Goh (not real name, H438) was a 36-year-old male. In June 2010 he had diarrhea and his blood pressure was low. He was admitted into a private hospital in his home town. An USG was done and he was told that his liver was not good. After three days he was discharged from the hospital. Health returned to normal. Two weeks later his abdomen became hard. He went back to the hospital again and a CT scan done indicated hepatoma – or liver cancer.
Goh came to a private hospital in Penang. He was asked to undergo surgery, to remove half of his liver. An operation was done but was later aborted. This open-close surgery cost him RM 10,000.
Not knowing what else to do, Goh and his family came to seek our advice on 24 October 2010. His CT scan report dated 15 October 2010 stated: “Both lobes of liver are enlarged and studded with multiple ill-defined heterogeneously enhancing lesions. The largest lesion located in segment 4b measures 15 x 20 x 15.6 cm. Impression: Multicentric hepatoma with minimal ascites and dilated left intrahepatic duct.”
Blood test results elevated liver enzymes. SGOT = 203, SGPT = 56, Alkaline phosphatase = 736 and Alpha-fetoprotein = 213.73.
Goh presented with pains in the shoulder area. These pains only appeared after the surgery. Before that there was no pain. He was not able to sleep. His eyes were blood shot. His abdomen was extended with both legs swollen. His breathing was difficult.
Unfortunately, Goh died not long after seeing us.
Comments: I don’t think it is necessary for me to give any comment on this case. The fact speaks for itself. Goh died barely two months after this aborted surgery. What do you think – would he have died earlier or later if he did not undergo that surgery?
This is one book which I believe everyone should read – Confession of a Medical Heretic by Robert Mendelsohn. The author is not an ordinary man. In the US, he wrote a syndicated column called “The People’s Doctor”. He was an associate professor at the University of Illinois Medical School and a director of Chicago’s Michael Reese Hospital. He was also chairman of the Medical Licensure Committee for the state of Illinois. In Chapter 3 of his book, Dr. Medelsohn wrote:
- I believe that my generation of doctors will be remembered for … the millions of mutilations which are ceremoniously carried out every year in operating rooms.
- Conservative estimates … say that about 2.4 million operations performed every year are unnecessary.
- My feeling is that somewhere around ninety percent of surgery is a waste of time, energy, money and life.
- Modern cancer surgery someday will be regarded with the same kind of horror that we now regard the use of leeches in George Washington’s time.
- Greed plays a role in causing unnecessary surgery … there’s no doubt that if you eliminated all unnecessary surgery, most surgeons would go out of business.
- Ignorance plays a part in a lot of unnecessary surgery.
- Greed and ignorance aren’t the most important reasons why there is so much unnecessary surgery. It’s basically a problem of belief: doctors believe in surgery. There is a certain fascination in “going under the knife” … that (surgeon) can overcome anything because he can operate you … “You don’t have to take care of yourself, we can fix you if you go wrong.”
- To protect yourself … your first step is to educate yourself. Get a second opinion. If you decide that surgery isn’t the answer, do whatever you have to do to detach yourself from the situation. In any situation short of an emergency, you’ve got plenty of time not only to decide whether or not you need the surgery but also who should perform the operation.
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