invariably I have later been apologised to by those involved. I have tried to understand the enormous responsibility involved. I am aware that a mistake on my part, if not picked up by the team, could be fatal but I am still working one step removed from them.  I have the easy job.

I went to school with someone who went on to be a leading neonatal cardiac surgeon. He is older than I am and has retired from surgery as such but still advises. I know of his work. He developed a different technique to repair a congenital cardiac problem known as "atrioventricular septal defect". I don't understand the surgery in the least but I do understand that his work using something called a "modified single patch technique" (as opposed to the older "single or double patch technique") has meant less time in theatre and better surgical outcomes. It is not the sort of technique that comes about overnight. It required years of study and planning and working with teams of people in order to save tiny lives.

I thought of all this again yesterday as people around me were discussing the pros and cons of having a neonatal cardiac surgery unit here. Mostly I kept my mouth shut and my thoughts to myself but I mentioned the team work involved and the work of this man, a man I admire. It was at that point that someone else looked at me and said,

   "I had no idea that there was so much to all this surgery business."

I doubt any of us have any idea at all. Only those involved can know. Those holding the purse strings need to listen to the surgeons and their teams - not the accountants or the politicians.