Last Updated on Monday, 05 December 2016 16:45
Published on Monday, 05 December 2016 16:38


Neurosurgery is an intricate field of medicine demanding not only exemplary surgical skills but also pre and intra op-decision making, all of which can have great impact on the patient's life.

Complications are an unfortunate part of surgery making the consequences of treatment worse than the original disease, bringing great suffering to the patient and his family, and tarnish the reputation of the surgeon and the specialty at large. Complications may arise due to an error of execution, may be related to the technology or tools employed, or simply to an insurmountable disease.

It is often said, "It is better to stay out of complication than get out of complication", a reflection of an old adage," Prevention is better than cure". The coin of complications has 2 sides, anticipation or prevention, and management.

Neurosurgery is a vast specialty with myriad subspecialties and rapidly evolving technology. Though fundamentals of anatomy, physiology, pathology and surgery remain the same, the mode of treatment is ever changing and progressively minimalistic. Modern technology ushers new adventurers and the inevitable 'learning curve' with its accompanying problems.

When dealing with the issue of 'Complication', on one hand there is scientific learning. On the other hand there are ethical considerations and issues, philosophical aspects, moral obligations or probity, and legal implications.

All this makes the subject of 'Complications' very encompassing. Whilst most medical conferences deal with rather staid and conventional discussion of diseases, both common and uncommon, their superb management and results, with a slide on complications rushed in towards the end, very few have shown the fortitude to only discuss pitfalls of management and a confession of errors and mistakes. We need to shift from the 'How I do it' rhetoric to 'How I would not do it', or 'How I wish I had done it differently'.

Let this be an open forum of unabashed declaration of our failures and what we learnt and want to share with others on a level ground. No one is allowed to talk about successes, except when having encountered the unexpected disaster, how one was able or unable to surmount it.

Such deliberations will be far more humbling and enriching than those indulging in boastful one-upmanship. Whilst we may savoursuccess, we learn only from failures. Failure is a defeat only if you don't learn from it. That is the carry-home message!