I recently posted a video on my Facebook page showing a guy who ran a 10km marathon after undergoing an amputation above the knee on one side dancing away and celebrating his achievement. This was seen by many and liked extensively. I was trying to make a point that a positive mental attitude would be beneficial to everyone!
However, when I try to highlight the mental state to a routine patient of mine, I get weird feedbacks. Let me share a recent story of Mrs. Asha Srivastava. Mrs. Asha Srivastava, a 65-year-old lady was sitting in front of me with her husband and her son. I had operated her 8 weeks ago for both knee replacement surgeries. She was from Kanpur and wanted to meet me before she booked her tickets to go back to Kanpur. She wanted me to make sure that all was well with her operated knees. I checked her knees and everything was perfect. However, I noted that both her surgical scars looked dirty and filled with scabs. I pointed that to her. She told me that though she was having a bath every day she was careful not to apply soap or water to the operated areas she feared it would damage her implant inside the knee!
Mrs. Srivastava showed signs of extreme anxiety throughout her stay in the hospital. She asked me before the surgery, for how long does one have to get admitted for both knee replacement surgeries? When I told her that 5 days stay in the hospital would be required, she told me "I will stay for 15 days as I don't want to take any chances". Like most patients, she was ready to be discharged on the 5th day. We were not going to do anything specific for her from that day onwards. She was taught exercises and had to do them at home plus take medicines as prescribed. She was worried that she would not be able to do exercises on her own without any physiotherapist supervising her. I told her that we could arrange someone to visit her home if she insisted. She told me "but a hospital is better than home"! Though we joked about the fact that "normal" patients are keen to go home as early as possible, she disagreed. She got bored after 10 days of stay and then finally went home. She used to ring us up for vague complaints and anxiety related issues like palpitations and panic attacks. Not washing her knees was the last straw. I told her highly educated son that he needs to address this anxiety issue by seeking professional help!
He threw a fit." Doctor, any patient would be anxious to undergo surgery and you are overreacting"! When told him that I have been operating patients for 26years and this was the first time I had seen such a level of anxiety, he retorted “See, for you surgery is routine, and you must have done many, but for my mother, it is the first surgery"!
It reminded me of a bad review a patient left on my website a few months ago. Two young daughters had brought their mother who was in severe depression because of her bad knees and a bad back. She needed not one but three surgeries. I was explaining to them that we had to operate her back before we could do her knee replacement surgery. They had come with the expectation that I would post their mother for a knee replacement. This70-year-old lady could barely walk and had not gone outside her home for 198 months! She showed all signs of depression. When I told them to see a psychiatrist before the surgery would be planned, both of them looked offended. When I explained to them that mental factors do affect the surgical outcome they were not impressed. They left and wrote a nasty review stating that I had misdiagnosed their mother!
A few years ago one of our ambulance drivers brought his elderly father from a tiny village in Uttar Pradesh. This old man was scheduled for a knee replacement surgery. He did not ask many questions and was extremely happy that his son could get him treated for free at a big hospital in the city of Mumbai. He did well after surgery and would obey every command of the entire treating team. He was asked to see me 15 days after his surgery. Usually, the patients walk with the help of a walker or a stick at this juncture. I was amazed to see him walk in my room without any walking aid! When I congratulated him, our ambulance driver told me that this old man had traveled from Vasai (a suburb of Mumbai) in a local train, climbed the railway bridge at Vasai and Bandra I was aghast! Then this ambulance driver told me something I will not forget. He said “Doctor Sahib, he did all this because there was no one around to “poison” his mind about what would happen after the surgery, how much would it hurt etc.” and that’s why he did so well! I see patients who come with preconceived ideas that the surgery would hurt badly, they would never be able to walk again, and they would be bedridden for weeks or months. All these patients quote their relatives who have given them this “free” (mis) information. None of these “relatives” are doctors and most of them are uneducated.
In short, a positive mental attitude helps one recover from any surgery or illness easily. We should never portray a negative image of the surgery or the outcome if we are even casually talking to our friends or relatives. It has a long-lasting impact on their psyche.