What if I’m concerned the doctor will think I don’t trust him if I go get a second opinion?
I think you should let go of your anxiety about that. I’ve heard the comment made that surgery is a calculated risk. The surgeons do the calculating, and the patients take the risk. This is your life and this is your decision to make. And if there’s information that you feel can help you, you should feel free to access it.

What happens if I hear my surgeon’s very good, but when I try to talk to him, he’s rushing me and is on to the next patient before I’ve finished my sheet of questions? Should I go elsewhere?
Hopefully, even before you ask, he will have volunteered additional resources in his office or institution to help answer your questions. If that’s not available, I think it is right to feel uncomfortable, and you ought to seek more information elsewhere.

It’s OK then to expect that your surgeon may not be the source of all the information you need?
In fact, the surgeon should not be the only source of information because there are many aspects of the process of having an operation that I think are better communicated by nurses, physicians assistants, anesthesiologists, and others that will be involved in your care.

You mentioned the surgeon does the calculating and I take the risk. What about the risk, especially with anesthesia?
There’s an enormous spectrum of risk that’s associated with surgery. For patients who are otherwise healthy, the risks of anesthesia are extremely low. And they should be weighed against the benefit that you anticipate getting from the operation. If it’s an operation that’s designed to make your life longer, with convincing statistical evidence that the operation will do that, the risk of anesthesia is generally trivial in comparison. And with regard to issues of quality of life, we take chances all the time to improve our quality of life. We travel in airplanes, cars, boats…we walk around on streets crowded with traffic…we eat in restaurants…all have risk and, obviously, a quality of life benefit. I think anesthesia ought to be considered in the same context.

What about pain? I’m concerned that being cut into is going to cause a lot of pain, especially after the operation.
Post-operative pain now is generally very well controlled with medication, and with some relaxation therapies. Some people would argue that hypnosis can be helpful here as well. But the mainstay of post-operative pain management is certainly the use of medication. It’s most important that you be given adequate doses. The medications themselves are well-established and quite safe.

You mentioned relaxation and hypnosis. Is it realistic to expect that some kinds of alternative or complementary medicine could be part of the surgical experience?
It’s very variable. There are some patients who are very receptive to these techniques, which are most valuable in my opinion for the subjective benefit they provide. They simply make you feel better. That’s just not true of everybody. If it works for you, by all means do it, provided that what’s being proposed is safe and compatible with the surgery or the medicines that you’re taking.

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