Dear Editor - Four decades of backache
2009
Dear Editor
I love Talkback - I don’t feel so alone.
I have had back ache – not severe – on and off for four decades. Everyone who works on building sites (except surveyors) gets it. About 10 years ago I got a different ache – not sciatica – a new constant ache in a different league altogether. My local hospital took nearly a year to scan and then ordered a myelograph. A doctor in Harley Street told me this was irrelevant and I needed urgent surgery. I had another scan at a different hospital, saw a consultant surgeon who confirmed my need for urgent surgery and said he’d refer me to the National Orthopaedic Hospital. It sounded good. In the event, I eventually got a referral to one of London’s large international teaching hospitals. I was happy to have surgery provided a qualified surgeon did it and I was not used for practice by a part-trained surgeon. The hospital legal department told me that the surgeon would “choose a suitable student and supervise him”. My own wishes didn’t seem to enter into it!
Needless to say, I would prefer to (and do) live with constant severe pain and double incontinence than be practised on by an unknown student surgeon and possibly get an uncertain outcome with no redress due to the legal niceties of the NHS consent form.
So now I know why lots of people don’t have the surgery, they, like me, prefer not to gamble with their backs to benefit some anonymous trainee surgeon’s learning curve.
What does this say for our NHS?
Mr P S – London
BackCare’s response
Mr S was obviously right in wanting to find a competent spinal surgeon. These are usually located in large teaching hospitals where a team of orthopaedic and neurosurgeons co-exist and will ideally work together to provide a comprehensive spinal care service, so Mr S was sent to the right place. The question of trainee surgeons is more difficult; trainee surgeons are qualified doctors who wish to specialise in surgery. At present surgical trainees wishing to practise spinal surgery will go away to a specialist centre in spinal surgery to specialise at the end of their training to acquire the necessary skills.
We all want to feel confident about the ability of the person who is going to carry out a highly complex and potentially high risk procedure but doctors also have to learn. They do this by working as part of a team under the supervision of the consultant. However, is it enough that a surgical trainee has trained for many years and will be at the end of their extensive surgical training before they come near you and be supervised by the consultant? It was not for Mr S but perhaps the answer is to meet the team and to feel confident in them as a group rather than just in the consultant.