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August 10, 2012
A Tale of Two Surgeries (Almost) in China
by Jeff Lindsay

When I moved to China last year with my wife, I had a huge list of things that I wanted to see and experience. I had a much shorter list of things to avoid, with one thing in particular at the top: surgery. I had heard some frightening things about healthcare in China -- though perhaps not as frightening as what the Chinese hear about the American system. Many advised me to avoid hospitalization and surgery at all costs.

That healthy goal became a bit impractical after an unpleasant fall while foolishly running across a wet Shanghai street recently and hitting a slick, glossy zebra stripe. The sprawling, body-slamming collision not just with the ground but with a projecting curb did more than just impart some painful bruises.

I later discovered a surprise hernia that would require laparoscopic surgery. After exploring many options, I found a highly skilled Chinese surgeon that a U.S. physician had recommended, and he helped me become comfortable with the options and the system here. I found that I could have him do the surgery in the "VIP Clinic" of a public hospital for about 1/5 the cost of one of the private hospitals that cater to foreigners.

The experience I had at a Shanghai hospital far exceeded my expectations, with care that seemed better than what I would have expected in the U.S. I had a private room and a group of fun, responsive, and kind nurses who treated me like a celebrity. I guess they don't get many Americans there. I also had good contact and help from my surgeon.

I was on my feet right away and got excellent follow-up care with a full recovery and no pain. Fabulous. I can't imagine how my care could have been any better.

Shortly after that, I had an MRI done at the same hospital to examine a knee that I had injured earlier. Again, I was delighted with the experience. Getting the MRI was quick, easy, and much cheaper than in the U.S., and I was able to see a knee specialist right away who quickly pointed out the problem: a torn meniscus. Knee surgery was needed to repair it. Let's schedule it for next week. Simple minimally invasive surgery. No problem.

After the positive experience I had with the hernia repair, I was ready for round two at that outstanding hospital. I scheduled the surgery and made arrangements with my employer to miss a few days for the procedure. I would be in the hospital four days, then on crutches for a few weeks. And my knee trouble would be gone. Easy. And inexpensive enough that my limited insurance would cover most of it.

As surgery day neared, though, I began to feel like I was missing something. I didn't really know what procedure was going to be used and what the odds of success were. There had been no discussion of these important details. I called and wanted to speak with the surgeon, but was told I could get all my answers when I checked in to the hospital.

When I got there, I was soon greeted by a team of assistants who discussed the procedure. They would remove part or perhaps all of my meniscus, the important shock absorbing pad in the knee joint. But the surgeon has only spoken of "repair" and I assumed that mean suturing the torn section together again. Why had the removal not been discussed with me?

Now several negative aspects of this second brush with surgery came to my mind -- the brusque manner of the surgeon, his visual difficulty in reading the MRI chart, his apparent forgetting of who I was when I saw him on my second visit following initial consultation the previous week. The emotional brain had come up with an answer before the logical brain did and was already telling me to walk away, while I still could.

Part of what helped me make the decision to walk were some of the secondary issues after check-in. Instead of the lovely private room I had in my first surgery with my own air conditioning remote control unit, I would be put in a much less attractive, older room shared with a grumpy looking patient and his wife, with several other disappointments compared to my first experience. They contributed to the willingness to flee, as did the unavailability of the surgeon himself to discuss my case.

After punting on the planned surgery, I made a couple of phone calls to get more information and second opinions from other doctors. I learned from a physical therapist that in many parts of the healthcare system here, there is a tendency to turn to surgery as a first option instead of as a last resort.

Just two days before, we had visited a Chinese friend of ours, a vendor struggling to make a living in a little market near our home, in a local hospital. She had just delivered a baby and was sharing a tiny room with three other new mothers. She had been given a C-section. She wasn't sure that it was necessary. Apparently C-sections are far more common here than in the United States, and there may be a general problem with unnecessary surgery of other kinds.

There are remarkably skilled surgeons here and some outstanding hospitals, but it's important to make sure that the surgery is really needed.

I took my MRI chart and went to get second opinions, first visiting a surgeon at another hospital and then a physical therapist. Both of them explained to me that my knee trouble was still minor enough that surgery would be ill-advised right now. Better to rely on exercises and other steps to strengthen and protect the knee rather than jump to surgery. This made sense and I've began a program with the physical therapist that appears to be restoring my range of motion.

Maybe I'll need surgery later, but I'm glad to explore other options first. I feel that I came within inches of surgery that may have left me in a worse condition and with high expenses, some risk, and high inconvenience. If it weren't for some confidence-shaking experiences after checking into the hospital, I could have had unnecessary surgery. I'm relieved and even elated that I avoided the knife the second time.

At the same hospital, I had two encounters with the world of surgery, one a glorious success that made me whole again and one a near miss where I'm grateful to have escaped intact rather than have an unnecessary procedure that might have damaged me. There were two similar events with trained, experienced men, but with different sets of facts.

The experiences have given me several Gospel analogies to think about. First is the issue of unnecessary surgery. The great maxim of the Hippocratic Oath, "First, do no harm," applies to what we do in religion. Doing no harm means avoiding unnecessary surgery and other forms of tissue damage, temporary or otherwise, in dealing with others. Those in church callings and all of us in our daily walk must recognize that in our ministry, there are opportunities to unintentionally harm others. If we aren't seeking to understand the needs and feelings of others and treating them with love and caution, we may through neglect or through crude blunders cause harm to souls around us.

Bishops and stake presidents, for example, interacting regularly and personally with so many diverse people, like physicians have numerous opportunities to heal or, if careless, to injure, even when attempting to do divine surgery to help other souls. We mortals can't get it right all the time and will make mistakes -- may we Latter-day Saints humbly bear with the occasional or even frequent mistakes of those trying to help.

I know from my own experience as a bishop years ago how easy it is to misunderstand a person and their needs, and, when overzealous or careless, to cause pain and injury that was not intended. Other times, the pain of some Church actions such as a disciplinary council can be an essential step toward our recovery, like the wounds I received for my successful hernia repair. But whatever the action, may Church leaders always seek to ensure that an action that could cause pain truly is necessary, and that the commitment to do no harm or, rather, to do good the Lord's way, is in our heart and mind.

Another lesson from my experience is the need to change our plans sometimes and punt, or, in this case, to walk. Not to walk away from the Gospel or from God, but to walk away from things that may harm us, even when our logical brain tells us they are needed.

Sometimes there are settings in our lives that are too difficult or too risky for us, and we need to have the confidence to say no. This can even include, rarely but still certainly, turning down a calling. I did that once. It was one of the most difficult decisions I ever made, but one that was done with faith, prayer, fasting, and seeking the Lord's guidance in a very difficult and painful setting, and I think it was what I had to do.

Of course, in other cases, the decision to refuse a calling may be easier to make. The first calling I ever issued was as a new counselor in a bishopric. I wanted the calling to be a spiritual experience for the less-active woman I was extending it to, and prepared prayerfully. When she came in and I issued the calling, tears filled her eyes.

"Wow, I thought, maybe this is a touching spiritual experience for her." Then she sobbed and blurted, "I need to leave this Church." Her life was in turmoil, she felt the Church wasn't for her, and she wanted help to get her name off the records.

Well, I think the bishop's decision to extend that call to the woman may have been inspired and may have helped her move forward with whatever needed to happen in her life at the time, but it certainly would have been wrong for her to accept the calling. In that case, clearly, whatever inspiration there was to extend a calling did not translate into a need to accept the calling.

As I recall, the bishop was able to work with her right away in what I believe was a sensitive, compassionate manner, and I think her name was soon removed, as much as we wish she would have stayed. I hope she has since come back.

Further, just as one great hospital had surgeons and staff with different levels of expertise in dealing with patients, so should we members understand that the "hospital" of the Church will have great variability in the skills and wisdom of those who are called to lead us or minister to us. Some will make mistakes. Being mentally and spiritually prepared for human imperfection is an important part of our own quest for wellness.

Finally, we should understand how failure to meet the needs and clearly respond to the questions of "patients" in the Church -- namely, all of our members, and especially new members still unfamiliar with all the details of being a Latter-day Saint -- can lead to concerns and anxieties that may move them to walk out of our midst. Unlike the second surgeon who wasn't there to answer my questions, may we be there to answer questions that others have, or at least point them in the right direction.

And whatever we do, may we provide an environment in the Church in and all our dealings with others where it is clear that their well-being is our primary goal, and that, in spite of natural human limitations in all of us, our desires are to not just do no harm, but to do good, the way the Lord would have us do it.

When our "patients" (fellow patients, actually) sense that charity, the pure love of Christ, is the driving force in our actions, they will be more able to stay around for, endure and recover from the pains occasionally caused either by our skilled surgery or our clumsiness, and sometimes both.

Now I recognize some might read this story, consider my analogy of the Church as a hospital, and say, "See, there are times when it's best to just walk away from the Church." I disagree with drawing that conclusion from my analogy. Actually, the best outcome would have been staying in that hospital but receiving appropriate treatment. It was a place that had healed me with precise and almost miraculous surgery, and as a result of the confidence-building experience I was perhaps too quick to blindly trust an errant diagnosis from another authority figure without doing more of my homework and asking more questions initially.

For my knee problem, the hospital and its clinics had outstanding resources and experts with the right skills to have given me the treatment I needed, but one person appears to have stood in the way. Had I known more earlier, had I done more homework, I could have recognized a potential mistake in the second surgeon's recommendation and asked for alternative treatment from the right experts and done it more easily and at lower cost than the route I ended up pursuing.

In the end, though, I walked away -- not from health care, not from organized medicine, not from the institution of the hospital per se, but from inappropriate treatment by one person who drew overly hasty conclusions. I'm still a fan of the hospital and recommend it to others as an outstanding choice for health care.

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