What about choosing to have the standard procedure that’s been done for years, versus doing something that’s experimental? How do I evaluate that?
Always evaluate that in the context of the outcome that you want. If it’s most important to you that the operation has predictable results, and you’re satisfied with what’s known about the results of the established procedure, then by all means stick with it. But there may be limitations in the standard approach and a newer approach may be designed to address those limitations. You should expect an explanation of why the newer procedure is likely to provide you with additional benefits. And you should have information on what the safety of that newer approach entails.

You talk about quality of life. Are there cases where, even if the surgeon says to have surgery, I can look at my life and say, “I don’t need to do this?”
Sure. Let’s say you’re someone whose major enjoyments in life come from a rather sedentary existence. You enjoy reading, puttering around the garden. And you do not particularly enjoy activities like tennis or running. You may have a knee condition and when you do engage in vigorous activities, you have pain, and that pain would best be relieved by surgery, a ligament repair in your knee. If in your lifestyle, that pain is infrequent and it keeps you from the activities that are unimportant to you, then by no means should you even consider having an operation. Conversely, if you play singles tennis three times a week and the pain is keeping you from doing what is a very important part of your life, by all means do it. The question is: how important is the pain in your knee in the context of what’s important to you?

What if it’s not me who’s considering surgery, but a close family member or friend, is there a role for me, or should I stay out of the way?
I think you can be an enormous help. First and foremost you can help them focus on the fundamental questions. You can be a sounding board for their concerns. If it’s someone to whom you’re very close, I think it can be helpful to you to join them at the time of the surgical consultation so that they have essentially a second set of ears, or second antenna, to recall the enormous amount of information that’s usually being exchanged in such an encounter.

I hear a lot of stories about surgeries done in the past from older people. Is surgery a lot different these days?
It’s a completely transformed world compared to 20 or 30 years ago. It is a much safer world. Many of the operations we did then have become obsolete. And the things we do now weren’t even considered then.

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